How To Outsmart Your Boss On ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. There are few data on how long-term exposure may affect a pregnant fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders like hearing loss or impaired 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 versus the risks for the baby. Physicians don't have the data needed to provide clear recommendations but they can provide information on risks and benefits that aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications in early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large 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. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to minimize the chance of bias.
However, the study had its limitations. The researchers were unable in the beginning to distinguish the effects caused by the medication from the disorder. This limitation makes it difficult to know whether the small differences observed in the groups that were exposed are due to the use of medication or the confounding effect of comorbidities. The researchers did not look at long-term outcomes for the offspring.
The study revealed that infants whose mother took adhd without medication medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean delivery or having a child with a low Apgar score (less than 7). These increases appeared to be independent of the type of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both mother and child from continued treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with adhd medication online and treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is a question that doctors are having to face. The majority of these decisions are taken 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 and their own best adhd medication for adults judgment for each patient.
Particularly, the subject of potential risks to the baby can be a challenge. Many studies on this topic are based on observational evidence instead of controlled research and their findings are often contradictory. The majority of studies focus on live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these shortcomings by analyzing both information on deceased and live births.
Conclusion A few studies have found an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies show that there is a neutral, or slight negative effect. In every case an in-depth evaluation of the potential risks and benefits is required.
For many women with ADHD who suffer from cheapest adhd medication, the decision to stop medication can be difficult, if not impossible. In a recent article published 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. Furthermore, a loss of medication can interfere with the ability to perform job-related tasks and drive safely that are crucial aspects of a normal life for many people suffering from ADHD.
She suggests that women who are not sure whether to continue taking medication or discontinue it due to pregnancy should educate family members, colleagues, and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment. In addition, educating them can help the woman feel supported in her struggle with her decision. Certain medications can pass through the placenta. If a patient 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 of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these medications could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two massive data sets to study more than 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. While the overall risk remains low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increased risk of specific heart defects, like ventriculo-septal defects (VSD).
The researchers of the study found no connection between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies that showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to pregnancy. The risk increased in the latter part of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean birth or have an insufficient Apgar after delivery, and have a baby that needed breathing assistance at birth. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who did not have any other medical issues that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they encounter pregnant women. They suggest that although the discussion of risks and benefits is important however, the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also warn that while discontinuing the medications is an alternative, it is not an option that is recommended due to the high incidence of depression and other mental health problems for women who are expecting or post-partum. Research has also shown that women who stop taking their medication will have a tough transitioning to life without them once the baby is born.
Nursing
It can be a challenge to become a mother. Women with ADHD who have to deal with their symptoms while attending physician appointments as well as getting ready for the arrival of their child and adjusting to new household routines are often faced with a number of difficulties. Many women decide to continue taking their adhd medication and pregnancy medication during pregnancy.
The risk to nursing infant is low estrogen And adhd medication because the majority of stimulant medications is absorbed through breast milk at low levels. The amount of exposure to medications will vary based on the dosage, frequency of administration and time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't fully known.
Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication against the potential risks to the foetus. As long as more information is available, doctors can inquire about pregnant patients if they have an history of ADHD or if they intend to take medication in the perinatal stage.
Many studies have shown that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. In response, an increasing number of patients are opting to do so. They have discovered, in consultation with their doctors, that the benefits of continuing their current medication far outweigh any possible risks.
It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, as well as monitoring for signs of deterioration and the need for adjustments to the medication regimen.