Why No One Cares About ADHD Medication Pregnancy
Why No One Cares About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women with ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs can affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of taking them against the potential risks to the foetus. Physicians do not have the information needed to give clear guidelines but they can provide information regarding benefits and risks that can help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at a greater risk of fetal malformations, or structural birth defects. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure accurate case classification and to minimize the chance of bias.
However, the researchers' study was not without its flaws. The researchers were unable in the beginning to distinguish the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the groups that were exposed to the use of medication, or if they were confounded by comorbidities. The researchers also did not study long-term outcomes for offspring.
The study did show that infants whose mothers took ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication used during pregnancy.
Women who used stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medication during pregnancies in the early stages can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, help them develop strategies to improve coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Many doctors are faced with the decision of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are often taken without clear and authoritative evidence. Instead, doctors have to consider their own expertise, the experience of other doctors, and the research that has been conducted on the subject.
The issue of risk to the infant can be particularly tricky. Many studies on this subject are based on observations instead of controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations by analyzing both data on live and deceased births.
Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies have shown that there is a neutral, or slightly negative, effect. In the end, a careful risk/benefit assessment must be conducted in every situation.
For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In a recent piece 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 isolation. Furthermore, a loss of medication may affect the ability to complete work-related tasks and safely drive that are crucial aspects of a normal life for many people with ADHD.
She recommends that women who are unsure about whether to continue or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and the advantages of continuing the current treatment plan. In addition, educating them can make the woman feel more comfortable in her struggle with her decision. It is important to note that some medications are able to pass through the placenta, so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be transferred to the infant.
Birth Defects and Risk of
As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases as does the concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two huge datasets to analyze more than 4.3 million pregnancy and determine whether stimulant medications increased birth defects. Although the risk overall remains low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study found no link between the use of early medications and congenital abnormalities such as facial clefting or club foot. The results are in the same vein as previous studies that showed an insignificant, but small increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. The risk grew in the later part of pregnancy, as many women decide to stop taking their medication.
Women who took ADHD medication in the first trimester were more likely to require a caesarean birth, have an insufficient Apgar after birth and had a baby that required breathing assistance when they were born. The researchers of the study were unable to eliminate bias due to selection because they limited their study to women without other medical conditions that could have contributed to the findings.
Researchers hope that their research will provide doctors with information when they meet 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 also caution 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 issues in women who are pregnant or post-partum. Additionally, research suggests that women who stop taking their medications will have a tough transitioning to life without them after the baby is born.
Nursing
The responsibilities of a new mom can be overwhelming. Women suffering from ADHD can face severe challenges when they have to manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to new routines. This is why many women decide to continue taking their ADHD medications throughout pregnancy.
The majority of stimulant medications pass through breast milk in small amounts, therefore the risk to infant who is breastfeeding is low. However, the rate of medication exposure to the newborn can vary depending on the dosage, frequency it is taken and the time of the day the medication is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn isn't well known.
Due to the absence of research, some doctors might be tempted to stop taking stimulant medication during the pregnancy of a woman. It's a difficult choice for the woman, who must weigh the advantages of her medication against the risks to the fetus. In the meantime, until more information is available, GPs should ask all pregnant patients about their history of ADHD and if they plan or are taking to take medication during the perinatal period.
Numerous studies have proven that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are opting to do so. They have found through consultation with their doctor, that the benefits of continuing their current medication far outweigh any potential risks.
Women with website ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and build coping mechanisms. This should be a multidisciplinary process including obstetricians, GPs, and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother as well as the child, as well as monitoring for signs of deterioration and the need for adjustments to the medication regimen.