"Ask Me Anything": Ten Answers To Your Questions About ADHD Medication Pregnancy
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There aren't enough data on how long-term exposure may affect a pregnant fetus.
A recent study 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 the need for higher-quality research.
Risk/Benefit Analysis
Pregnant women who use ADHD medications need to balance the advantages of using them against the risks to the fetus. Doctors don't have the data needed to give clear guidelines, but they can provide information on risks and benefits that help pregnant women make informed decisions.
A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a massive population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct classification of the cases and to reduce the possibility of bias.
However, the study was not without its flaws. The researchers were unable in the beginning to distinguish the effects caused by the medication from the disorder. This makes it difficult to know whether the limited associations observed in the groups that were exposed are due to medication use or comorbidities that cause confusion. The researchers also did not examine long-term outcomes for offspring.
The study did find that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had taken off their 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 medications during pregnancy also had a higher chance of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication 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. Doctors should discuss with their patients about this issue and as much as possible, assist them develop coping strategies that could reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are taken in the absence of clear and authoritative evidence regardless, so doctors must weigh what they know, the experiences of other doctors, and what research suggests about the subject, along with their own best adhd medication for adults judgment for each patient.
Particularly, the issue of possible risks to the infant can be difficult. The research on this subject is based on observations rather than controlled studies, and many of the findings are contradictory. The majority of studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study discussed in this journal club addresses these issues by analyzing data on live and deceased births.
Conclusion A few studies have shown an association between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies have shown an unintended, or slight negative impact. In every case, a careful evaluation of the benefits and risks is required.
It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping adhd medication not working medications during pregnancy can lead to depression and feelings of being isolated. Additionally, the loss of medication may affect the ability to complete jobs and drive safely which are essential aspects of a normal life for many people suffering from ADHD.
She suggests that women who are not sure whether to take the medication or stop it due to their pregnancy, educate their family members, coworkers and acquaintances about the condition, its effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. It is important to note that certain medications can i get adhd medication without a diagnosis be absorbed through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug could be transferred to the infant.
Risk of Birth Defects
As the use and misuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. 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 to examine more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.
The researchers behind the study found no link between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are consistent with previous studies revealing the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of pregnancy. The risk grew in the latter half of pregnancy, as many women begin to discontinue their ADHD medications.
Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth, have an insufficient Apgar after delivery and have a baby who needed breathing assistance at birth. The researchers of the study could not eliminate bias due to selection because they limited the study to women without other medical conditions that might have contributed to the findings.
Researchers hope that their study will inform physicians when they meet pregnant women. The researchers suggest that while discussing risks and benefits are important, the choice on whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and her requirements.
The authors also warn that while discontinuing the medications is an option, it isn't an option that is recommended due to the high incidence of depression and other mental health issues among women who are pregnant or postpartum. Further, the research suggests that women who decide to stop their medications are more likely to experience difficulties getting used to life without them following the birth of their baby.
Nursing
It can be a challenge to become a mom. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to new routines. Many women decide to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a Low Estrogen And Adhd Medication level. The amount of exposure to medications will differ based on dosage the medication is administered, its frequency and time of day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn infant is not well known.
Because of the lack of research, some physicians may be inclined to discontinue stimulant drugs during a woman's pregnancy. It's a difficult choice for the mother, who must weigh the benefits of her medication against the risk to the embryo. In the meantime, until more information is available, GPs may inquire about pregnant patients whether they have a background of ADHD or if they plan to take medication in the perinatal period.
Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, a growing number of patients are choosing to do so. They have concluded after consulting with their doctors, that the benefits of continuing their current medication outweigh any risk.
Women who suffer from ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD be aware of their symptoms and the root cause, learn about available treatment options and reinforce existing strategies for coping. This should involve a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, and monitoring for signs of deterioration, and, if needed adjustments to the medication regimen.