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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breast-feeding. There isn't much information on how long-term exposure to these medications may affect the fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies. Risk/Benefit Analysis Women who are expecting and taking ADHD medication must weigh the benefits of taking it against the potential dangers for the fetus. The doctors don't have the information to give clear advice however they can provide information about risks and benefits to help pregnant women make informed choices. A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate case classification and to limit the possibility of bias. However, the researchers' study had its limitations. In particular, they were not able to differentiate the effects of the medication from the effects of the disorder that is underlying. This makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medications or confounded by co-morbidities. Additionally the study did not study long-term offspring outcomes. The study revealed that infants whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy or had stopped taking their medication before or during pregnancy. This was due to central nervous system-related disorders and the increased risk of admission was not found to be influenced by the stimulant medications were used during pregnancy. Women who were taking stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases did not seem to be influenced by the type of medication that was used during pregnancy. Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the more beneficial outcomes for both baby and mother of continued treatment for the woman’s disorder. Doctors should discuss with their patients about this and as much as possible, assist them develop coping strategies that can lessen the effects 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 discontinue treatment during pregnancy is a question that more and more doctors have to face. These decisions are usually made without clear and reliable evidence. Instead, physicians must consider their own expertise in conjunction with the experiences of other doctors, and the research that has been conducted on the subject. In particular, the issue of potential risks for the infant can be difficult. The research on this issue is based on observations instead of controlled studies and a lot of the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations by analyzing both data on live and deceased births. Conclusion A few studies have shown an association between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show an unintended, or somewhat negative, effect. In each case, a careful evaluation of the potential risks and benefits should be conducted. For many women with ADHD who suffer from ADHD, the decision to stop taking medication can be difficult, if not impossible. 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 increase depression and feelings of being isolated. A decrease in medication could also affect the ability to safely drive and perform work-related tasks, which are essential aspects of everyday life for those suffering from ADHD. She recommends women who are uncertain about whether to continue or discontinue medication due to their pregnancy should consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. Educating them can also help the woman feel supported when she is struggling with her decision. It is important to remember that certain drugs can pass through the placenta, therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can be transferred to the infant. Risk of Birth Defects As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets researchers were able analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication exposure was associated with slightly higher rates of certain heart defects, such as ventriculoseptal defect. The authors of the study could not discover any connection between early medication usage and other congenital anomalies, like facial deformities, or club feet. The results are consistent with previous studies that have shown an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications before the birth of their child. The risk was higher in the later part of pregnancy, when many women decide to stop taking their medication. Women who used ADHD medications in the first trimester of pregnancy were also more likely to experience caesarean section, low Apgar score following delivery, and a baby who needed breathing assistance at birth. The authors of the study were unable to eliminate bias due to selection because they limited their study to women who did not have any other medical conditions that could have contributed to the findings. The researchers hope their study will help inform the clinical decisions of doctors who treat pregnant women. The researchers suggest that, while discussing the risks and benefits are important, the choice on whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and her needs. adhd anxiety medication warn that, while stopping the medication is an alternative, 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 who are recently post-partum. Furthermore, research suggests that women who choose to stop taking their medications are more likely to experience difficulties getting used to life without them after the birth of their baby. Nursing The responsibilities of a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments as well as getting ready for the arrival of their child and adjusting to new household routines can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy. The risk to a breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the rate of exposure to medication by the infant can differ based on dosage, how often it is taken and at what time the medication is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not well known. Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the risks to the embryo. In the meantime, until more information is available, GPs should ask all pregnant patients about their history of ADHD and whether they are taking or planning to take medication during the perinatal period. A growing number of studies have shown that most women can safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are opting to do this. adhd medication for adults uk have concluded after consulting with their doctors, that the benefits of retaining their current medication outweigh risk. Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for managing. This should include an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if needed, adjustments to the medication regimen.