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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medication during pregnancy and breastfeeding is challenging for women with the condition There arent many studies on how exposure to ADHD for a long time could affect a pregnant fetus A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision febrile seizures or IQ impairment The authors acknowledge that more high quality studies are needed RiskBenefit Analysis Women who are expecting and taking ADHD medication should evaluate the benefits of using it versus the risks to the baby Physicians dont have the data to provide clear recommendations but they can provide information about risks and benefits to assist pregnant women to make informed choices A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects Researchers used a large populationbased case control study to examine the prevalence of major structural defects in infants born to mothers who were taking stimulants during pregnancy Pediatric cardiologists clinical geneticists and other experts reviewed the cases in order to make sure that the classification was accurate and to minimize any bias The research conducted by the researchers was not without limitations The researchers were not able in the beginning to differentiate the effects triggered by the medication from the disorder This makes it difficult for researchers to establish whether the small differences observed between the exposed groups were due to the use of medication or if they were affected by comorbidities In addition the study did not study longterm offspring outcomes The study showed that babies whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit NICU in comparison to those whose mothers did not use 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 affected by the stimulant medications used during pregnancy Women who took stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a baby with an low Apgar score less than 7 These increases appear to be independent of the type of medication taken during pregnancy Researchers suggest that the minor risk of using ADHD medications during early pregnancies may be offset by the greater benefits to both baby and mother of continued treatment for the womans disorder Doctors should discuss with their patients about this issue and if possible help them improve coping skills which can lessen 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 keep 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 have to take into account their own experience and experience as well as the experiences of other physicians and the research on the subject The issue of potential risks to infants is extremely difficult The research on this issue is based on observation rather than controlled studies and a lot of the results are in conflict In addition most studies limit their analysis to live births which may underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy adhd medication for adults uk presented in this journal club addresses these limitations by looking at data from both live and deceased births The conclusion While some studies have found a positive association between ADHD medications and the possibility of certain birth defects other studies have not found any evidence of a link and most studies have a neutral or slightly negative impact In the end an accurate riskbenefit analysis must be done in each situation It can be difficult if not impossible for women with ADHD to stop taking their medication In adhd anxiety medication published in the Archives of Womens Mental Health by psychologist Jennifer Russell she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of loneliness A decrease in medication could also impact the ability to drive safely and to perform workrelated tasks which are vital aspects of normal life for those with ADHD She suggests women who are unsure about whether to keep or stop taking medication because of their pregnancy consider informing family members friends and colleagues about the condition its effects on daily functioning and the benefits of keeping the current treatment regimen Educating them can also make the woman feel more comfortable when she is struggling with her decision Some medications can pass through the placenta If the patient decides to stop taking her ADHD medication while breastfeeding it is crucial to be aware that the drug could be transferred to the baby Risk of Birth Defects As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder ADHD grows there are concerns over the impact that these drugs might have on foetuses Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject Researchers used two massive data sets to examine more than 43 million pregnancy and determine if the use of stimulant medications increased the risk of birth defects While the overall risk remains low the researchers discovered that the firsttrimester exposure to ADHD medications was associated with an increase in the risk of certain heart defects such as ventriculoseptal defect VSD The authors of the study could not discover any connection between early medication usage and other congenital anomalies like facial deformities or club feet The results are in line with previous studies that have shown the presence of a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications before the time of pregnancy The risk was higher during the latter part of pregnancy as many women are forced to stop taking their medication Women who were taking ADHD medication during the first trimester were more likely need a caesarean have an insufficient Apgar after delivery and had a baby that required help breathing when they were born However the researchers of the study were unable to eliminate bias due to selection by limiting the study to women who didnt have any other medical conditions that could be a contributing factor to these findings adhd medication for adults uk hope that their research will serve to inform the clinical decisions of physicians who see pregnant women They recommend that while discussing risks and benefits is important however the decision to stop or keep medication should be based on the womans needs and the severity of her ADHD symptoms The authors also advise that while stopping the medication is an option it isnt an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or recently postpartum Research has also shown that women who stop taking their medication will have a difficult adjustment to life without them once the baby is born Nursing The responsibilities of a new mom can be overwhelming Women suffering from ADHD can face severe challenges when they must manage their symptoms go to doctor appointments prepare for the birth of a baby and adjust to new routines Therefore many women decide to continue taking their ADHD medications throughout pregnancy The risk to breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level The amount of exposure to medications can vary depending upon the dosage the medication is administered its frequency and the time of the day In addition individual medications enter the babys system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn isnt yet fully known Some physicians may discontinue stimulant medications during a womans pregnancy due to the lack of research Its a difficult choice for the woman who must weigh the advantages of her medication against the potential risks to the embryo In the meantime until more information is available doctors should ask all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time A increasing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing In response a rising number of patients are choosing to continue their medication They have discovered in consultation with their physicians that the benefits of keeping their current medication outweigh possible risks Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment including nonpharmacological management strategies Psychoeducation is also required to help women with ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and reinforce existing strategies for managing This should be a multidisciplinary effort together with obstetricians GPs and psychiatrists Counselling for pregnancy should include discussion of a management plan for both the mother and child as well as monitoring for signs of deterioration and if necessary adjustments to the medication regimen