Why No One Cares About ADHD Medication Pregnancy
Why No One Cares About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and nursing is challenging for women with the condition. Little data exists about how long-term exposure to these drugs can affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies.
Risk/Benefit Analysis
Pregnant women who use ADHD medications must weigh the advantages of taking them against potential risks to the foetus. Doctors don't have enough data to provide clear recommendations but they can provide information on risks and benefits to help pregnant women make informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers conducted a massive population-based study of case control to assess the frequency of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to ensure that the classification was accurate and to reduce any bias.
However, the researchers' study had its limitations. The researchers were not able in the beginning to differentiate the effects of the medication from the disorder. This makes it difficult to know whether the limited associations observed in the exposed groups result from medication use or comorbidities that cause confusion. Additionally the study did not study long-term offspring outcomes.
The study showed that infants whose mother took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This was due to central nervous system disorders. The increased 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 risk of having a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These risks did not seem to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, help them develop strategies to improve coping skills that can lessen the negative impact of her condition on her daily functioning and relationships.
Medication Interactions
Many doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. Often, these decisions are made without solid and reliable evidence regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what the research suggests on the subject and their own best judgment for each patient.
Particularly, the issue of potential risks for the baby can be tricky. The research on this issue is based on observations rather than controlled studies and a lot of the results are in conflict. Additionally, the majority of studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these shortcomings by analyzing data on live and deceased births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies show that there is a neutral, or slightly negative, effect. In all cases an in-depth evaluation of the risks and benefits is required.
For a lot of women with ADHD and ADD, the decision to stop taking medication is difficult, if not impossible. In a recent piece 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 being isolated. A decrease in medication could also impact the ability to safely drive and perform work-related tasks, which are crucial aspects of normal life for those with ADHD.
She suggests that women who are unsure whether to continue taking the medication or stop it due to their pregnancy should educate family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Some medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug get more info may be transferred to her infant.
Risk of Birth Defects
As the use and misuse of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases as does the concern about the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies to determine whether the use of 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 risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study didn't discover any connection between early medication usage and other congenital anomalies like facial deformities, or club feet. The results are in agreement with previous studies that showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. The risk increased in the latter half of pregnancy, when a lot of women decided to stop taking their medication.
Women who used ADHD medications in the first trimester of pregnancy were also more likely to have a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance during birth. However, the authors of the study were unable to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could be a contributing factor to these findings.
The researchers hope their study will serve to inform the clinical decisions of doctors who see pregnant women. They advise that while a discussion of the risks and benefits is crucial however, the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also advise that while discontinuing the medications is an option, it is not a recommended practice because of the high prevalence of depression and other mental health issues in women who are pregnant or who are recently postpartum. Further, the research suggests that women who choose to stop taking their medication are more likely to have a difficult time getting used to life without them after the birth of their baby.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women with ADHD who have to deal with their symptoms while attending physician appointments and getting ready for the arrival of a baby and adapting to new routines in the home may face a lot of challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medications are absorbed through breast milk in very small amounts, so the risk for nursing infant is very low. The rate of exposure to medication will differ based on dosage and frequency of administration as well as time of day. Additionally, 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 comprehended.
Due to the absence of research, some physicians may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication against the possible dangers to the foetus. In the meantime, until more information is available, doctors can inquire about pregnant patients whether they have an history of ADHD or if they plan to take medication during the perinatal stage.
A increasing number of studies have revealed that women can continue their ADHD medication during pregnancy and while breastfeeding. In the end, more and more patients opt to do this and after consulting with their doctor, they have discovered that the benefits of maintaining their current medication exceed any risk.
It's important for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also required to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also be informed about treatment options and reinforce coping mechanisms. This should involve an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother and child, as well as monitoring for signs of deterioration and the need for adjustments to the medication regimen.