A Brief History Of ADHD Medication Pregnancy History Of ADHD Medication Pregnancy
A Brief History Of ADHD Medication Pregnancy History Of ADHD Medication Pregnancy
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ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these drugs may affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or 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 must weigh the benefits of taking it versus the risks to the foetus. Physicians don't have the data needed to give clear guidelines but they can provide information on the risks and benefits to help pregnant women make informed decisions.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large, population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to minimize the possibility of bias.
However, the researchers' study was not without its flaws. The researchers were unable, in the first place to distinguish the effects of the medication from the disorder. That limitation makes it difficult to know whether the small differences observed in the groups that were exposed are due to medication use or confounding by comorbidities. Additionally the study did not look at long-term offspring outcomes.
The study revealed that babies whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this issue and, if possible, help them develop coping strategies that can lessen the effects of her disorder on her daily functioning and her relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether or not to end treatment during pregnancy is a question that doctors are having to face. These decisions are usually taken without clear and authoritative evidence. Instead, physicians must weigh their own knowledge and experience, as well as the experiences of other doctors and the research that has been conducted on the subject.
The issue of potential risks to infants is particularly tricky. The research that has been conducted on this topic is based on observation rather than controlled studies and a lot of the results are conflicting. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. Most studies show an unintended, or slight negative impact. In the end, a careful risk/benefit assessment must be done in each case.
For a lot of women with ADHD who suffer from ADHD, the decision to stop medication can be difficult, if not impossible. In fact, in an article recently published 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. Additionally, the loss of medication can affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for a lot of people with ADHD.
She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy, educate their family members, coworkers and friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment regimen. It can also make the woman feel more comfortable when she is struggling with her decision. It is important to note that certain medications can pass through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be passed on to the baby.
Risk of Birth Defects
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases as does the concern about the possible effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Utilizing two huge data sets researchers were able look at more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increased risk of specific heart defects, such as ventriculo-septal defect (VSD).
The researchers of the study did not discover any link between early use of medication and other congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies revealing an increase, but not significant, in the risk of heart malformations among women who began taking ADHD medications prior to the time of the time of pregnancy. The risk grew in the later part of pregnancy, click here as many women are forced to stop taking their ADHD medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean delivery or have an insufficient Apgar after delivery, and have a baby who needed help breathing 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 be a contributing factor to these findings.
Researchers hope that their research will provide doctors with information when they encounter pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the decision regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors also advise that even though stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health problems for women who are expecting or recently post-partum. Additionally, the research suggests that women who decide to stop their medications are more likely to experience a difficult time adapting to life without them following the birth of their baby.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments and making preparations for the arrival of a baby and adjusting to new household routines may face a lot of challenges. This is why many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medicines are absorbed by breast milk in very small amounts, therefore the risk for breastfeeding infant is minimal. However, the amount of exposure to medication by the newborn may differ based on the dosage, frequency it is administered, and the time of the day the medication is administered. In addition, different drugs enter the infant's system via the gastrointestinal tract or breast milk. The effect on the health of a newborn isn't completely comprehended.
Due to the absence of research, some doctors may recommend stopping stimulant medications during a woman's pregnancy. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication with the potential dangers to the foetus. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal time.
A growing number of studies have revealed that women can continue to take their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are choosing to continue their medication. They have concluded through consultation with their doctor, that the benefits of retaining their current medication far outweigh any possible risks.
It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior 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 women suffering from ADHD understand the symptoms and underlying disorder. They should also be informed about treatment options and strengthen coping mechanisms. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if needed modifications to the medication regimen.