20 Myths About ADHD Medication Pregnancy: Busted

ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs may affect the fetus.

how to treat adhd without medication in adults  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 that more high-quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against potential risks to the fetus. Physicians don't have the data needed to provide clear recommendations, but they can provide information regarding risks and benefits that assist pregnant women in making informed decisions.

A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to assess the risk of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to eliminate any bias.

The study of the researchers was not without its limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medications or confounded by the presence of comorbidities. In addition the study did not examine the long-term effects of offspring on their parents.

The study showed that infants whose mother had taken ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission did not appear to be influenced by the stimulant medications were taken during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean delivery or having a baby with a low Apgar score (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages can be offset by greater benefits to both mother and baby of continuing treatment for the woman’s disorder. Physicians should speak with their patients about this and try to help them develop coping skills that may reduce the impact of her disorder in her daily functioning and her relationships.

Interactions with Medication

As more women than ever are diagnosed with ADHD and being treated with medication, the dilemma of whether to keep or end treatment during pregnancy is a question that more and more physicians confront. These decisions are often made without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors, and the research on the subject.

In particular, the issue of potential risks to the infant can be difficult. The research that has been conducted on this topic is based on observation instead of controlled studies and the results are contradictory. In addition, most studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in this journal club addresses these limitations by looking at data from both live and deceased births.

Conclusion A few studies have shown an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. Most studies have shown that there is a neutral, or slight negative effect. In the end an accurate risk-benefit analysis must be conducted in every instance.

It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent article published 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. In addition, a decrease in medication can affect the ability to do jobs and drive safely, which are important aspects of a normal life for many people with ADHD.

She suggests that women who are not sure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers, and acquaintances about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. It will also help a woman feel supported in her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Risk of Birth Defects

As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases as does the concern about the possible effects of the drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Using two massive data sets researchers were able analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects like ventriculoseptal defect.

The researchers of the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. The findings are in line with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk increased in the latter part of pregnancy when many women stopped taking 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 after delivery and a baby that required breathing assistance during birth. However the researchers of the study were not able to eliminate selection bias by restricting the study to women who didn't have other medical issues that could be a contributing factor to these findings.

Researchers hope that their study will provide doctors with information when they meet pregnant women. They recommend that, while a discussion of the risks and benefits is crucial, the decision to stop or maintain medication should be based on each woman's needs and the severity of her ADHD symptoms.

The authors also caution that, while stopping the medication is an option, 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 postpartum. Further, research shows that women who stop taking their medication will have a tough transitioning to life without them once the baby is born.

Nursing

The responsibilities of being a new mom can be overwhelming. Women suffering from ADHD may face a lot of challenges when they have to manage their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to a new routine. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medications is absorbed through breast milk in low amounts. However, the frequency of medication exposure to the infant can differ based on dosage, frequency it is administered and the time of the day the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn infant is not fully understood.

Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the possible risks to the fetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period.

A increasing number of studies have revealed that women can continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are choosing to do so. They have concluded, in consultation with their doctor, that the benefits of retaining their current medication far outweigh any risk.

Women with ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD recognize their symptoms and the root cause and learn about treatment options and reinforce existing coping strategies. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration and, if needed adjustments to the medication regimen.