10 Wrong Answers For Common ADHD Medication Pregnancy Questions: Do You Know The Right Answers?
10 Wrong Answers For Common ADHD Medication Pregnancy Questions: Do You Know The Right Answers?
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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There aren't many studies regarding how exposure over time may affect a fetus.
A study recently 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 needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must consider the benefits of taking it against the possible dangers for the foetus. Doctors don't have the information needed to make unequivocal recommendations however they can provide information about the risks and benefits to assist pregnant women in making informed decisions.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was correct and to reduce any 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 disorder that is underlying. This makes it difficult for researchers to determine if the small associations observed among the exposed groups were due to medication use or affected by co-morbidities. Additionally, the researchers did not look at the long-term effects of offspring on their parents.
The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this issue and try to help them develop coping strategies that can lessen the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether or not to discontinue treatment during pregnancy is one that more and more doctors have to face. These decisions are usually made without clear and authoritative evidence. Instead, physicians must take into account their own experience in conjunction with the experiences of other physicians and the research on the topic.
In particular, the issue of potential risks to the baby can be tricky. The research on this issue is based on observation rather than controlled studies, and a lot of the results are contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link and the majority of studies show a neutral or even slightly negative impact. Therefore an accurate risk-benefit analysis is required in every situation.
It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of isolation. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are essential aspects of everyday life for those suffering from ADHD.
She recommends women who are uncertain about whether or not to discontinue medication click here due to their pregnancy consider educating family members, friends and colleagues about the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. Educating them can also help the woman feel supported when she is struggling with her decision. Some medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her baby.
Risk of Birth Defects
As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Researchers used two huge data sets to study more than 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The researchers of the study found no connection between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The results are consistent with previous studies that have shown the presence of a small, but significant increase in the risk of heart malformations among women who started taking ADHD medications prior to the time of the birth of their child. The risk increased in the latter half of pregnancy when many women stopped taking their medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby who required help breathing at birth. However, the authors of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical conditions that could have contributed to these findings.
Researchers hope that their study will help doctors when they encounter pregnant women. The researchers recommend that while discussing risks and benefits are important, the decision about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her requirements.
The authors caution that, even though stopping the medication is an option to look into, it is not recommended due to the high prevalence of depression and other mental problems for women who are pregnant or have recently given birth. Additionally, the research suggests that women who choose to stop taking their medications are more likely to have difficulties adapting to life without them following the birth of their baby.
Nursing
It can be a challenge to become a mom. Women with ADHD who have to manage their symptoms while attending physician appointments as well as preparing 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 majority of stimulant medications are absorbed through breast milk in low amounts, therefore the risk for infant who is breastfeeding is low. However, the amount of exposure to medication by the newborn may differ based on dosage, frequency it is administered, and at what time the medication is administered. In addition, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn isn't yet fully understood.
Because of the lack of research, some doctors may recommend stopping stimulant drugs during the pregnancy of a woman. It is a difficult decision for the woman who must weigh the benefits of taking her medication as well as the potential risks to the fetus. As long as more information is available, doctors may ask pregnant patients whether they have a background of ADHD or if they plan to take medication during the perinatal stage.
Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and while breast-feeding. As a result, more and more patients opt to do this and, in consultation with their doctor they have discovered that the benefits of continuing their current medication far exceed any risk.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should be a multidisciplinary effort with the GPs, obstetricians, and psychiatrists. Pregnancy counselling should include the discussion of a treatment plan for both the mother and child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.