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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. There are few data on how long-term exposure 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 such as hearing loss or vision, 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 medications need to balance the benefits of using them against the risks to the foetus. Doctors don't have enough data to give clear advice but they can provide information on risks and benefits to assist pregnant women to make informed choices. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations, or structural birth defects. Researchers conducted a massive population-based case control study to assess the frequency of major structural defects in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to minimize the chance of bias. However, the study had its limitations. The most important issue was that they were not able to differentiate the effects of the medication from the disorder that is underlying. This limitation makes it difficult for researchers to establish whether the few associations observed between the groups exposed were due to the use of medication or if they were affected by comorbidities. Additionally the study did not examine the long-term effects of offspring on their parents. The study did show that infants whose mothers had taken ADHD medication during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did appear to be independent of the type of medication taken during pregnancy. Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages can be offset by greater benefits for mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, if they are able, assist them in developing strategies to improve coping skills that may minimize the effects of her disorder on her daily functioning and relationships. Medication Interactions As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or discontinue treatment during pregnancy is one that doctors are having to face. Often, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests on the subject, along with their best judgment for each patient. In particular, the issue of potential risks to the infant can be difficult. The research on this issue is based on observation instead of controlled studies and many of the findings are in conflict. Furthermore, most studies restrict their analysis to live births, which may underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study presented in the journal club addresses these shortcomings by analyzing information on deceased and live births. Conclusion A few studies have revealed an association between ADHD medications and certain birth defects However, other studies haven't found a correlation. The majority of studies show an unintended, or somewhat negative, impact. In all cases, a careful evaluation of the potential risks and benefits is required. click here! can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. 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 lead to depression and feelings of loneliness. A decrease in medication could also impact the ability to drive safely and to perform work-related tasks which are vital aspects of daily life for those with ADHD. She suggests that women who aren't sure whether to take the medication or stop it due to their pregnancy educate family members, coworkers, and their friends about the condition, its effects on daily functioning, and the benefits of keeping the current treatment regimen. It can also help a woman feel confident about her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it's important to be aware that the medication may be transferred to her baby. Birth Defects and Risk of As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases, so does concern about the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers used two huge data sets to study over 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect. The authors of the study found no connection between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in agreement with previous studies which showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter half of pregnancy when many women decided to stop taking their medication. Women who used ADHD medications during the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance at birth. However the researchers of the study were unable to eliminate selection bias by restricting the study to women who did not have any other medical issues that could have contributed to these findings. The researchers hope their study will serve to inform the clinical decisions of doctors who encounter pregnant women. They suggest that although discussing the risks and benefits is crucial however, the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms. The authors caution that, although stopping the medication is an option to consider, it is not advised due to the high prevalence of depression and other mental disorders among women who are pregnant or recently gave birth. Furthermore, adhd medications for adults suggests that women who choose to stop taking their medication are more likely to experience difficulties adapting to life without them following the birth of their baby. Nursing The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. As such, many women elect to continue taking their ADHD medication throughout the pregnancy. The majority of stimulant drugs are absorbed through breast milk in low amounts, therefore the risk to breastfeeding infant is minimal. The rate of exposure to medication will differ based on dosage the medication is administered, its frequency and time of day. In addition, different medications are introduced into the baby's system via the gastrointestinal tract or through breast milk. The impact of these medications on the health of a newborn is not completely known. Because of the lack of research, some doctors may recommend stopping stimulant medication during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the benefits of her medication against the risk to the fetus. In the meantime, until more information is available, doctors may inquire about pregnant patients whether they have an history of ADHD or if they intend to take medication in the perinatal period. Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In the end, many patients opt to do this and, in consultation with their physician, they have discovered that the benefits of continuing their current medication far outweigh any risks. Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and build coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if needed adjustments to the medication regime.