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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. There isn't much information on how long-term exposure to these medications could affect the fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications must weigh the benefits of using them against the risks to the foetus. The doctors don't have the information to give clear advice but they can provide information on the risks and benefits to help pregnant women make an informed decision. A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major structural birth defects. Researchers conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was correct and to minimize any bias. The research conducted by the researchers was not without its limitations. The researchers were not able to, in the first place to differentiate the effects caused by the medication from the disorder. This limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or confounding by comorbidities. Researchers also did not look at long-term outcomes for offspring. The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had 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 medications were used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases did not appear to be influenced by the type of medication that was used during pregnancy. The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit for both mother and child of continuing treatment for the woman's condition. Physicians should talk to their patients about this issue and, if possible, help them improve coping skills which can lessen the impact of her disorder in her daily life and relationships. Medication Interactions Many doctors are faced with the decision of whether to keep treatment or stop during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made without any evidence that is clear and definitive either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and what the research says on the topic as well as their own best judgment for each individual patient. Particularly, the issue of possible risks to the infant can be difficult. A lot of studies on this issue are based on observational data rather than controlled research and their conclusions are often contradictory. In addition, most studies limit their analysis to live births, which could underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both the data from deceased and live births. The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. In the end, a careful risk/benefit analysis is required in every instance. It can be difficult, if not impossible, for women suffering from 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 lead to depression and feelings of loneliness. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are vital aspects of normal life for those with ADHD. She suggests that women who aren't sure whether to take the medication or stop due to pregnancy, educate their family members, colleagues, and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment regimen. Educating them can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to remember that some medications are able to be absorbed through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby. Birth Defects Risk As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs might have on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect. The authors of the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies which showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication prior to the time of pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women stopped taking their medication. Women who used 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 that required help breathing at birth. However the authors of the study were unable to eliminate selection bias by limiting the study to women who did not have other medical issues that could have contributed to these findings. Researchers hope that their research will help doctors when they meet pregnant women. The researchers suggest that while discussing risks and benefits are important, the choice 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 caution that, even though stopping the medication is a possibility to consider, it is not recommended due to the high rate depression and mental health issues in women who are expecting or who have recently given birth. Research has also shown that women who stop taking their medications will have a difficult transitioning to life without them after the baby is born. Nursing The responsibilities of a new mom can be overwhelming. Women with ADHD may face a lot of challenges when they must deal with 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 risk for nursing infant is low because the majority of stimulant medication is absorbed through breast milk at a low level. The rate of medication exposure will vary based on the dosage, frequency of administration and the time of the day. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The impact on a newborn's health is not fully understood. 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 woman, who must weigh the advantages of continuing her medication against the potential risks to the embryo. Until more information becomes available, doctors can ask pregnant patients if they have an history of ADHD or if they plan to take medication during the perinatal phase. Many studies have shown that women can continue to take their ADHD medication in a safe manner during pregnancy and breast-feeding. In response, an increasing number of patients are opting to do this. They have discovered, in consultation with their doctors that the benefits of keeping their current medication outweigh any potential risks. Women who suffer from ADHD who are planning to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. adhd medications uk should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD be aware of their symptoms and underlying disorder and learn about treatments and to reinforce existing strategies for managing. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatry. Pregnancy counselling should include the discussion of a plan for management 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.