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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There aren't many studies on how long-term exposure may affect a pregnant fetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological disorders such as hearing or vision impairment seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against potential risks to the fetus. Doctors don't have the information needed to give clear guidelines 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 were taking ADHD medication during their early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case control study to assess the frequency of major structural defects in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to make sure that the classification was correct and to minimize any bias. However, the study was not without its flaws. Researchers were unable in the beginning to distinguish the effects of the medication from the disorder. This limitation makes it difficult for researchers to establish whether the small associations observed among the exposed groups were due to the use of medication or if they were caused by the presence of comorbidities. The researchers also did not examine long-term outcomes for offspring. The study did reveal that infants whose mothers took ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system-related disorders and the increased risk for admission was not found to be influenced by which stimulant medications were used during pregnancy. medication adhd adults who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean delivery or having a baby born with an low Apgar score (less than 7). These increases appeared to be independent of the type of medication used during pregnancy. Researchers suggest that the minor risk of using ADHD medications in early pregnancies can be offset by more beneficial outcomes for both mother and baby of continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies to improve coping skills which can reduce the impact of her disorder on her daily life and relationships. Interactions with Medication As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether to keep or stop treatment during pregnancy is one that more and more doctors face. The majority of these decisions are made in the absence of solid and reliable evidence in either case, which means that doctors have to weigh their experience from their own experiences, those of other doctors, and what research suggests about the subject as well as their own judgments for each individual patient. In particular, the issue of potential risks for the infant can be difficult. Many of the studies on this issue are based on observational data rather than controlled research, and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in this journal club addresses these shortcomings by analyzing data on live and deceased births. The conclusion is that while some studies have shown a positive association between ADHD medications and the risk of certain birth defects, others have found no such relationship, and most studies demonstrate a neutral or slight negative effect. In the end, a careful risk/benefit analysis must be done in each situation. For many women with 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. In addition, a decrease in medication can affect the ability to do work-related tasks and safely drive that are crucial aspects of a normal life for a lot of people with ADHD. She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy educate family members, coworkers and friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment regimen. In addition, educating them can help the woman feel supported when she is struggling with her decision. It is also worth noting that certain medications are able to be absorbed through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby. Birth Defects Risk As the use and use of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Using two massive data sets researchers were able look at more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect. The researchers behind the study found no association between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are in the same vein as previous studies that showed the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. The risk was higher in the latter half of pregnancy, as many women are forced to stop taking their ADHD medication. Women who used ADHD medications in the first trimester of their pregnancies were also more likely to experience a caesarean section, a low Apgar score after delivery and a baby who needed breathing assistance during birth. However the researchers of the study were unable to eliminate selection bias by limiting the study to women who did not have other medical issues that could have contributed to the findings. Researchers hope their research will provide doctors with information when they see pregnant women. They recommend that, while a discussion of the risks and benefits is crucial but the decision to stop or continue medication must be based on each woman's requirements and the severity of her ADHD symptoms. The authors also advise that even though stopping the medication is an option, it is not an option to consider due to the high incidence of depression and other mental health problems in women who are pregnant or recently post-partum. Furthermore, research suggests that women who decide to stop their medications are more likely to have difficulties adjusting to life without them after the baby's arrival. Nursing It can be a stressful experience to become a mom. Women with ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy. The majority of stimulant medications are absorbed by breast milk in very small quantities, so the risk to the breastfeeding infant is minimal. However, the frequency of exposure to medications by the newborn may differ based on dosage, how often it is administered, and the time of day it is administered. In addition, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn isn't completely understood. Due to the absence of research, some doctors may be inclined to discontinue stimulant medication during a woman's pregnancy. This is a difficult decision for the woman, who must weigh the advantages of her medication against the risks to the embryo. Until more information becomes available, GPs can inquire about pregnant patients if they have an background of ADHD or if they plan to take medication during the perinatal period. Many studies have shown that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. As a result, more and more patients are choosing to do so and after consulting with their doctor, they have found that the benefits of maintaining their current medication far outweigh any risks. Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological strategies. medication for adhd adults is also necessary to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also learn about treatment options and reinforce the coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatrists. Pregnancy counselling should include the discussion of a plan for management for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.