20 Myths About ADHD Medication Pregnancy: Dispelled
20 Myths About ADHD Medication Pregnancy: Dispelled
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and breastfeeding is a challenge for women suffering from the condition. There are few data on how exposure to ADHD for a long time could affect a fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological conditions like impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to consider the benefits of taking it against the potential risks to the baby. Physicians do not have the necessary data to make unequivocal recommendations but they can provide information about benefits and risks that can assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers used a large population-based case control study to examine the prevalence of structural defects that were major in infants who were born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure 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 triggered by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small associations observed among the groups that were exposed to the use of medication, or if they were caused by comorbidities. Additionally, the researchers did not examine the long-term effects of offspring on their parents.
The study did reveal that infants whose mothers took ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or taken off their medication prior to or during pregnancy. This was due to central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications during early pregnancies may be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman’s disorder. Physicians should talk to their patients about this issue and, if possible, help them develop coping strategies that could reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or discontinue treatment during pregnancy is a question that more and more doctors have to face. Often, 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 says on the topic, along with their own best judgment for each individual patient.
The issue of possible risks to the infant can be extremely difficult. Many of the studies on this issue are based on observational data instead of controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative impact. Therefore an accurate risk-benefit analysis must be conducted in every situation.
It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. In addition, a decrease in medication may affect the ability to complete jobs and drive safely, which are important aspects of a normal life for many people with ADHD.
She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers, and their friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment plan. It can also aid in ensuring that the woman feels supported in her struggle with her decision. It is also worth noting that certain drugs can be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the infant.
Risk of Birth Defects
As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two massive datasets to analyze over 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD exposure to medication was associated website with slightly higher risk of certain heart defects, like ventriculoseptal defect.
The researchers behind the study found no connection between early medication use and congenital abnormalities like facial clefting, or club foot. The results are in line with previous studies revealing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to pregnancy. The risk increased in the latter part of pregnancy, when a lot of women stopped taking their medication.
Women who were taking ADHD medication in the first trimester were more likely to need a caesarean, have an insufficient Apgar after delivery, and have a baby that needed help breathing after birth. The authors of the study were not able to eliminate bias due to selection because they limited their study to women without other medical conditions that could have contributed to the findings.
Researchers hope their research will provide doctors with information when they see pregnant women. The researchers advise that, while discussing benefits and risks are important, the decision about whether to continue or stop medication should be according to the severity of each woman's ADHD symptoms and her requirements.
The authors also caution that even though stopping the medication is an alternative, it is not an option that is recommended due to the high rate of depression and other mental health problems for women who are expecting or who are recently post-partum. Research has also shown that women who stop taking their medication will have a tough adjustment to life without them after the baby is born.
Nursing
It can be a stressful experience becoming a mother. Women suffering from ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at a low level. The rate of medication exposure can vary depending upon the dosage, frequency of administration and time of day. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn infant is not fully known.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the possible risks to the embryo. Until more information becomes available, GPs may ask pregnant patients if they have any background of ADHD or if they plan to take medication during the perinatal period.
A growing number of studies have revealed that most women can safely continue their ADHD medication during pregnancy and breastfeeding. As a result, many patients choose to do so and, in consultation with their physician, they have discovered that the benefits of continuing their current medication far exceed any risk.
It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant people with ADHD be aware of their symptoms and the root cause, learn about available treatment options and reinforce existing strategies for coping. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration, and, if necessary modifications to the medication regime.