20 Myths About ADHD Medication Pregnancy: Dispelled
20 Myths About ADHD Medication Pregnancy: Dispelled
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data regarding how exposure over time may affect a pregnant fetus.
A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological disorders such as hearing or vision impairment seizures, 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 need to balance the benefits of taking them against the potential risks to the fetus. Physicians don't have the information needed to provide clear recommendations, but they can provide information on benefits and risks that can aid pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have a significantly increased risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large sample-based case control study to compare the incidence of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to ensure that the classification was accurate and to reduce any bias.
However, the study had its limitations. The researchers were unable in the beginning, 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 exposed were due to the use of medications or caused by co-morbidities. In addition the study did not look at the long-term outcomes of offspring.
The study found that infants whose mothers had taken ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or quit taking the medication prior to or during pregnancy. The reason for this was central nervous system-related disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, where they are able, assist them in developing strategies for improving their coping skills which can reduce the effects of her disorder on her daily functioning and relationships.
Medication Interactions
Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made in the absence of clear and authoritative evidence in either case, which means that doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests about the subject, along with their best judgment for each individual patient.
Particularly, the issue of potential risks for the baby can be tricky. A lot of studies on this topic are based on observations rather than controlled research and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study presented in the journal club addresses these limitations by analyzing both data on live and deceased births.
Conclusion: While some studies have shown an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown an unintended, or slight negative effect. In all cases, a careful study of the benefits and risks should be conducted.
It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation and family conflict for these patients. A decrease in medication could also affect the ability to drive safely and to perform work-related tasks which are crucial aspects of normal life for those with ADHD.
She recommends that women who are unsure about whether to keep or discontinue medication due to their pregnancy, consider the possibility of educating friends, family members, and coworkers on the condition, its impact on daily functioning, and on the advantages of staying on the current treatment plan. It can also aid in ensuring that the woman feels supported when she is struggling with her website decision. Certain medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her infant.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Using two massive data sets, researchers were able to look at more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect.
The researchers of the study found no link between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies revealing a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to pregnancy. This risk increased during the latter part of pregnancy, as many women decide to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely require a caesarean birth or have a low Apgar after delivery, and had a baby that required breathing assistance when they were born. The authors of the study could not remove bias in selection since they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.
Researchers hope that their research will help doctors when they meet pregnant women. The researchers recommend that while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements.
The authors also warn that while discontinuing the medications 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 are pregnant or postpartum. Research has also shown that women who stop taking their medication will have a harder adjustment to life without them after the baby is born.
Nursing
It can be overwhelming becoming a mother. Women suffering from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to new routines. As such, many women elect to continue taking their ADHD medication throughout the pregnancy.
The majority of stimulant medications pass through breast milk in small quantities, so the risk to the infant who is breastfeeding is low. However, the amount of exposure to medications by the newborn may differ based on the dosage, frequency it is taken and the time of the day the medication is administered. In addition, different medications enter the baby’s system through the gastrointestinal tract, or through breast milk. The effect on the health of a newborn isn't fully comprehended.
Because of the lack of evidence, some doctors may be inclined to discontinue stimulant drugs 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. As long as more information is available, GPs may ask pregnant patients if they have an background of ADHD or if they are planning to take medication during the perinatal stage.
Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner while breastfeeding and during pregnancy. In response, an increasing number of patients are choosing to do so. They have found, in consultation with their doctor that the benefits of keeping their current medication outweigh any possible risks.
Women who suffer from ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant people with ADHD be aware of their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing strategies for coping. This should be an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.