The Biggest “Myths” About ADHD Medication Pregnancy May Actually Be Right

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 isn't much information on how long-term exposure to these medications may affect the fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are needed. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have enough data to provide clear recommendations however they can provide information about risks and benefits to help pregnant women make informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy, as well as those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure accurate case classification and to minimize the possibility of bias. The study conducted by the researchers was not without its limitations. Researchers were unable to, in the first place, to separate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small differences observed between the groups that were exposed to medication use or confounded by comorbidities. The researchers also did not examine long-term outcomes for the offspring. The study showed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications 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 one whose baby scored low on the Apgar scale (less than 7). adhd anxiety medication appear to be unrelated to the type of medication used during pregnancy. The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit to both mother and child from continued treatment for the woman's condition. Physicians should speak with their patients about this and, if possible, help them improve coping skills which could reduce the effects of her disorder on her daily life and relationships. Medication Interactions Doctors are increasingly faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made without clear and authoritative evidence either way, so physicians have to weigh their experience about their experiences, the experiences of other doctors, and what research says on the topic as well as their own judgments for each patient. adhd medication online of risk to infants is extremely difficult. The research on this subject is based on observations rather than controlled studies and many of the findings are conflicting. Most studies restrict their analysis to live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in this journal club addresses these limitations by looking at data from both live and deceased births. Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown that there is a neutral, or somewhat negative, effect. Therefore an accurate risk-benefit analysis is required in every situation. For a lot of women with 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 lead to depression and feelings of loneliness. The loss of medication can also impact the ability to safely drive and perform work-related tasks, which are vital aspects of daily life for people with ADHD. She recommends women who are unsure about whether to keep or stop medication in light of their pregnancy consider informing family members, friends and colleagues about the condition, its effects on daily life, and the advantages of continuing the current treatment plan. It can also aid in ensuring that the woman feels supported in her struggle with her decision. Some medications can pass through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the drug may be transferred to her infant. Birth Defects Risk As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Using two massive data sets researchers were able analyze more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medications was linked to an increased risk of specific heart defects, such as ventriculoseptal defect (VSD). The authors of the study could not find any association between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in agreement with previous studies that have shown a small, but significant increase in the number of cardiac malformations among women who started taking ADHD medication prior to pregnancy. The risk grew during the latter part of pregnancy, when many women are forced to stop taking their ADHD medication. Women who were taking ADHD medication during the first trimester were more likely to require a caesarean delivery and also have an insufficient Apgar after delivery, and have a baby that needed breathing assistance when they were born. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could have contributed to these findings. The researchers hope their research will help inform the clinical decisions of physicians who treat pregnant women. The researchers recommend that while discussing risks and benefits are important, the decision on whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her needs. The authors warn that, while stopping the medication is an option to think about, it isn't advised due to the high prevalence of depression and mental health issues among women who are pregnant or who have recently given birth. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have difficulties adjusting to life without them following the baby's arrival. Nursing The responsibilities of being a new mom can be overwhelming. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments as well as preparing for the arrival of a baby and adapting to new routines in the home can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy. The risk to a breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk in low amounts. The rate of medication exposure will vary based on the dosage and frequency of administration as well as the time of day. In addition, different medications enter the baby’s system via the gastrointestinal tract or through breast milk. The impact on the health of a newborn is not fully understood. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult decision for the woman who must weigh the advantages of continuing her medication against the potential risks to the foetus. Until more information becomes available, GPs may ask pregnant patients whether they have a history of ADHD or if they intend to take medication in the perinatal period. Many studies have shown that women can continue to take their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, a rising number of patients are choosing to do this. They have concluded through consultation with their doctors, that the benefits of keeping their current medication outweigh any potential risks. Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and reinforce the coping mechanisms. This should be an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, and monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.