stagepine36

ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There are few data regarding how exposure over time may affect a foetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental conditions like impaired vision or hearing, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required. Risk/Benefit Analysis Women who are expecting and taking ADHD medication need to consider the benefits of taking it versus the dangers for the baby. Doctors don't have enough data to make unambiguous recommendations however they can provide information on the risks and benefits to assist pregnant women to make informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy and those who had not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure accurate case classification and to limit the possibility of bias. The study of the researchers was not without its limitations. The researchers were unable, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult to know whether the small differences observed in the exposed groups result from medication use or the confounding effect of comorbidities. The researchers also did not examine long-term outcomes for offspring. The study revealed that infants whose mothers took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who did not use any medication during pregnancy or 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 medication used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases did not appear to be influenced by the kind of medication used during pregnancy. The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both the mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this and try to help them develop coping skills that could reduce the impact of her disorder in her daily functioning and her relationships. Interactions with Medication More and more doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. Often, these decisions are made in the absence of any evidence that is clear and definitive in either case, which means that doctors have to weigh their experience 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 patient. In particular, the issue of potential risks to the baby can be a challenge. The research on this subject is based on observation instead of controlled studies and a lot of the results are conflicting. The majority of studies focus on live births, which can underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study presented in the journal club addresses these shortcomings by analyzing information on deceased and live births. The conclusion is that while certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link and the majority of studies show a neutral or even slightly negative impact. As a result, a careful risk/benefit assessment is required in every situation. For many women with ADHD and ADD, the decision to stop taking medication can be difficult, if not impossible. In a recent article published in 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 being isolated. The loss of medication can affect the ability to safely drive and perform work-related tasks, which are essential aspects of normal life for those with ADHD. She suggests that women who aren't sure whether to continue taking the medication or discontinue it due to pregnancy, educate their family members, coworkers and their friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication may be transferred to her baby. Risk of Birth Defects As the use and abuse of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers utilized two massive data sets to study over 4.3 million pregnant women and determine whether stimulant medications increased the risk of birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medications was linked to a slightly higher rate of certain heart defects, such as ventriculoseptal defect (VSD). The researchers of the study could not find any association between the use of early medications and other congenital anomalies like facial deformities or club feet. The results are in line with previous studies showing the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications before pregnancy. This risk increased during the latter part of pregnancy, when a lot of women stopped taking their medication. Women who took ADHD medication during the first trimester were more likely need a caesarean and also have an insufficient Apgar after delivery and have a baby who needed help breathing at birth. The authors of the study could not eliminate selection bias because they limited the study to women without other medical conditions that might have contributed to the findings. Researchers hope their research will help doctors when they see pregnant women. They suggest that although discussing the benefits and risks is important, the decision to stop or maintain treatment must be based on each woman's requirements and the severity of her ADHD symptoms. The authors caution that, although stopping the medication is an option to think about, it isn't recommended due to the high prevalence of depression and other mental problems among women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medication will have a harder time adjusting to a life without them after the baby is born. Nursing It can be a challenge to become a mom. Women suffering from ADHD can face severe challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to new routines. Therefore, many women elect to continue taking their ADHD medication throughout the pregnancy. The risk to nursing infant is low because the majority of stimulant medication passes through breast milk at a low level. However, the amount of exposure to medications by the newborn may differ based on dosage, how often it is administered, and the time of the day it is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn isn't well understood. Due to the absence of research, some physicians may be inclined to discontinue stimulant medications during the pregnancy of a woman. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the risk to the foetus. In www.iampsychiatry.uk , until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time. Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are opting to do so. They have concluded through consultation with their physicians that the benefits of retaining their current medication outweigh any possible risks. Women with ADHD who are planning to nurse should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor as well as the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and reinforce coping mechanisms. This should be a multidisciplinary effort together with obstetricians, GPs, and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother and child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.