10 Things You Learned In Kindergarden Which Will Aid You In Obtaining ADHD Medication Pregnancy
10 Things You Learned In Kindergarden Which Will Aid You In Obtaining ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There is a lack of information about how long-term exposure to these drugs can affect the foetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders like hearing or vision impairment, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are needed.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication need to consider the benefits of taking it against the potential risks to the foetus. Physicians do not have the necessary data to provide clear recommendations however they can provide information on the risks and benefits to help pregnant women make 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 conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants in the early stages of pregnancy, as well as those who had not. Pediatric cardiologists, clinical geneticists and other experts looked over the cases to confirm that the classification was accurate and to reduce any bias.
However, the study had its limitations. The researchers were not able to, in the first place to distinguish the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small associations observed among the groups that were exposed to the use of medications, or if they were confounded by co-morbidities. Additionally the study did not look at the long-term effects of offspring on their parents.
The study revealed that infants whose mothers took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not take 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 for admission was not found to be affected by the type of stimulant medications were taken during pregnancy.
Women who took stimulant ADHD medication during pregnancy also had an increased chance of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy.
Researchers suggest that the minor risk of using ADHD medications in early pregnancies could be offset by the greater benefits for baby and mother of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills which can reduce the effects of her disorder on her daily functioning and relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether or not to end treatment during pregnancy is a question that more and more physicians have to face. Most of the time, these decisions are made in the absence of solid and reliable 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 on the subject and their own judgments for each patient.
Particularly, the issue of potential risks to the baby can be tricky. The research on this subject is based on observations rather than controlled studies and many of the findings are conflicting. Additionally, the majority of studies limit their analysis to live births, which may underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in this journal club addresses these issues by examining data on both live and deceased births.
The conclusion: While some studies have shown a positive association between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies show a neutral or even slightly negative impact. As a result, a careful risk/benefit assessment must be done in each case.
For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In an article published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for these patients. The loss of medication can also affect the ability to drive safely and to perform work-related tasks which are essential aspects of daily life for those with ADHD.
She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy educate family members, colleagues, and friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment. It can also help women feel confident about her decision. Some medications can pass through the placenta. If a woman decides not to take her ADHD medication while breastfeeding, it is crucial to be aware that the drug may be transferred to her baby.
Birth Defects and Risk of
As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the potential effects of these drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Utilizing two huge 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. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD).
The researchers of the study found no link between early medication use and other congenital anomalies, 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 the birth of their child. This risk increased during the latter part of pregnancy, as many women are forced to stop taking their ADHD medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery and also have an insufficient Apgar after birth and have a baby that needed help breathing at birth. The researchers of the study were not able to eliminate bias due to selection because they limited the study to women with no other medical conditions that could have contributed to the findings.
The researchers hope their research will help inform the clinical decisions of doctors who see pregnant women. They suggest that although a discussion of the benefits and risks is important however, the decision to stop or maintain medication should be based on each woman's needs and the severity of her ADHD symptoms.
The authors warn that, while stopping the medication is an option to consider, it is not advised due to the high rate depression and mental health issues among women who are pregnant or recently gave birth. Research has also shown that women who stop taking their medication will have a difficult time adjusting to a life without them once the baby is born.
Nursing
It can be a stressful experience becoming a mother. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments as well as making preparations for the arrival of a baby and adjusting to new household routines can experience severe challenges. Therefore, many women decide to continue taking their ADHD medications throughout the course of pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and the time of day. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not fully understood.
Because of the lack of evidence, some doctors may be inclined to discontinue stimulant medications during the get more info course of pregnancy. This is a difficult decision for the mother, who must weigh the advantages of her medication against the potential risks to the foetus. In the meantime, until more information is available, doctors may inquire about pregnant patients if they have an history of ADHD or if they are planning to take medication in the perinatal phase.
A increasing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are choosing to continue their medication. They have concluded through consultation with their physicians, that the benefits of continuing their current medication far outweigh any risk.
Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of their symptoms and underlying disorder and learn about treatment options and reinforce existing strategies for coping. This should involve a multidisciplinary approach with 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, if necessary, adjustments to the medication regimen.