7 Little Changes That'll Make A Huge Difference In Your ADHD Medication Pregnancy
7 Little Changes That'll Make A Huge Difference In Your ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There aren't enough data on how exposure to ADHD for a long time could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the benefits of taking them against the potential risks to the fetus. Doctors don't have the necessary data to make unequivocal recommendations but they can provide information regarding benefits and risks that can aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy did not have a greater risk of fetal malformations, or structural birth defects. Researchers conducted a large sample-based case control study to assess the frequency of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was accurate and to reduce any bias.
The study conducted by the researchers was not without its limitations. The most important issue was that they were unable to separate the effects of the medication from those of the disorder at hand. That limitation makes it difficult to know whether the small differences observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. The researchers did not examine long-term outcomes for the offspring.
The study revealed that infants whose mothers took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not take any medication during pregnancy, or had stopped taking their medication before or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases didn't seem to be influenced by the kind of medication used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the greater benefits to both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve coping skills that may minimize the effects of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject as well as their own judgments for each individual patient.
The issue of potential risks for infants can be particularly tricky. Many studies on this topic are based on observations rather than controlled research, and their findings are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
Conclusion A few studies have revealed an association between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies have shown a neutral, or even slightly negative, effect. In all cases an in-depth analysis of the potential risks and benefits must be performed.
It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. 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. The loss of medication can affect the ability to safely drive and complete work-related tasks, which are vital aspects of everyday life for people with ADHD.
She recommends women who are unsure about whether to continue or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the advantages of continuing the current treatment plan. It can also help a woman feel supported in her decision. Some medications can pass through the placenta. If the patient decides not to take her ADHD medication while breastfeeding, it is important to be aware that the medication could be passed on to her infant.
Risk of Birth Defects
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential effects of these drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two huge data sets to examine over 4.3 million pregnancy and determine if stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).
The authors of the study found no association between early medication use and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies that showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the birth of their child. This risk increased in the latter half of pregnancy, when many women begin to discontinue their medication.
Women who used ADHD medications during the first trimester of pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. The authors of the study were not able to eliminate selection bias because they limited the study to women with no other medical conditions that might have contributed to the findings.
The researchers hope their research will serve to inform the clinical decisions of physicians who treat pregnant women. The researchers recommend that while discussing benefits and risks are important, the decision on whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also caution that even though stopping the medication is an option, it is not an option to get more info consider due to the high prevalence of depression and other mental health issues among women who are pregnant or recently post-partum. Further, research shows that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
It can be a challenge to become a mother. Women with ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to a new routine. This is why many women elect to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medications are absorbed by breast milk in low amounts, so the risk to the infant who is breastfeeding is low. The rate of medication exposure can vary depending upon the dosage, frequency of administration and the time of the day. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The effect on the health of a newborn is not completely known.
Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the woman, who must weigh the advantages of continuing her medication against the risks to the embryo. In the meantime, until more information is available, doctors may ask pregnant patients whether they have an history of ADHD or if they plan to take medication during the perinatal phase.
Many studies have shown that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. As a result, many patients choose to do so and in consultation with their doctor they have found that the benefits of continuing their current medication far outweigh any risks.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of signs of deterioration, and, if needed modifications to the medication regimen.