ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how exposure to ADHD for a long time could affect a fetus.

A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders such as hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and take ADHD medication should evaluate the benefits of using it against the potential risks for the fetus. Doctors don't have the necessary data to provide clear recommendations, but they can provide information regarding risks and benefits that aid pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was accurate and to minimize any bias.

The study of the researchers was not without limitations. In particular, they were not able to differentiate the effects of the medication from the underlying disorder. This makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to the use of medication or if they were affected by the presence of comorbidities. Researchers also did not look at long-term outcomes for offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or stopped their medications before or during pregnancy. The reason for this was 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 were taking stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continuing treatment for the woman's condition. Doctors should discuss with their patients about this and try to help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships.

Medication Interactions

Doctors are increasingly faced with thep taking medication because of their pregnancy should consider informing family members, friends and colleagues about the condition, its effects on daily functioning, and on the advantages of continuing the current treatment regimen. It can also help a woman feel confident about her decision. It is also worth noting that certain medications can pass through the placenta, so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be transferred to the infant.

Risk of Birth Defects

As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases as does the concern about the possible effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Researchers used two massive data sets to examine over the counter best adhd medication for adults with anxiety and depression medication for adults (discover here) 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect.

The researchers of the study found no connection between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of cardiac malformations among women who started taking ADHD medications before pregnancy. The risk grew during the latter part of pregnancy, when many women begin to discontinue their ADHD medication.

Women who used ADHD medications in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score after delivery and a baby that required help breathing at birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who didn't have any other medical issues that could have contributed to the findings.

The researchers hope that their research will help inform the clinical decisions of physicians who treat pregnant women. They advise that while discussing the benefits and risks is important, the decision to stop or maintain medication should be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also warn that even though stopping the medication is an option, it is not an option that is recommended due to the high rate of depression and other mental health problems among women who can prescribe adhd medication are pregnant or recently postpartum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to experience a difficult time adapting to life without them after the birth of their baby.

Nursing

The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and time of day. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isn't yet fully understood.

Because of the lack of research, some doctors might be tempted to stop taking stimulant drugs during a woman's pregnancy. This is a difficult choice for the patient, who must balance the benefit of continuing her medication against the potential risks to the fetus. In the meantime, until more information is available, GPs can inquire about pregnant patients whether they have any background of ADHD or if they are planning to take medication in the perinatal stage.

A increasing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. This has led to many patients choose to do so, and in consultation with their physician, they have discovered that the benefits of keeping their current medication far outweigh any potential risks.

It is crucial for women suffering from ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and over The counter adhd medication for adults the underlying disorder and learn about treatment options and strengthen existing strategies for coping. This should involve a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.