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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD must make a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these medications could affect the fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high quality research is needed. Risk/Benefit Analysis Pregnant women who use ADHD medications need to balance the advantages of using them against the risks to the fetus. The doctors don't have the information to give clear advice but they can provide information on risks and benefits to help pregnant women make informed decisions. 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 structural birth defects. Researchers conducted a massive population-based case control study to assess the frequency of major structural defects in infants born to mothers who took 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. However, the researchers' study had its limitations. The researchers were unable, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medication, or if they were affected by co-morbidities. The researchers also did not examine the long-term effects for the offspring. The study did find that infants whose mothers had taken ADHD medication during pregnancy were at slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or stopped their medications before or during pregnancy. This increase was due to central nervous system-related disorders and the increased risk of admission was not found to be influenced by the stimulant medication was used during pregnancy. Women who were taking stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a baby born with a low Apgar score (less than 7). These increases appeared to be independent of the type of medication taken during pregnancy. Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages may be offset by the greater benefits to both mother and baby from continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, when possible, assist them in developing strategies to improve coping skills which can reduce the negative impact of her condition on her daily functioning and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether or not to end treatment during pregnancy is a question that more and more doctors have to face. These decisions are frequently taken without clear and authoritative evidence. Instead, physicians must consider their own expertise and experience, as well as the experiences of other doctors, and the research that has been conducted on the subject. Particularly, the subject of potential risks to the infant can be difficult. A lot of studies on this issue are based on observations rather than controlled research and their findings are often contradictory. Furthermore, most studies restrict their analysis to live births, which could underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these issues by examining data on both live and deceased births. The conclusion The conclusion: While some studies have shown a positive association between ADHD medications and the possibility of certain birth defects, others have found no connection, and most studies have a neutral or slightly negative effect. In all cases, a careful evaluation of the benefits and risks should be conducted. It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published in 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 these patients. The loss of medication can affect the ability to safely drive and complete work-related tasks, which are crucial aspects of everyday life for people with ADHD. She suggests that women who are not sure whether to continue taking the medication or stop due to pregnancy, educate their family members, colleagues, and their friends about the condition, its effects on daily functioning, and the benefits of continuing the current treatment plan. It can also help a woman feel confident about her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be passed on to her infant. Birth Defects and Risk of As the use and misuse of ADHD drugs to treat symptoms of attention deficit disorder 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 issue. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects. The researchers of the study didn't discover any connection between early use of medication and congenital anomalies like facial deformities or club feet. The findings are in line with previous studies showing an increase, but not significant, in the risk of heart malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk was higher in the latter half of pregnancy, when a lot of women decide to stop taking their ADHD medications. Women who were taking ADHD medication during the first trimester were more likely need a caesarean or have an insufficient Apgar after delivery and have a baby who needed help breathing after birth. The authors of the study were not able to eliminate bias due to selection because they restricted the study to women with no other medical conditions that could have contributed to the findings. Researchers hope that their research will inform physicians when they encounter pregnant women. They suggest that although a discussion of the benefits and risks is important however, the decision to stop or continue medication should be based on each woman's needs and the severity of her ADHD symptoms. The authors also caution that while discontinuing the medications is an alternative, it is not an option to consider due to the high incidence of depression and other mental health problems among women who are pregnant or recently post-partum. Further, research shows that women who stop taking their medication will have a difficult transitioning to life without them once the baby is born. Nursing The responsibilities of a new mother can be overwhelming. Women with ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of their child and adjust to a new routine. This is why 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 low levels. However, the rate of exposure to medications by the newborn may differ based on the dosage, frequency it is taken and at what time it is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn isn't yet fully known. Because of the lack of research, some doctors may recommend stopping stimulant medications during the course of pregnancy. It is a difficult decision for the woman, who must weigh the advantages of her medication against the risk to the foetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time. A increasing number of studies have proven that most women can safely continue to take their ADHD medication while they are pregnant and nursing. In the end, an increasing number of patients opt to do this and in consultation with their doctor they have found that the benefits of maintaining their current medication outweigh any potential risks. Women with ADHD who plan to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons for continuing treatment. adult adhd medication includes non-pharmacological methods. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing coping strategies. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a treatment plan for both the mother as well as the child, monitoring for signs of deterioration, and the need for adjustments to the medication regimen.