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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these medications could affect the foetus. 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 the need for higher-quality research. Risk/Benefit Analysis Women who are pregnant and taking ADHD medications must weigh the advantages of taking them against the potential risks to the foetus. Physicians do not have the information needed to make unequivocal recommendations but they can provide information on benefits and risks that can assist pregnant women in making informed choices. A study published in Molecular Psychiatry found that women who took ADHD medications during early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large population-based study of case-control to determine the prevalence of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to confirm that the classification was accurate and to reduce any bias. However, the researchers' study had its limitations. The researchers were not able to, in the first place, to separate the effects of the medication from the disorder. This makes it difficult to know whether the limited associations observed in the groups that were exposed are due to medication use or the confounding effect of comorbidities. The researchers did not look at long-term outcomes for offspring. The study found that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy or quit taking the medication prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy. Women who were taking stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy. Researchers suggest that the minor risks associated with the use ADHD medications during early pregnancies may be offset by the greater benefits for mother and baby of continuing treatment for the woman's condition. Physicians should speak with their patients about this issue and, if possible, help them improve coping skills which could reduce the impact of her disorder in her daily functioning and her relationships. Medication Interactions As more women than ever are being diagnosed with ADHD and being treated with medication, the dilemma of whether or not to stop treatment during pregnancy is one that doctors are having to face. These decisions are often made without clear and authoritative evidence. Instead, doctors have to consider their own expertise in conjunction with the experiences of other physicians and the research on the topic. The issue of possible risks for infants can be particularly tricky. The research on this issue is based on observation rather than controlled studies and many of the findings are conflicting. Most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study presented in the journal club addresses these issues, by examining both data on live and deceased births. Conclusion Some studies have shown an association between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show a neutral, or even somewhat negative, effect. Therefore, a careful risk/benefit assessment is required in every case. It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In a recent article in Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of isolation and family conflict for these patients. Additionally, the loss of medication can affect the ability to complete jobs and drive safely, which are important aspects of a normal life for a lot of people with ADHD. She suggests women who are unsure about whether to continue or discontinue medication due to their pregnancy consider educating family members, friends and colleagues about the condition, its effects on daily functioning, and on the advantages of continuing the current treatment regimen. It will also help a woman feel more confident in her decision. Some medications can pass through the placenta. If the patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her baby. Birth Defects and Risk of As the use and use of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing the concern over the potential effects of these drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two huge data sets to study more than 4.3 million pregnancy and determine whether stimulant medications caused birth defects. While the overall risk remains low, the scientists did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of specific heart defects, like ventriculo-septal defects (VSD). The researchers of the study didn't discover any link between the use of early medications and congenital anomalies like facial deformities, or club feet. The results are in line with previous studies that have shown a small but significant increase in the risk of heart malformations among women who started taking ADHD medications prior to the time of pregnancy. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication. Women who took ADHD medication in the first trimester of their pregnancies were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby that required breathing assistance at birth. The authors of the study were not able to remove bias in selection since they restricted the study to women with no other medical conditions that could have contributed to the findings. Researchers hope their research will inform physicians when they encounter pregnant women. They advise that while discussing 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 even though stopping the medication is an option, it is not an option to consider due to the high prevalence of depression and other mental health problems among women who are pregnant or post-partum. Research has also shown that women who stop taking their medication will have a difficult adjustment to life without them after the baby is born. Nursing It can be overwhelming to become a mom. Women who suffer from ADHD who have to deal with their symptoms while attending physician appointments, making preparations for the arrival of their child and adapting to new routines in the home may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy. The majority of stimulant medicines pass through breast milk in very small quantities, so the risk to breastfeeding infant is minimal. However, the rate of exposure to medication by the infant can differ based on dosage, how often it is administered, and at what time it is administered. Additionally, individual medications enter the body of the baby differently through the gastrointestinal tract and breast milk. The impact of this on a newborn is not fully understood. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman, who must weigh the benefits of taking her medication as well as the risks to the embryo. As long as there is no more information, GPs should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time. A increasing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are choosing to continue their medication. They have discovered, in consultation with their doctors, that the benefits of continuing their current medication outweigh potential risks. related internet page for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD understand their symptoms and the underlying disorder and learn about treatment options and strengthen existing strategies for managing. This should involve a multidisciplinary approach with the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, and monitoring for signs of deterioration, and, if needed modifications to the medication regime.