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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. Little data exists about how long-term exposure to these medications can affect the foetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental disorders such as impaired vision or hearing seizures, febrile seizures or IQ impairment. medication for adhd acknowledge the need for higher-quality studies. Risk/Benefit Analysis Women who are expecting and taking ADHD medication should consider the benefits of taking it against the possible risks to the baby. The doctors don't have the information to provide clear recommendations however they can provide information on the risks and benefits to aid pregnant women in making an informed decision. A study published in Molecular Psychiatry found that women who were taking ADHD medications during their early pregnancy did not face an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large sample-based case control study to compare the incidence of major structural defects in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure correct case classification and to minimize the chance of bias. However, the study had its limitations. The researchers were not able to, in the first place to differentiate the effects of the medication from the disorder. This limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or comorbidities that cause confusion. Additionally, the researchers did not study the long-term effects of offspring on their parents. The study revealed that infants whose mothers took ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU) as compared to those whose mothers did not use any medication during pregnancy, or had stopped taking their medication before or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher chance of having an emergency caesarean section or having the baby was not scoring well on the Apgar scale (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy. The research suggests that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this and as much as possible, assist them improve coping skills which could reduce the effects of her disorder on her daily life and relationships. Medication Interactions More and more doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and authoritative evidence. Instead, doctors must weigh their own knowledge in conjunction with the experiences of other doctors, and the research on the subject. Particularly, the subject of potential risks for the baby can be a challenge. The research on this subject is based on observation rather than controlled studies and a lot of the results are conflicting. Most studies limit their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by examining data on both live and deceased births. The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. In every case it is imperative to conduct a thorough study of the benefits and risks is required. For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is 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 loneliness. Furthermore, a loss of medication can interfere with the ability to do jobs and drive safely, which are important aspects of daily life for many people suffering from ADHD. She suggests women who are uncertain about whether to keep or discontinue medication due to their pregnancy consider educating family members, friends and colleagues on the condition, its impact on daily life, and the benefits of keeping the current treatment regimen. It can also aid in ensuring that the woman feels supported as she struggles with her decision. It is also worth noting that certain medications are able to pass through the placenta so if the patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the child. Risk of Birth Defects As the use and use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. Utilizing two huge data sets researchers were able examine more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. While the overall risk remains low, the scientists found that exposure in the first trimester to ADHD medications was linked to an increased risk of certain heart defects such as ventriculoseptal defect (VSD). The researchers of the study found no association 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 revealing a small but significant increase in the risk of heart malformations among women who started taking ADHD medications before the time of pregnancy. The risk grew in the latter half of pregnancy, when a lot of women are forced to stop taking their medication. Women who used ADHD medications in the first trimester of pregnancy were also more likely to have caesarean section, low Apgar score following delivery, and a baby who required breathing assistance during birth. The researchers of the study were unable to eliminate selection bias because they limited the study to women with no other medical conditions that might have contributed to the findings. Researchers hope their research will provide doctors with information when they encounter pregnant women. They advise that while the discussion of risks and benefits is important however, the decision to stop or maintain treatment should be based on each woman's needs and the severity of her ADHD symptoms. The authors caution that, although stopping the medication is a possibility to think about, it isn't advised due to the high rate depression and other mental problems among women who are pregnant or who have recently given birth. Further, research shows that women who stop taking their medications will have a tough adjustment to life without them once the baby is born. Nursing The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy. The majority of stimulant medicines pass through breast milk in small quantities, so the risk to the breastfeeding infant is minimal. However, the amount of exposure to medication by the newborn can vary depending on dosage, frequency it is administered, and the time of day it is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully understood. Due to the absence of evidence, some doctors might be tempted to stop taking stimulant medication during the pregnancy of a woman. This is a difficult decision for the mother, who must weigh the advantages of her medication against the risk to the fetus. As long as more information is available, GPs can ask pregnant patients if they have an history of ADHD or if they intend to take medication during the perinatal stage. Numerous studies have proven that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do this. They have concluded through consultation with their doctors, that the benefits of continuing their current medication outweigh risk. Women who suffer from ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also necessary to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build coping mechanisms. 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 as well as the child, as well as monitoring for signs of deterioration, and, if necessary adjustments to the medication regime.