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Blog entry by Norberto Canela

The Most Profound Problems In ADHD Medication Pregnancy

The Most Profound Problems In ADHD Medication Pregnancy

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. There aren't enough data on how long-term exposure may affect the foetus.

top-doctors-logo.pngA recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies.

Risk/Benefit Analysis

Pregnant women who prescribes adhd medication take ADHD medications need to balance the advantages of using them against the risks to the foetus. The doctors don't have the information to provide clear recommendations but they can provide information on the risks and benefits to assist pregnant women to make an informed decision.

A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face an higher risk of fetal cardiac malformations or major structural birth defects. Researchers used a large population-based study of case control to assess the frequency of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was correct and to reduce any bias.

human-givens-institute-logo.pngThe research conducted by the researchers had some limitations. In particular, they were unable to distinguish the effects of the medication from those of the underlying disorder. This limitation makes it difficult for researchers to determine if the small differences observed between the groups that were exposed to the use of medications, or if they were affected by comorbidities. Additionally the researchers did not examine long-term offspring outcomes.

The study found that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy or stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy.

Women who took stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean delivery or having a child with a low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy.

The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit to both mother and child of continuing 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 that may minimize the impact of her disorder on her daily functioning and relationships.

Medication Interactions

More and more doctors are confronted with the dilemma of whether to maintain treatment or stop during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made without solid and reliable evidence in either case, which means that 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 individual patient.

Particularly, the subject of possible risks to the baby can be tricky. Many studies on this issue are based on observational data instead of controlled research and their findings are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study that is discussed in the journal club addresses these shortcomings, by examining both the data from deceased and live births.

Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies show an unintended, or somewhat negative, impact. In the end an accurate risk-benefit analysis is required in every instance.

It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published in the Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping adhd medication making it worse (why not try these out) medication during pregnancy can lead to increased depression, feelings of loneliness and family conflict for those suffering from the disorder. A loss of medication may also affect the ability to safely drive and complete work-related tasks, which are crucial aspects of normal life for people with ADHD.

She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy, educate their family members, colleagues, and friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also help a woman feel supported in her decision. Certain medications can be passed through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is important to be aware that the drug may be transferred to her baby.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the medications could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Utilizing two huge data sets researchers were able to examine more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects like ventriculo-septal defects (VSD).

The researchers of the study found no link between the use of early medications and other congenital abnormalities, like facial clefting, or club foot. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the birth of their child. The risk increased in the latter part of pregnancy when many women stopped taking their medication.

Women who used non prescription adhd medication for adults medication in the first trimester of their pregnancies were also more likely to undergo a caesarean section, a low Apgar score following delivery, and a baby that required breathing assistance during birth. The authors of the study were not able to remove bias in selection since they limited the study to women with no other medical conditions that could have contributed to the findings.

The researchers hope their research will aid in the clinical decisions of physicians who see pregnant women. The researchers suggest that, while discussing benefits and risks are important, the decision regarding whether or not to stop medication should be in light of the severity of each woman's ADHD symptoms and the needs of the woman.

The authors also warn that, while stopping the medication is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health issues among women who are pregnant or recently post-partum. Research has also shown that women who stop taking their medication will have a tough time adjusting to a life without them after the baby is born.

Nursing

The responsibilities that come with being a new mother can be overwhelming. Women with adhd medication intuniv can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to new routines. This is why many women choose to continue taking their ADHD medication throughout the pregnancy.

The risk to breastfeeding infant is not too high since the majority of non stimulant adhd medication uk medications passes through breast milk in low amounts. However, the frequency of exposure to medication by the infant can differ based on dosage, frequency it is administered, and at what time the medication is administered. In addition, various drugs enter the infant's system via the gastrointestinal tract or breast milk. The effect on the health of a newborn isn't completely comprehended.

Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the possible risks to the foetus. Until more information is available, GPs should ask all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal time.

A growing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a growing number of patients are choosing to do so. They have discovered, in consultation with their doctors that the benefits of keeping their current medication outweigh any possible risks.

Women with ADHD who are planning to nurse should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber as well as the pros and cons for continuing treatment. This includes non prescription adhd medication uk-pharmacological methods. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatment options and strengthen existing coping strategies. This should involve a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.

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