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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There are few data on how exposure to ADHD for a long time could affect the foetus. 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 that further high-quality research is needed. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication must evaluate the benefits of using it versus the dangers for the fetus. Physicians don't have the data to provide clear recommendations however they can provide information on the risks and benefits to help pregnant women make an informed decision. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a higher risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, and those who did not. adhd anxiety medication and clinical geneticists examined the cases to ensure correct classification of the cases and to reduce the chance of bias. The research conducted by the researchers was not without its limitations. Researchers were unable to, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups exposed were due to medication use, or if they were confounded by co-morbidities. Researchers also did not examine long-term outcomes for the offspring. The study did reveal that infants whose mothers took ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission did not appear to be influenced by the stimulant medications were taken during pregnancy. Women who were taking 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 research suggests that the small risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit to both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and, if possible, help them develop coping skills that may reduce the impact of her disorder in her daily life and relationships. Medication Interactions Doctors are increasingly faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. The majority of these decisions are made without clear and authoritative evidence in either case, which means that doctors must weigh what they know from their own experiences, those of other doctors, and what research suggests on the subject and their own best judgment for each individual patient. The issue of possible risks for infants can be extremely difficult. adhd medication online on this topic are based on observations rather than controlled research, and their conclusions are often contradictory. The majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study presented in this journal club addresses these shortcomings by looking at data from both live and deceased births. Conclusion Some 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 an unintended, or slight negative impact. As a result an accurate risk-benefit analysis must be done in each case. It isn't easy, but not impossible, for women with ADHD to stop taking their medication. In fact, in an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness and family conflict for those suffering from the disorder. In addition, a decrease in medication can affect the ability to perform job-related tasks and drive safely which are essential aspects of a normal life for a lot of people with ADHD. She suggests women who are uncertain about whether to keep or discontinue medication due to their pregnancy should consider educating family members, friends, and coworkers on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. In addition, educating them can help the woman feel supported as she struggles with her decision. Certain medications can be passed through the placenta. If a patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication may be transferred to her infant. Risk of Birth Defects As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two huge datasets to analyze over 4.3 million pregnancy and determine if the use of stimulant medications caused birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of certain heart defects, like ventriculoseptal defect. The researchers behind the study found no link between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies that have shown the presence of a small, but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications prior to the time of the time of pregnancy. The risk grew during the latter part of pregnancy, when many women decide to stop taking their ADHD medications. Women who took 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 required help breathing at birth. However the authors of the study were unable to eliminate selection bias by limiting the study to women who didn't have other medical issues that could be a contributing factor to these findings. Researchers hope their research will provide doctors with information when they see pregnant women. They suggest that although discussing the risks and benefits is crucial, the decision to stop or continue medication should be based on each woman's requirements and the severity of her ADHD symptoms. The authors warn that, although stopping the medication is a possibility to think about, it isn't advised because of the high incidence of depression and mental health issues in women who are expecting or who have recently given birth. Further, the research suggests that women who choose to stop taking their medication are more likely to experience difficulties getting used to life without them following the birth of their baby. Nursing The responsibilities of a new mom can be overwhelming. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to a new routine. Therefore, many women decide to continue taking their ADHD medications throughout the course of pregnancy. The majority of stimulant medicines pass through breast milk in very small amounts, therefore the risk to the breastfeeding infant is minimal. However, the rate of exposure to medications by the newborn may differ based on the dosage, frequency it is administered and the time of the day it is administered. In addition, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The effect on a newborn's health is not completely known. Due to the absence of research, some physicians may be inclined to discontinue stimulant drugs during the pregnancy of a woman. This is a difficult decision for the woman who must weigh the advantages of continuing her medication against the potential 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 planning or taking to take medication during the perinatal period. A increasing number of studies have shown that women can continue their ADHD medication while they are pregnant and nursing. In the end, more and more patients opt to do this and, in consultation with their physician, they have discovered that the benefits of continuing their current medication far outweigh any risks. Women who suffer from ADHD who are planning to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help women with ADHD be aware of their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing coping strategies. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatrists. Counselling for pregnancy should include the discussion of a plan for management for both the mother and child, monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.