7 Little Changes That'll Make A Big Difference With Your ADHD Medication Pregnancy
7 Little Changes That'll Make A Big Difference With Your ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and breastfeeding is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these medications can affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must consider the benefits of taking it versus the risks for the foetus. Doctors don't have the data needed to provide clear recommendations but they can provide information regarding the risks and benefits to assist pregnant women in making informed decisions.
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 cardiac malformations or major structural birth defects. Researchers conducted a massive 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 and clinical geneticists examined the cases to ensure an accurate case classification and to minimize the chance of bias.
However, the researchers' study had its limitations. Most important, they were unable to distinguish the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to medication use or confounding by comorbidities. The researchers did not study long-term outcomes for offspring.
The study found that babies whose mothers took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk of admission did not appear to be influenced by which stimulant medications were used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean delivery or having a child with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy.
The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit for both mother and child of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this and, if possible, help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made without solid and reliable evidence in either case, which means that doctors must weigh their knowledge, the experiences of other doctors, and what the research says on the topic and their own best judgment for each individual patient.
In particular, the issue of potential risks to the baby can be a challenge. The research that has been conducted on this topic is based on observation rather than controlled studies, and many of the findings are in conflict. Most studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study presented in this journal club addresses these issues by examining data on both live and deceased births.
Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show that there is a neutral, or slight negative impact. In all cases, a careful study of the risks and benefits should be conducted.
For a lot of women with ADHD and ADD, the decision to discontinue medication is 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 affect the ability to do job-related tasks and drive safely, 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 discontinue it due to pregnancy should educate family members, coworkers and their friends about the condition, its impact on daily functioning and the benefits of keeping the current treatment. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Some medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the drug may be transferred to her baby.
Risk of Birth Defects
As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing as does the concern about the potential adverse effects of the drugs on foetuses. A study that was published read more in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets researchers were able look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defects.
The researchers of the study found no link between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication before the time of pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women decided to stop taking their medication.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth or have a low Apgar after delivery and had a baby that required breathing assistance when they were born. However, the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could be a contributing factor to these findings.
Researchers hope that their research will provide doctors with information when they see pregnant women. They suggest that although discussing the benefits and risks is important however, the decision to stop or keep medication must be based on each woman's requirements and the severity of her ADHD symptoms.
The authors warn that, while stopping the medication is a possibility to consider, it is not recommended due to the high prevalence of depression and other mental disorders for women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.
Nursing
It can be a challenge to become a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments and making preparations for the arrival of a child and adjusting to new household routines 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 through breast milk in low amounts, therefore the risk for nursing infant is very low. The amount of exposure to medications can vary depending upon the dosage, frequency of administration and time of day. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact on the health of a newborn is not fully comprehended.
Because of the lack of research, some physicians might be tempted to stop taking stimulant medication during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risks to the fetus. Until more information becomes available, doctors may ask pregnant patients if they have a background of ADHD or if they are planning to take medication during the perinatal phase.
Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner during pregnancy and breast-feeding. In the end, more and more patients are choosing to do so, and after consulting with their doctor, they have found that the benefits of maintaining their current medication far exceed any risk.
Women who suffer from ADHD who are planning to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and strengthen the coping mechanisms. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.