The Reason You Shouldn't Think About Making Improvements To Your ADHD Medication Pregnancy
The Reason You Shouldn't Think About Making Improvements To Your ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. There aren't enough data on how exposure to ADHD for a long time could affect a pregnant fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication should consider the benefits of taking it against the possible risks to the fetus. Physicians don't have the data to make unambiguous recommendations, but can provide information on the risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a massive sample-based case control study to examine the prevalence of major structural defects in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to make sure that the classification was accurate and to minimize any bias.
The study of the researchers was not without limitations. The researchers were not able to, in the first place, to separate the effects triggered by the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. The researchers did not look at the long-term effects for the offspring.
The study showed that infants whose mother had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not use any medication during pregnancy or had discontinued taking 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 medications used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve their coping abilities that can lessen the impact of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or discontinue treatment during pregnancy is a question that doctors are having to have to face. These decisions are frequently made without clear and reliable evidence. Instead, doctors must weigh their own knowledge, the experience of other physicians and the research on the subject.
Particularly, the issue of possible risks to the infant can be difficult. The research on this issue is based on observation rather than controlled studies, and the results are contradictory. Most studies limit their analysis to live-births, which could underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
The conclusion The conclusion: While some studies have shown that there is a positive correlation 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 demonstrate a neutral or slight negative effect. As a result, a careful risk/benefit assessment must be done in each case.
It isn't easy, but not impossible, for women with ADHD to stop taking their medication. 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 being isolated. A loss of medication may also affect the ability to drive safely and perform work-related tasks, which are vital aspects of normal life for people with ADHD.
She suggests that women who are not sure whether to continue taking the medication or stop it due to their pregnancy should educate family members, colleagues, and acquaintances about the condition, the effects on daily functioning, and the advantages of staying on the current treatment plan. Educating them can also make the woman feel more comfortable in her struggle with her decision. It is also worth noting that some medications can be absorbed through the placenta so if the patient decides to stop taking 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 of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about what impact the drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two huge data sets to study over 4.3 million pregnancy and determine if stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.
The researchers behind the study found no link between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies revealing a small but significant increase in the risk of heart malformations among women who started taking ADHD medications prior to the birth of their child. The risk was higher in the later part of pregnancy, as many women are forced to stop taking their medication.
Women who took ADHD medications in the first trimester of pregnancy were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance during birth. The researchers of the study were not able to remove bias in selection since they limited the study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who treat pregnant women. The researchers recommend that, while discussing the risks and benefits are important, the choice about whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors warn that, while stopping the medication is a possibility to look into, it is not advised due to the high prevalence of depression and other mental disorders among women who are pregnant or have recently given birth. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adapting to life without them after the birth of their baby.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk in low amounts. However, the rate of exposure to medications by the infant can differ based on the dosage, frequency it is administered, and the time of the get more info day the medication is administered. Additionally, different medications enter the baby’s system via the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not fully comprehended.
Because of the lack of research, some physicians might be tempted to stop taking stimulant medications during the pregnancy of a woman. This is a difficult choice for the patient, who must balance the benefit of continuing her medication with the potential risks to the fetus. As long as more information is available, doctors may ask pregnant patients whether they have a history of ADHD or if they plan to take medication in the perinatal period.
Many studies have shown that women can continue taking their ADHD medication safely while breastfeeding and during pregnancy. In response, a growing number of patients are opting to do this. They have concluded after consulting with their physicians that the benefits of continuing their current medication far outweigh any possible risks.
It is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.