ADHD Medication During Pregnancy and Breastfeeding<br /><br />The choice of whether to stop or continue ADHD medications during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There isn't much information on how long-term exposure to these drugs can affect the foetus.<br /><br />A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.<br /><br />Risk/Benefit Analysis<br /><br /><br /><br />Women who are pregnant and take ADHD medication need to consider the benefits of taking it against the possible risks for the baby. Doctors don't have enough data to make unambiguous recommendations, but can provide information on the risks and benefits to aid pregnant women in making informed choices.<br /><br />A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive population-based case control study to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to limit the chance of bias.<br /><br />However, the researchers' study was not without its flaws. Researchers were unable, in the first place, to separate the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to the use of medication or if they were caused by the presence of comorbidities. Researchers also did not examine long-term outcomes for the offspring.<br /><br />The study found that infants 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 had stopped taking their medication before or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.<br /><br />Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.<br /><br />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. Physicians should talk to their patients about this and try to help them improve coping skills which could reduce the effects of her disorder on her daily functioning and her relationships.<br /><br />Medication Interactions<br /><br />As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is one that doctors are having to face. The majority of these decisions are made without any evidence that is clear and definitive regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests on the subject, along with their own best judgment for each individual patient.<br /><br />The issue of possible risks to infants is difficult to determine. The research that has been conducted on this topic is based on observation instead of controlled studies and a lot of the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which could underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.<br /><br />The conclusion The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have found no such relationship, and most studies have a neutral or slightly negative effect. In the end an accurate risk-benefit analysis must be conducted in every situation.<br /><br />For a lot of women with ADHD, the decision to discontinue medication is 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 loneliness. A decrease in medication could affect the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for those suffering from ADHD.<br /><br />She suggests that women who are not sure whether to continue taking the medication or discontinue it due to pregnancy should educate family members, coworkers, and acquaintances about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. In addition, educating them can make the woman feel more comfortable as she struggles with her decision. Certain medications can be passed through the placenta. If the patient decides to not take her ADHD medication while breastfeeding, it is important to be aware that the medication may be transferred to her infant.<br /><br />Birth Defects Risk<br /><br />As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over 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. Researchers used two huge data sets to study over 4.3 million pregnancy and determine if stimulant medication use caused birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.<br /><br />The authors of the study found no link between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. The risk increased in the latter half of pregnancy when a large number of women decided to stop taking their medication.<br /><br />Women who took ADHD medications in the first trimester of their pregnancy were also more likely to have caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance during birth. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could have contributed to the findings.<br /><br />Researchers hope that their research will help doctors when they see pregnant women. The researchers recommend that, while discussing benefits and risks are important, the choice regarding whether or not to stop taking medication should be in light of the severity of each woman's ADHD symptoms and the needs of the woman.<br /><br />The authors warn that, although stopping the medication is an option to think about, it isn't advised due to the high rate depression and mental health issues among women who are pregnant or who have recently given birth. Research has also shown that women who stop taking their medications will have a tough time adjusting to a life without them once the baby is born.<br /><br />Nursing<br /><br />It can be overwhelming to become a mom. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a child and getting used to new routines at home may face a lot of challenges. As such, many women elect to continue taking their ADHD medications throughout the course of pregnancy.<br /><br />The majority of stimulant drugs are absorbed by breast milk in very small quantities, so the risk to the nursing infant is very low. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of day. In addition, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not completely known.<br /><br />Due to the absence of research, some physicians may be inclined to discontinue stimulant drugs during the pregnancy of a woman. This is a difficult decision for the woman who must weigh the benefits of her medication against the risk to the foetus. Until more information becomes available, doctors may ask pregnant patients if they have any background of ADHD or if they are planning to take medication during the perinatal phase.<br /><br />Numerous studies have proven that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. As <a href="https://www.iampsychiatry.uk/adult-adhd-medication/">adult adhd treatments www.iampsychiatry.uk</a> , an increasing number of patients are choosing to do so and in consultation with their doctor they have found that the benefits of continuing their current medication far outweigh any risks.<br /><br />Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and build strategies for coping. This should be an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother and child, and monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.<br /><br />