How To Beat Your Boss ADHD Medication Pregnancy
How To Beat Your Boss ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data regarding how exposure over time may affect the pregnant 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 the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the advantages of using them against the risks to the foetus. Physicians don't have the data to give clear advice but they can provide information on risks and benefits to aid pregnant women in making an informed decision.
A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face an increased risk of fetal heart malformations or major structural birth defects. Researchers used a large population-based case control study to assess the frequency of major structural defects in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to ensure that the classification was correct and to eliminate any bias.
However, the study had its limitations. In particular, they were not able to differentiate the effects of the medication from the disorder at hand. This makes it difficult for researchers to establish whether the small differences observed between the groups exposed were due to the use of medications or if they were caused by the presence of comorbidities. The researchers did not look at long-term outcomes for the offspring.
The study revealed that babies whose mothers had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both the mother and child of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies to improve their coping abilities that may minimize the impact of her disorder on her daily functioning and relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are frequently made without clear and reliable evidence. Instead, doctors must consider their own expertise, the experience of other doctors, and the research on the subject.
The issue of risk to the infant can be difficult to determine. The research on this issue is based on observations instead of controlled studies and many of the findings are contradictory. The majority of studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion Some studies have shown an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies have shown that there is a neutral, or somewhat negative, impact. In the end, a careful risk/benefit analysis is required in every case.
For many women with ADHD and ADD, the decision to discontinue medication can be difficult, if not impossible. In a recent article published in the 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 complete work-related tasks and safely drive, which are important aspects of daily life for many people with ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy educate family members, coworkers, and their friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also make the woman feel more comfortable in her struggle with her decision. Some medications can pass through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication may be transferred to her infant.
Birth Defects and Risk of
As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets, researchers were able to examine more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.
The authors of the study did not discover any connection between early medication usage and other congenital anomalies like facial deformities or club feet. The results are consistent with previous studies that have shown the presence of a small, but significant I Am Psychiatry increase in the risk of heart malformations in women who started taking ADHD medications prior to pregnancy. This risk increased in the later part of pregnancy, as many women begin to discontinue their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery, have a low Apgar after birth and have a baby who needed breathing assistance after birth. However the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to these findings.
Researchers hope their research will provide doctors with information when they encounter pregnant women. They advise that while a discussion of risks and benefits is important however, the decision to stop or keep medication should be based on each woman's requirements and the severity of her ADHD symptoms.
The authors caution that, even though stopping the medication is an option to consider, it is not advised because of the high incidence of depression and mental health issues for women who are pregnant or recently gave birth. Furthermore, research suggests that women who decide to stop taking their medication are more likely to experience a difficult time adjusting to life without them following the birth of their baby.
Nursing
The responsibilities of being a new mom can be overwhelming. Women with ADHD who have to deal with their symptoms while attending doctor appointments and getting ready for the arrival of their child and adapting to new routines in the home may face a lot of challenges. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant drugs are absorbed by breast milk in small quantities, so the risk to breastfeeding infant is minimal. However, the rate of medication exposure to the infant can differ based on dosage, frequency it is taken and the time of the day the medication is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or through breast milk. The impact of these medications on the health of a newborn is not fully comprehended.
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 continuing her medication against the potential risks to the fetus. As long as there is no more information, GPs should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time.
A growing number of studies have shown that the majority of women are able to safely continue taking their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are choosing to do so. They have found through consultation with their physicians that the benefits of keeping their current medication outweigh any risk.
It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and build strategies for coping. This should involve a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.