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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There isn't much information on how long-term exposure to these medications may affect the foetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality studies. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians do not have the information needed to make unequivocal recommendations but they can provide information regarding benefits and risks that can aid pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was accurate and to eliminate any bias. The study conducted by the researchers was not without its limitations. Most important, they were not able to differentiate the effects of the medication from the effects of the disorder that is underlying. This makes it difficult to determine whether the small associations observed in the exposed groups result from medication use or confounding by comorbidities. Additionally the researchers did not examine the long-term effects of offspring on their parents. adhd depression medication revealed that babies whose mothers had taken ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) as compared to mothers who did not take any medication during pregnancy or had quit taking the medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be influenced by the stimulant medications were taken during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy. The research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them develop coping skills that can lessen the impact of her disorder in her daily functioning and her relationships. Interactions with Medication Doctors are increasingly faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. medications for adhd uk of the time, these decisions are made without any evidence that is clear and definitive regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what the research suggests about the subject and their own best judgment for each patient. In particular, the issue of potential risks for the infant can be difficult. A lot of studies on this subject are based on observations rather than controlled research, and their conclusions are often contradictory. The majority of studies focus on live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study presented in this journal club addresses these issues by looking at data from both live and deceased births. Conclusion Some studies have revealed an association between ADHD medications and certain birth defects, other studies have not established a link. Most studies show a neutral, or even slight negative effect. In all cases it is imperative to conduct a thorough analysis of the benefits and risks must be performed. It can be challenging, if not impossible for women with ADHD to stop taking their medication. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation, and family conflict for these patients. In addition, a decrease in medication may affect the ability to perform job-related tasks and drive safely, which are important aspects of daily life for many people with ADHD. She suggests women who are uncertain about whether or not to discontinue medication due to their pregnancy should consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. It can also help a woman feel more confident in her decision. It is also worth noting that certain drugs can be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be passed on to the baby. Risk of Birth Defects As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns over the impact that these drugs could have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Using two massive data sets researchers were able look at more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects. The authors of the study found no association between early medication use and other congenital abnormalities, like facial clefting, or club foot. The results are consistent with previous studies showing an increase, but not significant, in the risk of heart malformations among women who began taking ADHD medications prior to the time of pregnancy. This risk increased in the later part of pregnancy, as many women decide to stop taking their ADHD medication. Women who were taking ADHD medication during the first trimester were more likely need a caesarean or have an insufficient Apgar after delivery and have a baby who needed breathing assistance at birth. However, the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have other medical issues that could have contributed to the findings. Researchers hope that their study will inform physicians when they see pregnant women. They suggest that although discussing the risks and benefits is crucial but the decision to stop or keep medication must be based on each woman's needs and the severity of her ADHD symptoms. The authors also caution that while discontinuing the medications is an option, it is not an option to consider due to the high rate of depression and other mental health problems among women who are pregnant or who are recently postpartum. Additionally, the research suggests that women who decide to stop their medications are more likely to have difficulties adapting to life without them following the baby's arrival. Nursing The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and getting used to new routines at home may face a lot of challenges. As such, many women choose to continue taking their ADHD medications throughout pregnancy. The majority of stimulant medicines are absorbed by breast milk in small amounts, therefore the risk to nursing infant is very low. The amount of exposure to medications will vary based on the dosage, frequency of administration and the time of day. In addition, various medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn is not fully known. Due to the absence of evidence, some doctors may recommend stopping stimulant drugs during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risk to the embryo. As long as more information is available, doctors can inquire about pregnant patients if they have any background of ADHD or if they intend to take medication in the perinatal stage. A increasing number of studies have shown that most women can safely continue their ADHD medication while they are pregnant and nursing. As a result, more and more patients opt to do this and, after consulting with their doctor, they have discovered that the benefits of continuing their current medication outweigh any risks. It's important for women with ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also learn about treatment options and strengthen coping mechanisms. This should involve a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if needed, adjustments to the medication regime.