Why No One Cares About ADHD Medication Pregnancy
Why No One Cares About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and nursing is a challenge for women suffering from the condition. Little data exists about how long-term exposure to these medications could affect the fetus.
A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications must weigh the benefits of using them against the risks to the foetus. Doctors don't have enough data to make unambiguous recommendations however 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 greater risk of fetal malformations, or structural birth defects. Researchers used a large population-based study of case control to compare the incidence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to limit the possibility of bias.
However, the researchers' study had its limitations. The researchers were unable, in the first place to differentiate the effects caused by the medication from the disorder. This makes it difficult for researchers to establish whether the few associations observed between the exposed groups were due to medication use or caused by comorbidities. In addition, the researchers did not examine the long-term effects of offspring on their parents.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system-related disorders, and the higher risk of admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher likelihood of having an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
The research suggests that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the higher benefit to both mother and child from continued treatment for the woman's disorder. Physicians should speak with their patients about this issue and, if possible, help them improve coping skills which can lessen the impact of her disorder in her daily life and relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is a question that more and more physicians confront. Most of the time, these decisions are made without any evidence that is clear and definitive either way, so physicians must weigh their knowledge from their own experiences, those of other doctors, and what research suggests about the subject as well as their own best judgment for each patient.
The issue of potential risks to the infant can be difficult to determine. Many of the studies on this topic are based on observational evidence instead of controlled research and their findings are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these issues, by examining both the data from deceased and live births.
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 show a neutral or even slight negative effect. In each case, a careful study of the potential risks and benefits should be conducted.
It isn't easy, but not impossible for women with ADHD to stop taking their medication. In an article published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for those suffering from the disorder. Additionally, the loss of medication can affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.
She recommends that women who are unsure about whether to keep or stop medication in light of their pregnancy should consider informing family members, friends, and coworkers on the condition, its impact on daily functioning, and on the advantages of continuing the current treatment plan. In addition, educating them can make the woman feel more comfortable when she is struggling with her decision. It is important to remember that some medications are able to be absorbed through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the infant.
Birth Defects and Risk of
As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns over the impact that these drugs might have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Using two massive data sets researchers were able look at more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall remains low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects such as ventriculoseptal defect (VSD).
The authors of the study did not find any association between the use of early medications and other congenital anomalies, like facial deformities, or club feet. The results are in line with previous studies revealing a small but significant increase in the risk of heart malformations in women who started taking ADHD medications prior to pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women began to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely require a caesarean delivery and also have a low Apgar after birth and have a baby that needed help breathing after birth. The researchers of the study could not eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings.
Researchers hope that their research will inform physicians when they encounter pregnant women. The researchers advise that while discussing risks and benefits are important, the decision regarding whether or not to stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman.
The authors caution that, although stopping the medication is a possibility to look into, it is not advised due to the high rate depression and other mental problems in women who are expecting or recently gave birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to have a difficult time adjusting to life without them after the baby's arrival.
Nursing
It can be a stressful experience becoming a mother. Women who suffer 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 child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed by breast milk in very small amounts, therefore the risk to the infant who is breastfeeding is low. The rate of medication exposure get more info will vary based on the dosage, frequency of administration and time of day. Additionally, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The impact on a newborn's health is not fully comprehended.
Some physicians may discontinue stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman, who must weigh the advantages of her medication against the risks to the foetus. In the meantime, until more information is available, doctors can inquire about pregnant patients whether they have any background of ADHD or if they intend to take medication in the perinatal phase.
A increasing number of studies have proven that women can continue their ADHD medication while they are pregnant and nursing. As a result, many 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 potential risks.
Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be educated about treatment options and strengthen coping mechanisms. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if necessary, adjustments to the medication regimen.