ADHD Medication During Pregnancy and Breastfeeding

The decision to stop or keep ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There aren't many studies regarding how exposure over time may affect a fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication need to consider the benefits of taking it against the possible risks to the baby. Physicians don't have the information needed to give clear guidelines, but they can provide information regarding the risks and benefits to help pregnant women make informed decisions.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers used a vast population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate classification of the cases and to reduce the chance of bias.

The research conducted by the researchers was not without limitations. In particular, they were not able to differentiate the effects of the medication from the underlying disorder. This limitation makes it difficult to determine whether the small associations observed in the exposed groups are due to medication use or comorbidities that cause confusion. The researchers also did not study the long-term effects for the offspring.

The study did reveal that infants whose mothers had taken adhd Medication guide medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy.

Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a baby born with an low Apgar score (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy.

The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefit for both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this issue and try to help them improve coping skills which can lessen the impact of her disorder in her daily functioning and her relationships.

Medication Interactions

Doctors are increasingly faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are often taken without clear and authoritative evidence. Instead, physicians must weigh their own knowledge and experience, as well as the experiences of other doctors and the research on the subject.

The issue of potential risks to infants is difficult to determine. The research on this issue is based on observations rather than controlled studies and a lot of the results are conflicting. The majority of studies focus on live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study presented in the journal club addresses these shortcomings, by examining both the data from deceased and live births.

Conclusion: While some studies have shown an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies show a neutral, or even somewhat negative, impact. In the end, a careful risk/benefit assessment must be conducted in every situation.

It can be challenging, if not impossible for women suffering from ADHD to stop taking their medication. In fact, in an article recently published in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for these patients. In addition, a decrease in medication may affect the ability to perform job-related tasks and drive safely, which are important aspects of a normal life for many people suffering from ADHD.

She suggests women who are uncertain about whether to keep or stop taking medication because of their pregnancy, consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help the woman feel supported when she is struggling with her decision. It is important to note that certain medications are able to pass through the placenta so if the patient decides to discontinue her ADHD best medication for adhd and anxiety during pregnancy and breastfeeding, she should be aware that the effects of the drug can be passed on to the baby.

Birth Defects and Risk of

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the impact that these drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. With two massive data sets researchers were able to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, such as ventriculo-septal defect (VSD).

The authors of the study found no link between the use of early medications and congenital abnormalities like facial clefting, or club foot. The findings are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.

Women who were taking ADHD medication during the first trimester were more likely require a caesarean birth, have a low Apgar after delivery and had a baby that required help breathing when they were born. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who didn't have any other medical issues that could be a contributing factor to these findings.

The researchers hope that their research will help inform the clinical decisions of doctors who see pregnant women. The researchers recommend that, while discussing the risks and benefits are important, the choice regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and her requirements.

The authors caution that, although stopping the medication is a possibility to consider, it is not advised due to the high rate depression and other mental problems among women who are pregnant or have recently given birth. Additionally, research suggests that women who stop taking their medications will have a harder transitioning to life without them after the baby is born.

Nursing

It can be a stressful experience becoming a mother. Women with ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and adjusting to new household routines are often faced with a number of difficulties. Many women choose to continue taking their ADHD medication during pregnancy.

The risk to nursing infant is low because the majority of stimulant medication passes through breast milk in low amounts. However, the rate of exposure to medication by the newborn may differ based on dosage, how often it is taken and the time of the day it is administered. Additionally, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on a newborn's health is not completely understood.

Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the woman, who must weigh the benefits of continuing her medication against the risk to the foetus. As long as more information is available, GPs may inquire about pregnant patients if they have a 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 without risk while breastfeeding and during pregnancy. In the end, more and more patients opt to do this and, in consultation with their doctor they have found that the benefits of keeping their current medication outweigh any risks.

It is essential for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss the medication for autism and adhd they are taking with their physician as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce the coping mechanisms. This should be an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include discussion of a management plan for both mother and child, monitoring for signs of deterioration and the need for adjustments to the medication for inattentive adhd regimen.