How To Outsmart Your Boss On ADHD Medication Pregnancy

How To Outsmart Your Boss On ADHD Medication Pregnancy

Blog Article

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There is a lack of information about how long-term exposure to these medications may affect the fetus.

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 that more high quality studies are required.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication should weigh the benefits of taking it versus the dangers for the baby. Doctors don't have the information needed to give clear guidelines but they can provide information on the risks and benefits to aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. The researchers used a large population-based study of case-control to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists examined the cases to ensure accurate classification of the cases and to reduce the chance of bias.

However, the researchers' study was not without its flaws. In particular, they were unable to distinguish the effects of the medication from the disorder at hand. This limitation makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to medication use or confounded by the presence of comorbidities. In addition the researchers did not examine the long-term effects of offspring on their parents.

The study found that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or had stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases did appear to be independent of the type of medication used during pregnancy.

Researchers suggest that the minor risk of using ADHD medications during early pregnancies can be offset by greater benefits to both mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of clear and authoritative evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what the research suggests about the subject and their own best judgment for each patient.

Particularly, the subject of potential risks to the baby can be a challenge. The research that has been conducted on this topic is based on observation instead of controlled studies and a lot of the results are contradictory. Furthermore, most studies restrict their analysis to live births, which may undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these shortcomings by analyzing both the data from 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 most studies demonstrate a neutral or slight negative effect. In the end an accurate risk-benefit analysis must be done in each instance.

It can be challenging, if not impossible, for women with ADHD to stop taking their medication. In a recent article 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. Furthermore, a loss of medication can affect the ability to complete job-related tasks and drive safely which are essential aspects of a normal life for many people with ADHD.

She suggests women who are uncertain about whether to continue or discontinue medication due to their pregnancy consider educating family members, friends, and coworkers on the condition, its effects on daily functioning, and on the advantages of staying on the current treatment plan. It will also help a woman feel supported in her decision. It is important to remember that certain drugs can be absorbed through the placenta therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug could be transferred to the child.

Risk of Birth Defects

As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these drugs could have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. With two massive data sets, researchers were able to 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, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.

The researchers of the study could not find any association between early use of medication and other congenital anomalies, like facial deformities, or club feet. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the birth of their child. The risk increased in the latter half of pregnancy, when a lot of women stopped taking their medication.

Women who were taking ADHD medication during the first trimester were more likely require a caesarean delivery, have an insufficient Apgar after birth and have a baby who needed help breathing after birth. However the researchers of the study were unable to eliminate selection bias by restricting the study to women who did not have any other medical conditions that could have contributed to the findings.

The researchers hope their research will help inform the clinical decisions of physicians who treat pregnant women. The researchers suggest that, while discussing risks and benefits are crucial, the decision regarding whether or not to stop more info medication should be based on the severity of each woman's ADHD symptoms and her requirements.

The authors warn that, even though stopping the medication is a possibility to think about, it isn't recommended because of the high incidence of depression and mental health issues among women who are pregnant or have recently given birth. Additionally, research suggests that women who stop taking their medications will have a harder adjustment to life without them after the baby is born.

Nursing

It can be overwhelming to become a mom. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to a new routine. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.

The majority of stimulant drugs are absorbed through breast milk in very small amounts, so the risk for nursing infant is very low. However, the frequency of exposure to medications by the newborn can vary depending on the dosage, frequency it is administered, and the time of the day it is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn infant is not well known.

Some doctors may stop taking stimulant medications 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 keeping 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 planning or taking to take medication during the perinatal period.

A increasing number of studies have proven that most women can safely continue to take their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are choosing to do so. They have concluded after consulting with their doctor that the benefits of continuing their current medication outweigh any potential risks.

Women who suffer from ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and underlying disorder, learn about available treatments and to reinforce existing strategies for coping. This should be a multidisciplinary effort with the GPs, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.