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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medication during pregnancy and breastfeeding is a challenge for women suffering from the condition. There aren't many studies on how long-term exposure may affect the foetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological disorders such as hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against the potential risks to the foetus. Physicians don't have the necessary data to make unequivocal recommendations but they can provide information about benefits and risks that can help pregnant women make informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy did not have a higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to examine the prevalence 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 confirm that the classification was correct and to eliminate any bias. However, the study was not without its flaws. Most important, they were unable to distinguish the effects of the medication from those of the disorder that is underlying. This makes it difficult to determine whether the small differences observed in the groups that were exposed result from medication use or the confounding effect 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 slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had taken off their medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not affected by the stimulant medication that was used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy. The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits for both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this and try to help them develop coping skills that could reduce the impact of her disorder in her daily life and relationships. Interactions with Medication As more women than ever are being diagnosed with ADHD and being treated with medication, the question of whether to keep or stop treatment during pregnancy is one that doctors are having to confront. These decisions are often taken without clear and authoritative evidence. Instead, physicians must take into account their own experience and experience, as well as the experiences of other physicians and the research on the topic. The issue of possible risks to the infant can be difficult to determine. Many of the studies on this issue are based on observational data rather than controlled research, and their findings are often contradictory. Most studies limit their analysis to live births, which can underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues, by examining both data on live and deceased births. Conclusion Some studies have shown an association between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show a neutral, or even slight negative impact. As a result an accurate risk-benefit analysis is required in every case. For a lot of women with ADHD, the decision to discontinue medication is difficult, if not impossible. In fact, in an article recently published in 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 patients with ADHD. A decrease in medication could also impact the ability to drive safely and perform work-related tasks, which are crucial aspects of everyday life for those suffering from ADHD. She recommends that women who are unsure about whether to continue or stop medication in light of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment plan. It can also help a woman feel confident about her decision. It is also worth noting that some medications 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. Birth Defects and Risk of As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the potential adverse effects of the drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Researchers utilized two massive datasets to analyze over 4.3 million pregnancies and determine if the use of stimulant medications caused birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects like ventriculoseptal defect. The researchers behind the study found no link between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in the same vein as previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter part of pregnancy, as many women decide to stop taking their ADHD medication. Women who took ADHD medications during the first trimester of pregnancy were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby who required breathing assistance during birth. The authors of the study could not eliminate selection bias because 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 research will help inform the clinical decisions of doctors who encounter pregnant women. The researchers recommend that while discussing the risks and benefits are important, the decision about whether to continue or stop medication should be made according to the severity of each woman's ADHD symptoms and the needs of the woman. The authors also warn that while discontinuing the medications is an option, it is not a recommended practice because of the high incidence of depression and other mental health issues in women who are pregnant or recently post-partum. Further, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them after the birth of their baby. Nursing It can be overwhelming to become a mother. Women suffering from ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout the course of pregnancy. The majority of stimulant drugs are absorbed through breast milk in small amounts, therefore the risk to nursing infant is very low. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and the time of day. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn is not well known. Some physicians may discontinue 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 advantages of continuing her medication against the risks to the foetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period. Many studies have shown that women can continue to take their ADHD medication safely while breastfeeding and during pregnancy. As a result, more and more patients are choosing to do so and, in consultation with their physician, they have discovered that the benefits of keeping their current medication outweigh any potential risks. Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. please click the next webpage should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and reinforce existing coping strategies. This should involve a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, and monitoring for signs of deterioration and the need for adjustments to the medication regimen.