15 Current Trends To Watch For ADHD Medication Pregnancy
15 Current Trends To Watch For ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how exposure to ADHD for a long time could affect the pregnant fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental conditions like hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the potential risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations but they can provide information about the 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 sample-based case control study to compare the incidence 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 ensure that the classification was accurate and to reduce any bias.
However, the researchers' study had its limitations. The researchers were not able in the beginning to differentiate the effects of the medication from the disorder. This 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 comorbidities. The researchers also did not study long-term outcomes for offspring.
The study showed that babies whose mothers had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean section or having a child with a low Apgar score (less than 7). These increases did not appear to be affected 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 can be offset by greater benefits to both mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily functioning 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 keep or end treatment during pregnancy is a question that more and more doctors face. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research says on the topic and their own best judgment for each patient.
Particularly, the subject of possible risks to the baby can be a challenge. A lot of studies on this topic are based on observations rather than controlled research, and their findings 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 discussed in the journal club addresses these limitations, by examining both the data from deceased and live births.
Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies have shown an unintended, or somewhat negative, effect. Therefore an accurate risk-benefit analysis must be conducted in every case.
For women suffering from ADHD and ADD, the decision to discontinue medication can be difficult, if not impossible. In fact, in a recent article 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 loneliness and family conflict for these patients. In addition, a decrease in medication can affect the ability to complete job-related tasks and drive safely that are crucial aspects of daily life for a lot of people with ADHD.
She recommends women who are unsure about whether or not to stop taking medication because of their pregnancy should consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily functioning, and on the advantages of continuing the current treatment plan. It can also help women feel more confident in her decision. Some medications can pass through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be passed on to her baby.
Risk of Birth Defects
As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two massive datasets to analyze over 4.3 million pregnant women and determine if stimulant medication use increased birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study didn't discover any connection between the use of early medications and other congenital anomalies, like facial deformities, or club feet. The results are in agreement with previous studies which showed the existence of a slight, but here significant 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 increased in the latter half of pregnancy, when a lot of women began to stop taking their medication.
Women who used ADHD medications in the first trimester of their pregnancy were also more likely to undergo a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance at birth. However the authors of the study were not able to eliminate selection bias by limiting the study to women who did not have any other medical conditions that could have contributed to these findings.
Researchers hope their research will provide doctors with information when they see pregnant women. They advise that while discussing the benefits and risks 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 also warn that even though stopping the medication is an alternative, it is not an option to consider due to the high incidence of depression and other mental health issues among women who are pregnant or recently post-partum. Research has also shown that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk at low levels. The amount of exposure to medications can vary depending upon the dosage the medication is administered, its frequency and the time of day. In addition, various drugs enter the infant's system via the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely comprehended.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the potential risks to the embryo. In the meantime, until more information is available, GPs may inquire about pregnant patients whether they have any background of ADHD or if they intend to take medication during the perinatal period.
A growing number of studies have shown that women can continue to take their ADHD medication while they are pregnant and nursing. In the end, an increasing number of patients are choosing to do so, and in consultation with their physician, they have found that the benefits of maintaining their current medication outweigh any potential risks.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD recognize their symptoms and underlying disorder Learn about the available treatment options and strengthen existing coping strategies. This should be a multidisciplinary process including obstetricians, GPs, and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if needed, adjustments to the medication regime.