Ask Me Anything: 10 Answers To Your Questions About ADHD Medication Pregnancy
Ask Me Anything: 10 Answers To Your Questions 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. There aren't many studies on how exposure to ADHD for a long time could affect the foetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological disorders such as 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 need to consider the benefits of taking it against the potential risks to the baby. The doctors don't have the information to provide clear recommendations but they can provide information about risks and benefits to assist pregnant women to make informed decisions.
A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to reduce any bias.
However, the study had its limitations. Researchers were unable in the beginning, to separate the effects triggered by the medication from the disorder. This makes it difficult to determine whether the small associations observed in the exposed groups result from medication use or confounding by comorbidities. In addition the study did not examine long-term offspring outcomes.
The study did show that infants whose mothers had taken ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or cut back on their medications prior to or during pregnancy. This was due to central nervous system-related disorders and the increased risk of admission was not found to be influenced by the stimulant medication was used during pregnancy.
Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases appear to be independent of the type of medication used during pregnancy.
Researchers suggest that the small risk of using ADHD medications in early pregnancies may be offset by the more beneficial outcomes for both baby and mother of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve coping skills that may minimize the effects of her disorder on her daily functioning and relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to continue or end treatment during pregnancy is one that more and more physicians confront. These decisions are usually taken without clear and authoritative evidence. Instead, doctors have to take into account their own experience, the experience of other physicians and the research on the topic.
The issue of possible risks to the infant can be particularly tricky. Many of the studies on this topic are based on observational data rather than controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which could underestimate severe teratogenic effects that 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.
Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not established a link. Most studies have shown that there is a neutral, or slightly negative, effect. In each case, a careful study of the potential risks and benefits is required.
It can be difficult, 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 increase depression and feelings of isolation. Additionally, the loss of medication may affect the ability to perform work-related tasks and safely drive, which are important aspects of a normal life for a lot of people with ADHD.
She suggests that women who aren't sure whether read more to take the medication or stop it due to their pregnancy, educate their family members, coworkers, and acquaintances about the condition, the impact on daily functioning and the advantages of staying on the current treatment. It can also help a woman feel confident about her decision. It is important to remember that some medications are able to pass through the placenta so if the patient decides to discontinue 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.
Risk of Birth Defects
As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Researchers used two huge datasets to analyze more than 4.3 million pregnant women and determine if the use of stimulant medications increased birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD).
The authors of the study didn't find any association between early medication usage and 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 started taking ADHD medication prior to the time of the time of pregnancy. The risk was higher during the latter part of pregnancy, when a lot of women begin to discontinue their ADHD medications.
Women who used ADHD medications during the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance at birth. However the researchers of the study were not able to eliminate selection bias by restricting the study to women who did not have any other medical issues that could have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who treat pregnant women. They advise that while a discussion of risks and benefits is important however, the decision to stop or maintain medication should be based on the woman's requirements and the severity of her ADHD symptoms.
The authors warn that, even though stopping the medication is a possibility to think about, it isn't recommended due to the high prevalence of depression and other mental problems for women who are pregnant or have recently given birth. Further, the research suggests that women who choose to stop taking their medications are more likely to experience a difficult time adjusting to life without them following the baby's arrival.
Nursing
It can be a stressful experience to become a mom. Women suffering from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to new routines. This is why many women decide to continue taking their ADHD medications throughout the course of pregnancy.
The risk to breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk in low amounts. However, the amount of exposure to medication by the newborn may differ based on the dosage, frequency it is administered, and the time of the day it is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't completely understood.
Due to the absence of evidence, some doctors may be inclined to discontinue stimulant drugs during the course of pregnancy. It is a difficult decision for the woman who must weigh the benefits of her medication against the risk to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal period.
A growing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are opting to do this. They have concluded after consulting with their physicians that the benefits of keeping their current medication far outweigh any possible risks.
Women who suffer from ADHD who are planning to breastfeed should seek advice from 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 methods. Psychoeducation should also be provided to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing coping strategies. 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 as well as the child, and monitoring for indicators of deterioration, and, if needed adjustments to the medication regimen.