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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medication during pregnancy and nursing is a difficult decision for women suffering from the condition. Little data exists about how long-term exposure to these medications can affect the fetus. A recent study 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 that more high-quality studies are required. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications need to balance the benefits of taking them against the potential risks to the foetus. Doctors don't have enough data to make unambiguous recommendations however they can provide information about risks and benefits to help pregnant women make 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. The researchers used 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 early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was accurate and to eliminate any bias. However, the study was not without its flaws. The researchers were unable to, in the first place to differentiate the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medication or if they were confounded by the presence of comorbidities. In addition, the researchers did not look at long-term offspring outcomes. The study did find that babies whose mothers had taken ADHD medications during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or stopped their medications before or during pregnancy. This increase was due to central nervous system-related disorders, and the increased risk of admission did not appear to be influenced by the stimulant medication was used during pregnancy. Women who used stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean delivery or having a child with an low Apgar score (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy. Researchers suggest that the minor risks associated with the use ADHD medications during early pregnancies can be offset by greater benefits for mother and baby of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily functioning and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether to continue or end treatment during pregnancy is a question that more and more physicians have to face. These decisions are usually made without clear and authoritative evidence. Instead, doctors have to consider their own expertise and experience, as well as the experiences of other physicians and the research on the subject. Suggested Looking at of risk for infants can be extremely difficult. The research on this subject is based on observations rather than controlled studies and a lot of the results are contradictory. The majority of studies focus on live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these shortcomings by analyzing both information on deceased and live births. The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, other studies have found no such relationship and the majority of studies have a neutral or slightly negative effect. In all cases, a careful analysis of the benefits and risks must be performed. It can be difficult, if not impossible for women with ADHD to stop taking their medication. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. A loss of medication may also impact the ability to drive safely and to perform work-related tasks which are vital aspects of normal life for those with ADHD. She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy educate family members, colleagues, and acquaintances about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. In addition, educating them can aid in ensuring that the woman feels supported as she struggles with her decision. Some medications can pass through the placenta. If a patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be transferred to the infant. Risk of Birth Defects As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns over the impact that these drugs might have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Using two massive data sets researchers were able to examine more than 4.3 million pregnancies and see whether stimulant medication use 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 a slightly higher rate of certain heart defects such as ventriculoseptal defect (VSD). The researchers of the study didn't discover any link between the use of early medications and other congenital anomalies, like facial deformities, or club feet. The results are in line with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to pregnancy. This risk increased in the latter half of pregnancy, when a lot of women begin to discontinue their medication. Women who took ADHD medication in the first trimester were more likely to require a caesarean delivery or have an insufficient Apgar after delivery, and have a baby who needed help breathing at birth. However, the authors of the study were not able to eliminate selection bias by restricting the study to women who didn't have any other medical conditions that could have contributed to the findings. Researchers hope that their study will provide doctors with information when they see pregnant women. The researchers recommend that while discussing the risks and benefits are important, the decision regarding whether or not to stop medication should be 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 alternative, it is not an option to consider due to the high rate of depression and other mental health issues for women who are expecting or recently postpartum. Further, research shows that women who stop taking their medication will have a tough adjustment to life without them after the baby is born. Nursing click the next web page that come with being a new mom can be overwhelming. Women with ADHD who have to deal with their symptoms while attending doctor appointments and preparing for the arrival of a baby and adapting to new routines in the home can experience severe challenges. Therefore, many women elect to continue taking their ADHD medications throughout the course of pregnancy. The majority of stimulant medications pass through breast milk in small quantities, so the risk for infant who is breastfeeding is low. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of the day. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn is not fully understood. Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication against the potential risks to the fetus. Until more information becomes available, doctors can inquire about pregnant patients whether they have an background of ADHD or if they plan to take medication in the perinatal phase. A growing number of studies have proven that most women can safely continue to take their ADHD medication during pregnancy and breastfeeding. In response, a growing number of patients are opting to do so. They have found after consulting with their doctors, that the benefits of keeping their current medication outweigh any risk. It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help pregnant women suffering from ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and strengthen existing strategies for managing. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regimen.