ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies regarding how exposure over time may affect the fetus.

A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality research is needed.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must evaluate the benefits of using it against the possible risks for the foetus. Doctors don't have enough data to provide clear recommendations, but can provide information on the risks and benefits to help pregnant women make informed choices.

A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a massive population-based study of case control to examine the prevalence of structural defects that were major in infants born to mothers who were taking stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias.

The research conducted by the researchers was not without its limitations. The researchers were not able in the beginning, to separate the effects triggered by the medication from the disorder. This limitation makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or confounding by comorbidities. Additionally the study did not examine long-term offspring outcomes.

The study showed that infants whose mother had taken ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy, or had quit taking the medication prior to 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 delivery or having a baby born with low Apgar score (less than 7). These increases appear to be independent of the type of medication taken during pregnancy.

The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both the mother and child from continued treatment for the woman's condition. Doctors should discuss with their patients about this and, if possible, help them develop coping skills that can a general physician prescribe adhd medication, more about Tyc, lessen the effects of her dtop taking medication because of their pregnancy should consider the possibility of educating friends, family members, and coworkers on the condition, its effects on daily functioning, and on the advantages of continuing the current treatment regimen. It can also aid in ensuring that the woman feels supported in her struggle with her decision. It is important to note that some drugs can pass through the placenta, therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the child.

Birth Defects Risk

As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. With two massive data sets researchers were able to look at more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect.

The researchers of the study found no connection between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to the birth of their child. The risk increased in the latter part of pregnancy, when a lot of women stopped taking their medication.

Women who used ADHD medications during the first trimester of their pregnancy were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. However the researchers of the study were not able to eliminate bias due to selection 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 encounter pregnant women. They recommend that, while discussing the benefits and risks is important but the decision to stop or keep treatment must be based on each woman's requirements and the severity of her ADHD symptoms.

The authors also advise that, while stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health problems for women who are expecting or post-partum. Additionally, the research suggests that women who decide to stop taking their medication are more likely to have a difficult time getting used to life without them after the birth of their baby.

Nursing

The responsibilities of being a new mom can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy.

The majority of stimulant medicines pass through breast milk in low quantities, so the risk for nursing infant is very low. However, the rate of exposure to medications 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. The impact of this on a newborn infant is not yet fully understood.

Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must weigh the benefits of continuing her medication against the potential risks to the embryo. As long as more information is available, GPs can inquire about pregnant patients if they have an history of ADHD or if they are planning to take medication in the perinatal phase.

Many studies have shown that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. In the end, an increasing number of patients are choosing to do so and, in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any potential risks.

Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary approach together with obstetricians, GPs and psychiatrists. The pregnancy counselling should consist of the discussion of a treatment plan for both the mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.