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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There are few data on how long-term exposure may affect a fetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental disorders such as impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies. Risk/Benefit Analysis Pregnant women who take ADHD medications must weigh the advantages of taking them against the potential risks to the fetus. The doctors don't have the information to make unambiguous recommendations, but can provide information on risks and benefits to assist pregnant women to make informed choices. A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast, population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure accurate case classification and to limit the chance of bias. The study of the researchers was not without limitations. Researchers were unable, in the first place, to separate the effects of the medication from the disorder. adhd medication for adults uk makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or confounding by comorbidities. In addition the researchers did not examine the long-term effects of offspring on their parents. The study revealed that infants whose mothers had taken ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy or stopped taking their medication before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy. Women who took stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy. The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both mother and child of continued treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, help them develop strategies to improve coping skills which can reduce the impact of her disorder on her daily functioning and relationships. Medication Interactions Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made without any evidence that is clear and definitive in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests on the subject and their best judgment for each individual patient. Particularly, the issue of potential risks to the baby can be a challenge. A lot of studies on this topic are based on observational data rather than controlled research and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. adhd medication for adults uk presented in the journal club addresses these limitations by analyzing data on live and deceased births. Conclusion A few studies have revealed a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. The majority of studies show an unintended, or slightly negative, impact. As a result, a careful risk/benefit assessment must be done in each instance. It can be challenging, 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, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for those suffering from the disorder. Additionally, the loss of medication may affect the ability to do job-related tasks and drive safely, which are important aspects of daily life for many people with ADHD. She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy, educate their family members, colleagues, and acquaintances about the condition, the impact on daily functioning and the benefits of continuing the current treatment plan. It will also help a woman feel supported in her decision. Some medications can pass through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication could be transferred to the infant. Risk of Birth Defects As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about what impact the medications could have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher rates of specific heart defects like ventriculoseptal defects. The authors of the study found no association between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are in agreement with previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication prior to the time of the birth of their child. The risk grew in the later part of pregnancy, as many women are forced to stop taking their ADHD medications. Women who used ADHD medications in the first trimester of their pregnancy were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby who required breathing assistance during birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have other medical issues that could be a contributing factor to these findings. Researchers hope that their study will help doctors when they meet pregnant women. The researchers advise that, while discussing the risks and benefits are important, the choice regarding whether or not to stop medication should be made according to the severity of each woman's ADHD symptoms and her requirements. The authors warn that, while stopping the medication is an option to look into, it is not advised because of the high incidence of depression and other mental disorders among women who are pregnant or have recently given birth. Further, the research suggests that women who decide to stop taking their medication are more likely to have a difficult time adjusting to life without them following the birth of their baby. Nursing The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who must work through their symptoms while attending physician appointments as well as making preparations for the arrival of their child and adapting to new routines in the home can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy. The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. The rate of medication exposure can vary depending upon the dosage, frequency of administration and the time of day. In addition, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk, and the effect of this on a newborn 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 complicated decision for the patient, who must balance the benefits of keeping her medication against the possible risks to the foetus. As long as more information is available, GPs may inquire about pregnant patients if they have an history of ADHD or if they are planning to take medication in the perinatal period. A growing number of studies have shown that most women can safely continue to take their ADHD medication during pregnancy and while breastfeeding. This has led to an increasing number of patients opt to do this, and in consultation with their physician, they have discovered that the benefits of continuing their current medication outweigh any risks. It is crucial for women suffering from ADHD who are considering breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be provided to help women with ADHD be aware of their symptoms and underlying disorder Learn about the available treatments and to reinforce existing coping strategies. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Counselling for pregnancy should include discussion of a management plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.