What NOT To Do In The ADHD Medication Pregnancy Industry
What NOT To Do In The ADHD Medication Pregnancy Industry
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There are few data on how long-term exposure may affect a foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians don't have the data to make unambiguous recommendations however they can provide information on the risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to minimize the possibility of bias.
However, the researchers' study was not without its flaws. Researchers were unable in the beginning to differentiate the effects caused by the medication from the disorder. This makes it difficult for researchers to determine if the small associations observed among the groups that were exposed to the use of medication, or if they were confounded by co-morbidities. In addition the researchers did not study the long-term effects of offspring on their parents.
The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk of admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, help them develop strategies to improve coping skills which can reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made without clear and authoritative evidence regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what research says on the topic as well as their own judgments for each individual patient.
Particularly, the issue of potential risks for the baby can be a challenge. Many of the studies on this subject are based on observational data instead of controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live-births, which could underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.
Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show that there is a neutral, or slight negative effect. In the end, a careful risk/benefit analysis must be done in each case.
For women suffering from ADHD, the decision to stop medication can be difficult, if not impossible. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. Furthermore, a loss of medication can affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.
She suggests that women who are unsure whether to take the medication or stop due to pregnancy should educate family members, coworkers and friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also help women feel supported in her decision. It is important to note that some medications are able to pass through the placenta, so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be transferred to the child.
Risk of Birth Defects
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so does concern about the potential effects of these drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers discovered that the first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD).
The researchers behind the study found no connection between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies that have shown an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. The risk was higher in the later part of pregnancy, as many women are forced to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery, have an insufficient Apgar after birth and have a baby who needed breathing assistance after birth. The researchers of the study were unable to eliminate bias due to selection because they limited the study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their research will aid in the clinical decisions of doctors who see pregnant women. The researchers recommend that, while discussing risks and benefits are important, the decision about whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and her needs.
The authors caution that, even though stopping the medication is an option to think about, it isn't advised due to the high rate depression and other mental disorders among women who are pregnant or recently gave birth. Additionally, research suggests 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 overwhelming becoming a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments and making preparations for the arrival of a child and getting used to new routines at home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. The rate of exposure to medication will vary based on the dosage, frequency of administration and the time of day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk check here and the impact of this on a newborn is not fully understood.
Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. It is a difficult decision for the mother, who must weigh the advantages of taking her medication as well as the risks to the foetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period.
Many studies have shown that women can continue to take their ADHD medication without risk during pregnancy and breast-feeding. As a result, an increasing number of patients are choosing to do so, and in consultation with their physician, they have found that the benefits of maintaining their current medication far outweigh any potential 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 their medication with their prescriber, and the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder, learn about available treatments and to reinforce existing strategies for coping. This should involve an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for indicators of deterioration, and, if necessary adjustments to the medication regimen.