The Most Worst Nightmare Concerning ADHD Medication Pregnancy Relived
The Most Worst Nightmare Concerning ADHD Medication Pregnancy Relived
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medication during pregnancy and nursing is a challenge for women suffering from the condition. There aren't many studies regarding how exposure over time may affect the foetus.
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 research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medications need to balance the benefits of using them against the risks to the foetus. Physicians don't have the data needed to provide clear recommendations but they can provide information about benefits and risks that can assist pregnant women in making informed choices.
A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a large population-based study of case control to assess the frequency of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to confirm that the classification was accurate and to reduce any bias.
However, the researchers' study was not without its flaws. Most important, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to medication use or caused by the presence of comorbidities. Additionally the researchers did not study long-term offspring outcomes.
The study revealed that infants whose mothers took ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers did not take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a baby with a low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the greater benefit to both the mother and child of continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and as much as possible, assist them develop coping strategies that could reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or stop treatment during pregnancy is a question that more and more physicians face. The majority of these decisions are made without solid and reliable evidence either way, so physicians must weigh what they know, the experiences of other doctors, and what research says on the topic, along with their own best judgment for each individual patient.
The issue of possible risks to the infant can be difficult to determine. The research on this issue is based on observation rather than controlled studies, and a lot of the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues, by examining both information on deceased and live births.
The conclusion is that while some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies show a neutral or even slightly negative effect. In every case an in-depth study of the potential risks and benefits is required.
For women suffering from ADHD, the decision to discontinue medication can be difficult, if not impossible. In fact, in an article recently published in the 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 patients with ADHD. Furthermore, a loss of medication may affect the ability to do work-related tasks and safely drive, which are important aspects of a normal life for many people with ADHD.
She recommends that women who are unsure about whether or not to stop taking medication because of their pregnancy should consider educating family members, friends, and coworkers on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. It can also help women feel confident about her decision. Certain medications can be passed through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her baby.
Risk of Birth Defects
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about what impact the drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets researchers were able examine more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medications was associated with an increased risk of certain heart defects such as ventriculo-septal defect (VSD).
The researchers of the study could not discover any link between the use of early medications and other congenital anomalies, such as facial deformities or club feet. The results are in the same vein as 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 pregnancy. The risk increased in the latter half of pregnancy when a large number of women began to stop taking their medication.
Women who took ADHD medications during the first trimester of their pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance during birth. The researchers of the study were unable to eliminate selection bias because they restricted the study to women with no other medical conditions that might have contributed to the findings.
Researchers hope their research will inform physicians 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 in light of the severity of each woman's ADHD symptoms and her needs.
The authors caution that, although stopping the medication is an option to look into, it is not recommended due to the high rate depression and other mental disorders in women who are expecting or who have recently given birth. Research has also shown that women who stop taking their medication will have a tough time adjusting to a life without them once the baby is born.
Nursing
It can be a stressful experience to become a mom. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.
The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk in low amounts. However, the amount of exposure to medication by the infant can differ based on dosage, how often it is administered and at what time the medication is administered. In addition, various drugs enter the infant's system through the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't completely comprehended.
Because of the lack of evidence, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. This is a difficult decision for the patient, who must weigh the benefits of continuing her medication against the possible dangers to the foetus. As long as there is no more information, GPs should ask all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal period.
A growing number of studies have proven that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are choosing to do so. They have discovered through consultation with their physicians, that the benefits of keeping their current medication outweigh any risk.
Women with ADHD who are planning to nurse should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros here and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be offered to help pregnant people with ADHD be aware of their symptoms and the root cause Learn about the available treatment options and reinforce existing strategies for managing. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration and, if needed modifications to the medication regimen.