Why People Don't Care About ADHD Medication Pregnancy
Why People Don't Care About ADHD Medication Pregnancy
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The choice of whether to stop or continue ADHD medications during pregnancy and nursing is a challenge for women suffering from the condition. There are few data on how long-term exposure may affect a fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication need to weigh the benefits of taking it against the possible risks for the fetus. Doctors don't have enough data to provide clear recommendations, but 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 in early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure 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 separate the effects caused by the medication from the disorder. That limitation makes it difficult to know whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. The researchers also did not examine long-term outcomes for offspring.
The study showed that infants whose mother took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not use any medication during pregnancy or had quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher chance of having an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy.
Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies may be offset by the greater benefits to both mother and baby from continuing treatment for the woman's disorder. Doctors should discuss with their patients about this and, if possible, help them improve coping skills which can lessen the effects of her disorder on her daily life and relationships.
Interactions with Medication
As more women than ever before are being diagnosed with ADHD and treated with medication, the dilemma of whether or not to end treatment during pregnancy is one that doctors are having to face. These decisions are frequently made without clear and authoritative evidence. Instead, physicians must consider their own expertise and experience, as well as the experiences of other doctors, and the research that has been conducted on the subject.
The issue of risk to infants is difficult to determine. Many of the studies on this subject are based on observational data instead of controlled research and their conclusions are often contradictory. Most studies focus on live-births, which could underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented in this journal club addresses these issues by analyzing data on live and deceased births.
The conclusion The conclusion: While certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, others have found no such relationship, and most studies show a neutral or even slightly negative impact. In every case, a careful evaluation of the benefits and risks is required.
For a lot of women with ADHD who suffer from ADHD, the decision to discontinue medication is difficult, if not impossible. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of isolation. The loss of medication can also affect the ability to safely drive and complete work-related tasks, which are crucial aspects of everyday life for people with ADHD.
She suggests that women who aren't sure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers and acquaintances about the condition, the effects on daily functioning, and the advantages of staying on the current treatment. In addition, educating them can aid in ensuring that the woman feels supported in her struggle with her decision. Some medications can pass through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be transferred to the baby.
Birth Defects Risk
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these drugs might have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. With two massive 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 remains low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increase in the risk of specific heart defects, such as ventriculoseptal defect (VSD).
The authors of the study did not find any association between early use of medication and other congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who began taking ADHD medication before the time of pregnancy. The risk increased in the latter half here of pregnancy when many women began to stop taking their medication.
Women who used ADHD medication in the first trimester of pregnancy were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. The authors of the study could not remove bias in selection since they limited the study to women who did not have any other medical conditions that might have contributed to the findings.
The researchers hope their study will aid in the clinical decisions of doctors who encounter pregnant women. The researchers recommend that while discussing benefits and risks are crucial, the decision on whether to continue or stop taking medication should be according to the severity of each woman's ADHD symptoms and the needs of the woman.
The authors also advise that, while stopping the medication is an alternative, it is not a recommended practice because of the high rate of depression and other mental health issues for women who are expecting or recently postpartum. Additionally, the research suggests that women who decide to stop their medications are more likely to experience a difficult time adjusting to life without them after the baby's arrival.
Nursing
It can be a stressful experience becoming a mother. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments as well as preparing for the arrival of their child and adapting to new routines in the home can experience severe challenges. As such, many women elect to continue taking their ADHD medications throughout the course of pregnancy.
The majority of stimulant medicines are absorbed by breast milk in low amounts, therefore the risk to infant who is breastfeeding is low. The amount of exposure to medications can vary depending upon the dosage and frequency of administration as well as the time of day. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn infant is not well understood.
Because of the lack of evidence, some doctors may be inclined to discontinue stimulant drugs during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the advantages of taking her medication as well as the potential risks to the fetus. Until more information becomes available, doctors can inquire about pregnant patients if they have a history of ADHD or if they are planning to take medication during the perinatal stage.
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 breastfeeding. In response, a growing number of patients are choosing to do this. They have discovered through consultation with their doctors that the benefits of retaining their current medication outweigh risk.
Women with ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD understand their symptoms and underlying disorder and learn about treatment options and strengthen existing coping strategies. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if needed modifications to the medication regime.