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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 aren't many studies on how exposure to ADHD for a long time could affect a 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 or vision impairment seizures, 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 must weigh the benefits of taking them against the potential risks to the fetus. Doctors don't have enough data to give clear advice but they can provide information about risks and benefits to assist pregnant women to make an informed decision. A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not have a significantly 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 babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to make sure that the classification was accurate and to reduce any bias. The study conducted by the researchers was not without limitations. The researchers were unable, in the first place to differentiate the effects triggered by the medication from the disorder. This makes it difficult to determine whether the small differences observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. The researchers did not study long-term outcomes for the offspring. The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy. Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a baby born with an low Apgar score (less than 7). These increases did not appear 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 medications during early pregnancies can be offset by greater benefits for mother and baby from continuing treatment for the woman’s disorder. Doctors should discuss with their patients about this and try to help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships. Medication Interactions More and more doctors are faced with the decision of whether to keep treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what research suggests on the subject and their best judgment for each patient. The issue of risk for infants can be particularly tricky. A lot of studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that result in abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by looking at data from both live and deceased births. Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. Most studies have shown a neutral, or even slightly negative, impact. As a result, a careful risk/benefit analysis is required in every case. It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. In addition, a decrease in medication can affect the ability to do jobs and drive safely, which are important aspects of a normal life for a lot of people with ADHD. She suggests women who are unsure about whether or not to discontinue medication due to their pregnancy, consider the possibility of educating friends, family members and colleagues about the condition, its impact on daily functioning, and on the advantages of staying on the current treatment regimen. Educating adhd in adults medication can also aid in ensuring that the woman feels supported as she struggles with her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication could be passed on to her infant. Birth Defects and Risk of As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on foetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medications was linked to an increased risk of certain heart defects, like ventriculo-septal defects (VSD). The authors of the study found no association between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women decided to stop taking their medication. Women who used ADHD medications in the first trimester of their pregnancies were also more likely to have caesarean section, low Apgar score following delivery, and a baby that required help breathing at birth. However, the authors of the study were not able to eliminate bias due to selection by limiting the study to women who didn't have any other medical conditions that could have contributed to the findings. Researchers hope their research will inform physicians when they see pregnant women. The researchers advise that, while discussing the risks and benefits are crucial, the decision regarding whether or not to stop medication should be according to the severity of each woman's ADHD symptoms and her needs. The authors caution that, while stopping the medication is a possibility to look into, it is not recommended due to the high rate depression and other mental disorders for women who are pregnant or recently gave birth. Further, the research suggests that women who decide to stop their medications are more likely to have difficulties adapting to life without them following the birth of their baby. Nursing It can be overwhelming to become a mom. Women who suffer from ADHD who have to deal with their symptoms while attending doctor appointments, preparing for the arrival of a baby and adjusting to new household routines may face a lot of challenges. As such, many women elect to continue taking their ADHD medications throughout pregnancy. The risk to nursing infant is low because the majority of stimulant medications is absorbed through breast milk in low amounts. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of day. Additionally, different 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 fully known. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. This is a difficult decision for the patient, who must weigh the benefit of continuing her medication with the potential dangers to the foetus. As long as more information is available, doctors can inquire about pregnant patients if they have any background of ADHD or if they plan to take medication in the perinatal phase. Numerous studies have proven that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. In response, a rising number of patients are opting to continue their medication. They have found, in consultation with their physicians that the benefits of retaining their current medication outweigh any potential risks. Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and underlying disorder Learn about the available treatments and to reinforce existing strategies for managing. This should involve a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.