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ADHD Medication During Pregnancy and Breastfeeding

general-medical-council-logo.pngThe decision to stop or keep ADHD medication during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There are few data regarding how exposure over time may affect a pregnant fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications used to treat adhd must weigh the benefits of taking them against the potential risks to the fetus. Physicians don't have the data needed to provide clear recommendations, but they can provide information on benefits and risks that can assist pregnant women in making informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at higher risk of fetal malformations, or structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to make sure that the classification was accurate and to reduce any bias.

However, the researchers' study was not without its flaws. The researchers were not able to, in the first place to differentiate the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to medication use or affected by co-morbidities. Researchers also did not study the long-term effects for the offspring.

The study found that babies whose mothers took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who did not use any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be affected by the type of stimulant medications were taken during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a child with a low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.

The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies for improving their coping skills that may minimize the impact 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 issue of whether to continue or discontinue treatment during pregnancy is one that more and more physicians have to face. These decisions are usually made without clear and reliable evidence. Instead, doctors have to consider their own expertise, the experience of other physicians and the research on the subject.

The issue of potential risks for infants can be difficult to determine. A lot of studies on this subject are based on observational evidence rather than controlled research and their findings are often contradictory. In addition, most studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing both information on deceased and live births.

The conclusion: While some studies have found that there is a positive correlation between ADHD medications and the possibility of certain birth defects, others have found no connection and the majority of studies have a neutral or slightly negative effect. In every case an in-depth analysis of the risks and benefits is required.

For many women with ADHD who suffer from adhd medication adults uk, 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 cause depression and feelings of being isolated. In addition, a decrease in medication may affect the ability to do work-related tasks and safely drive, which are important aspects of a normal life for a lot of people with ADHD.

She recommends that women who are unsure about whether to continue or stop taking medication because of their pregnancy, consider informing family members, friends and colleagues on the condition, its impact on daily life, and the benefits of keeping the current treatment plan. It can also help women feel supported in her decision. Some medications can pass through the placenta. If a patient decides to stop taking her adhd medication adderall uk medication while pregnant and breastfeeding, it's important to be aware that the medication could be passed on to her baby.

Birth Defects and Risk of

As the use and abuse of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (safest adhd medication), increases the concern over the potential effects of these drugs on fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine if stimulant medication use increased the risk of birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).

The authors of the study found no link between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies that showed a small, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the time of pregnancy. The risk increased in the latter half of pregnancy, when a lot of women decided to stop taking their medication.

Women who took ADHD medication in the first trimester were more likely require a caesarean birth and also have an insufficient Apgar after birth and had a baby that required help breathing at birth. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who didn't have any other medical conditions that could have contributed to the findings.

Researchers hope their research will inform physicians when they encounter pregnant women. They recommend that, while discussing the risks and benefits is crucial, the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors warn that, while stopping the medication is an option to look into, it is not recommended due to the high rate depression and other mental disorders for women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medications will have a difficult adjustment to life without them once the baby is born.

Nursing

It can be overwhelming to become a mother. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. Therefore, many women elect to continue taking their ADHD medication throughout the pregnancy.

The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the rate of exposure to medication by the newborn may differ based on the dosage, frequency it is taken and the time of day the medication is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not fully understood.

Due to the absence of research, some physicians may recommend stopping stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefits of keeping her medication against the potential risks to the foetus. As long as there is no more information, doctors should ask all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal time.

Numerous studies have demonstrated that women can continue taking their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, an increasing number of patients are opting to do so. They have concluded through consultation with their physicians that the benefits of retaining their current medication outweigh potential risks.

Women with ADHD who are planning to nurse should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help women with adhd sleep medication (http://rutelochki.ru) be aware of their symptoms and the root cause, learn about available treatments and to reinforce existing coping strategies. This should be a multidisciplinary process with the GPs, obstetricians, and psychiatry. The pregnancy counselling should consist of the discussion of a plan for management for both the mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.

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