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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medication during pregnancy and nursing is challenging for women with the condition. There are few data on how exposure to ADHD for a long time could affect the pregnant fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality studies are required. Risk/Benefit Analysis Pregnant women who take ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Doctors don't have the information needed to give clear guidelines but they can provide information on benefits and risks that can aid pregnant women in making informed decisions. medications for adhd uk published in Molecular Psychiatry found that women who were taking ADHD medications during early pregnancy did not face an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias. The study of the researchers was not without its limitations. Most important, they were unable to separate the effects of the medication from the disorder at hand. This makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medication or confounded by comorbidities. Additionally, adhd medication uk buy online did not look at long-term offspring outcomes. The study revealed 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 mothers who did not take any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy. Researchers suggest that the small risks associated with the use ADHD medications in early pregnancies could be offset by the greater benefits for mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss the issue with their patients and, where possible, help them develop strategies to improve their coping abilities that can lessen the effects of her disorder on her daily functioning and relationships. Medication Interactions As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether or not to stop treatment during pregnancy is one that more and more doctors face. These decisions are frequently made without clear and reliable evidence. Instead, physicians must weigh their own knowledge and experience, as well as the experiences of other doctors and the research on the subject. The issue of risk to the infant can be particularly tricky. The research on this subject is based on observations rather than controlled studies and many of the findings are contradictory. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these limitations by examining data on both live and deceased births. The conclusion The conclusion: While some studies have shown that there is a positive correlation between ADHD medications and the possibility of certain birth defects, other studies have found no connection and the majority of studies have a neutral or slightly negative effect. In each case, a careful study of the potential risks and benefits must be performed. For women suffering from ADHD and ADD, the decision to stop taking medication is difficult if not impossible. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for patients with ADHD. A decrease in medication could also impact the ability to safely drive and perform work-related tasks, which are vital aspects of everyday life for those with ADHD. She suggests that women who aren't sure whether to continue taking medication or discontinue it due to pregnancy should educate family members, colleagues, and acquaintances about the condition, its effects on daily functioning, and the advantages of staying on the current treatment plan. It will also help a woman feel confident about her decision. It is also worth noting that some medications are able to pass through the placenta, so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the medication could be transferred to the child. Risk of Birth Defects As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about the effects that the drugs could have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. Researchers found that while the overall risk is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects. The researchers of the study found no link between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in agreement with previous studies which showed the existence of a slight, but significant 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 was higher in the later part of pregnancy, as many women decide to stop taking their ADHD medication. Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth or have an insufficient Apgar after birth and have a baby who needed breathing assistance at birth. However the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have other medical issues that could have contributed to these findings. Researchers hope that their study will help doctors when they encounter pregnant women. The researchers recommend that while discussing benefits and risks are crucial, the decision about whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her requirements. The authors also caution that even though stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health issues among women who are pregnant or recently post-partum. Research has also shown that women who stop taking their medications will have a difficult time adjusting to a life without them once the baby is born. Nursing The responsibilities that come with being a new mother can be overwhelming. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and 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 medications are absorbed through breast milk in small quantities, so the risk to the nursing infant is very low. The rate of medication exposure can vary depending upon the dosage, frequency of administration and the time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not well understood. Because of the lack of research, some doctors may recommend stopping stimulant drugs during a woman's pregnancy. It's a difficult choice for the woman who must weigh the benefits of taking her medication as well as the risks to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and whether they are planning or taking to take medication during the perinatal time. A growing number of studies have shown that most women can safely continue to take their ADHD medication during pregnancy and breastfeeding. In response, an increasing number of patients are choosing to do so. They have found through consultation with their physicians, that the benefits of keeping their current medication outweigh any potential risks. Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician, and the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also necessary to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also be educated about treatment options and build coping mechanisms. This should include an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. The pregnancy counselling should consist of 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 the need for adjustments to the medication regimen.