The History Of ADHD Medication Pregnancy
The History Of ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications can affect the fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication should weigh the benefits of taking it versus the risks for the baby. Doctors don't have the data needed to provide clear recommendations however they can provide information about risks and benefits that aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was accurate and to eliminate any bias.
The research conducted by the researchers had some limitations. The most important issue was that they were not able to differentiate the effects of the medication from the underlying disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the groups that were exposed to the use of medications or if they were confounded by co-morbidities. Additionally, the researchers did not examine the long-term outcomes of offspring.
The study revealed that infants whose mother took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy, or had stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These risks did not seem to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies may be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies to improve their coping abilities which can reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the question of whether or not to stop treatment during pregnancy is one that doctors are having to have to face. The majority of these decisions are made in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what research says on the topic, along with their own judgments for each patient.
Particularly, the subject of potential risks for the infant can be difficult. The research on this issue is based on observation rather than controlled studies, and a lot of the results are in conflict. Furthermore, most studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by looking at data from both live and deceased births.
Conclusion Some studies have found an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. The majority of studies show an unintended, or slightly negative, effect. Therefore an accurate risk-benefit analysis must be conducted in every case.
For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. A loss of medication may also impact the ability to safely drive and to perform work-related tasks which are crucial aspects of everyday life for those with ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy educate family members, coworkers, and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment plan. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to remember that certain drugs can pass through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be transferred to the child.
Birth Defects and Risk of
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about what impact the drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Researchers used two huge data sets to study over 4.3 million pregnancy and determine if the use of stimulant medications caused birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The authors of the study found no connection between early medication use and other congenital anomalies, like facial clefting, or club foot. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter part of pregnancy when a large number of women stopped taking their medication.
Women who took ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who needed help breathing at birth. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have other medical issues that could have contributed to these findings.
Researchers website hope that their study will help doctors when they encounter pregnant women. They suggest that although a discussion of the benefits and risks is important but the decision to stop or maintain medication should be based on each woman's requirements and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is an option to think about, it isn't advised due to the high prevalence of depression and other mental problems among women who are pregnant or recently gave birth. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have a difficult time adapting to life without them after the birth of their baby.
Nursing
It can be a stressful experience to become a mom. Women with ADHD who have to manage their symptoms while attending doctor appointments as well as making preparations for the arrival of a baby and adapting to new routines in the home can experience severe challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The risk for nursing infant is low because the majority of stimulant medication is absorbed through breast milk at a low level. However, the amount of medication exposure to the newborn can vary depending on dosage, how often it is administered and at what time it is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't well understood.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the possible risks to the foetus. In the meantime, until more information is available, doctors can ask pregnant patients if they have any history of ADHD or if they intend to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. In response, a rising number of patients are choosing to do so. They have concluded, in consultation with their physicians, that the benefits of retaining their current medication far outweigh any potential risks.
Women who suffer from ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should include a multidisciplinary approach with the GP, obstetricians and psychiatry. The pregnancy counselling should consist of the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.