The Three Greatest Moments In ADHD Medication Pregnancy History
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during pregnancy and breastfeeding is challenging for women with the condition. There isn't much information on how long-term exposure to these medications could affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the advantages of using them against the risks to the fetus. Physicians don't have the data to give clear advice but they can provide information about risks and benefits to aid pregnant women in making informed decisions.
A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was accurate and to minimize any bias.
However, the researchers' study had its limitations. The most important issue was that they were unable to separate the effects of the medication from the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to medication use or if they were caused by the presence of comorbidities. The researchers also did not study the long-term effects for the offspring.
The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the minor risk of using ADHD medication during pregnancies in the early stages can be offset by greater benefits for mother and baby from continuing treatment for the woman's disorder. Doctors should discuss with their patients about this issue and, if possible, help them improve coping skills which may reduce the effects of her disorder on her daily functioning and her relationships.
Medication Interactions
Many doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must take into account their own experience, the experience of other doctors and the research on the subject.
In particular, the issue of potential risks to the baby can be tricky. The research on this issue is based on observations instead of controlled studies and many of the findings are in conflict. The majority of studies focus on live births, which may underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both the data from deceased and live births.
Conclusion: While some studies have found an association between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies have shown a neutral, or even slightly negative, impact. In all cases an in-depth evaluation of the potential risks and benefits should be conducted.
It can be challenging, if not impossible, for women with 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 can affect the ability to complete jobs and drive safely, which are important aspects of a normal life for a lot of people with ADHD.
She suggests women who are uncertain about whether to keep or stop medication in light of their pregnancy, consider educating family members, friends, and coworkers on the condition, its impact on daily life, and the advantages of continuing the current treatment plan. Educating them can also make the woman feel more comfortable when she is struggling with her decision. It is important to note 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 medication could be transferred to the child.
Risk of Birth Defects
As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the potential effects of these drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Using two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects, such as ventriculo-septal defect (VSD).
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 which showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of pregnancy. This risk increased in the latter half of pregnancy, as many women begin to discontinue their medication.
Women who used ADHD medications during the first trimester of their pregnancies were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby who needed help breathing at birth. The authors of the study could not eliminate bias due to selection because they limited the study to women without other medical conditions that might have contributed to the findings.
The researchers hope that their research will help inform the clinical decisions of doctors who encounter pregnant women. The researchers suggest that while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also warn that, while stopping the medication is an alternative, it is not a recommended practice because of the high rate of depression and other mental health problems for women who are expecting or recently post-partum. Additionally, research suggests that women who stop taking their medication will have a difficult adjustment to life without them after the baby is born.
Nursing
The responsibilities that come with being a new mom can be overwhelming. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy.
The risk for nursing infant is low because the majority of stimulant medication passes through breast milk in low amounts. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and the time of the day. Additionally, add medication adults enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully understood.
Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. It's a difficult choice for the woman, who must weigh the benefits of her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period.
Numerous studies have proven that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. In response, a growing number of patients are choosing to continue their medication. They have discovered, in consultation with their physicians, that the benefits of keeping their current medication far outweigh any risk.
Women with ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration, and, if needed adjustments to the medication regimen.