Ask Me Anything: 10 Responses To Your Questions About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough web page on how long-term exposure may affect the pregnant fetus.
A recent study 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 more high-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication should weigh the benefits of taking it against the potential risks to the fetus. The doctors don't have the information to provide clear recommendations but they can provide information about risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at 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 in early pregnancy, and those who did not. adult adhd treatments , clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to reduce any bias.
However, the researchers' study had its limitations. The researchers were unable, in the first place, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the exposed groups were due to the use of medication or confounded by co-morbidities. The researchers also did not examine the long-term effects for the offspring.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk of admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies may be offset by the greater benefits for mother and baby from continuing 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 life and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive in either case, which means that doctors must weigh what they know, the experiences of other doctors, and what research suggests about the subject as well as their best judgment for each patient.
In particular, the issue of possible risks to the baby can be a challenge. The research on this issue is based on observation rather than controlled studies and the results are contradictory. The majority of studies limit their analysis to live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these issues by analyzing information on deceased and live births.
The conclusion The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link and the majority of studies have a neutral or slight negative effect. In every case, a careful evaluation of the risks and benefits should be conducted.
It can be challenging, if not impossible for women with ADHD to stop taking their medication. In a recent piece 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 loneliness. A loss of medication may also impact the ability to safely drive and perform work-related tasks, which are crucial aspects of everyday life for those with ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy, educate their family members, coworkers, and acquaintances about the condition, its impact on daily functioning and the advantages of staying on the current treatment. Educating them can also aid in ensuring that the woman feels supported in her struggle with her decision. Certain medications can be passed through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be passed on to her baby.
Risk of Birth Defects
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these drugs could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. With two massive data sets researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.
The authors of the study did not discover any link between early use of medication and congenital anomalies like facial deformities, or club feet. The results are in line with previous studies showing a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk grew in the latter half of pregnancy, as many women are forced to stop taking their ADHD medications.
Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after delivery and have a baby that needed help breathing after birth. However the authors of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings.
The researchers hope that their research will serve to inform the clinical decisions of doctors who encounter pregnant women. They advise that while a discussion of risks and benefits is important, the decision to stop or continue medication should be based on the woman's needs and the severity of her ADHD symptoms.
The authors also advise that while discontinuing the medications is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health problems in women who are pregnant or recently post-partum. Further, the research suggests that women who decide to stop taking their medications are more likely to have difficulties adjusting to life without them following the baby's arrival.
Nursing
It can be overwhelming to become a mom. Women who suffer from 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 are often faced with a number of difficulties. As such, many women decide to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medications pass through breast milk in low quantities, so the risk to the infant who is breastfeeding is low. The rate of exposure to medication can vary depending upon the dosage and frequency of administration as well as time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not 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 benefit of continuing her medication against the potential dangers to the embryo. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, a rising number of patients are opting to do so. They have discovered through consultation with their doctor that the benefits of keeping their current medication outweigh risk.
Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and reinforce strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration, and, if necessary, adjustments to the medication regime.