The Most Pervasive Problems With ADHD Medication Pregnancy
The Most Pervasive Problems With ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. Little data exists about how long-term exposure to these drugs could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders such as impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of taking them against the potential risks to the foetus. Physicians do not have the information needed to make unequivocal recommendations however they can provide information about benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who took stimulants during early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to make sure that the classification was accurate and to eliminate any bias.
The study conducted by the researchers was not without limitations. Most important, they were unable to distinguish the effects of the medication from those of the disorder that is underlying. This limitation makes it difficult for researchers to determine 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 researchers did not study the long-term outcomes of offspring.
The study showed that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy or stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having an emergency caesarean section or having 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 taken during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit to both the mother and child of continued treatment for the woman's condition. Physicians should discuss this with their patients and, where possible, help them develop strategies for improving their coping skills which can reduce the effects of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the question of whether to keep or end treatment during pregnancy is a question that more and more physicians confront. The majority of these decisions are taken in the absence of solid and reliable evidence regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests on the subject and their own best judgment for each individual patient.
Particularly, the issue of possible risks to the infant can be difficult. Many of the studies on this issue are based on observational evidence instead of controlled research and their findings are often contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in the journal club addresses these issues by analyzing both click here information on deceased and live births.
Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies show an unintended, or slightly negative, effect. In each case an in-depth study of the risks and benefits should be conducted.
For a lot of women with ADHD, the decision to stop taking medication is difficult, if not impossible. In fact, in a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for those suffering from the disorder. In addition, a decrease in medication can interfere with the ability to do job-related tasks and drive safely that are crucial aspects of a normal life for a lot of people with ADHD.
She suggests that women who aren't sure whether to take the medication or stop due to pregnancy educate family members, coworkers, and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment. Educating them can also help the woman feel supported in her struggle with her decision. It is important to remember that some medications can be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the child.
Birth Defects Risk
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases as does the concern about the possible effects of the drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers used two huge datasets to analyze more than 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects like ventriculoseptal defects.
The authors of the study did not discover any connection between the use of early medications and congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies showing a small but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications prior to the birth of their child. This risk increased during the latter half of pregnancy, when a lot of women began to stop taking their medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. The researchers of the study were unable to eliminate bias due to selection because they limited their study to women without other medical conditions that might have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of physicians who treat pregnant women. The researchers suggest that, while discussing benefits and risks are crucial, the decision regarding whether or not to stop medication should be based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors caution that, while stopping the medication is a possibility to consider, it is not advised due to the high rate depression and other mental disorders for women who are pregnant or who have recently given birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience a difficult time getting used to life without them following the baby's arrival.
Nursing
It can be a challenge to become a mom. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at a low level. The amount of exposure to medications will differ based on dosage the medication is administered, its frequency and time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not yet fully known.
Some doctors may stop taking 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 keeping her medication with the potential dangers to the embryo. In the meantime, until more information is available, GPs can ask pregnant patients if they have a background of ADHD or if they plan to take medication in the perinatal phase.
Numerous studies have proven that women can continue to take their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do this. They have concluded after consulting with their doctors that the benefits of continuing their current medication outweigh risk.
It's important for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should be a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a treatment plan for both the mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.