4 Dirty Little Secrets About The ADHD Medication Pregnancy Industry

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how exposure to ADHD for a long time could affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological disorders such as hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against the potential risks to the fetus. Doctors don't have the information needed to give clear guidelines but they can provide information on risks and benefits that assist pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a large population-based case control study to assess the frequency of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to make sure that the classification was accurate and to minimize any bias.

However, the researchers' study was not without its flaws. Researchers were unable in the beginning to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to the use of medications, or if they were affected by the presence of comorbidities. In addition the study did not study the long-term effects of offspring on their parents.

The study revealed that infants whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medication was used during pregnancy.

Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both the mother and child of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, if possible, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships.

Interactions with Medication

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

The issue of risk to the infant can be difficult to determine. Many studies on this subject are based on observational data rather than controlled research and their conclusions are often contradictory. Additionally, the majority of studies limit their analysis to live births, which could underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births.

Conclusion Some studies have found an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies have shown an unintended, or somewhat negative, impact. Therefore an accurate risk-benefit analysis must be conducted in every situation.

It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In fact, in an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping adhd medication adults ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for these patients. The loss of medication can also impact the ability to drive safely and perform work-related tasks, which are vital aspects of everyday life for those suffering from ADHD.

She recommends that 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 coworkers on the condition, its effects on daily functioning, and the advantages of continuing the current treatment plan. In addition, educating them can make the woman feel more comfortable as she struggles with her decision. Some medications can pass through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her infant.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these drugs might have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two huge data sets to examine more than 4.3 million pregnancies and determine whether stimulant medications caused birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.

The authors of the study didn't discover any connection between the use of early medications and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the birth of their child. This risk increased during the latter part of pregnancy, when many women decide to stop taking their ADHD medications.

Women who took ADHD medications in the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance at birth. 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 conditions that could have contributed to these findings.

The researchers hope that their research will aid in the clinical decisions of doctors who treat pregnant women. The researchers recommend that, while discussing risks and benefits are crucial, the decision on whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman.

The authors caution that, even though stopping the medication is an option to think about, it isn't advised because of the high incidence of depression and other mental disorders among women who are pregnant or who have recently given birth. Further, the research suggests that women who choose to stop taking their medications are more likely to have difficulties getting used to life without them following the baby's arrival.

Nursing

The responsibilities of a new mother can be overwhelming. Women who suffer from adhd stimulant medication who must work through their symptoms while attending doctor appointments, making preparations for the arrival of a baby and adapting to new adhd medication routines in the home can experience severe 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 a low level. However, the amount of medication exposure to the infant can differ based on dosage, frequency it is administered, and the time of day it is administered. Additionally, different medications enter the baby's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not fully understood.

Because of the lack of research, some physicians might be tempted to stop taking stimulant medications during the course of pregnancy. It is a difficult decision for the woman who must weigh the benefits of her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether 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 while breast-feeding. In response, a growing number of patients are choosing to continue their medication. They have discovered through consultation with their physicians, that the benefits of continuing their current medication far outweigh any risk.

Women with ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continued treatment, including non stimulant adhd medications for adults-pharmacological strategies. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and the root cause and learn about treatments and to reinforce existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.