adhd medication weight loss uk Medication During Pregnancy and Breastfeeding

Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how exposure to ADHD for a long time could affect a fetus.

A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medication must consider the benefits of taking it versus the dangers for the fetus. Doctors don't have enough data to give clear advice however they can provide information on the risks and benefits to aid pregnant women in making informed decisions.

A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not face an increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a vast population-based case-control study to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants during the early stages of pregnancy and those who had not. Pediatric cardiologists and clinical geneticists examined the cases to ensure correct case classification and to limit the possibility of bias.

However, the study was not without its flaws. The researchers were not able in the beginning, to separate the effects of the medication from the disorder. This limitation makes it difficult to know whether the small differences observed in the exposed groups result from medication use or the confounding effect of comorbidities. Researchers also did not examine long-term outcomes for offspring.

The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who used stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a child with an low Apgar score (less than 7). These increases appear to be independent of the type of medication used during pregnancy.

The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both the mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, if they are able, assist them in developing strategies for improving their coping skills that can lessen the effects of her disorder on her daily life and relationships.

Medication Interactions

Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with adhd no medication. These decisions are frequently made without clear and reliable evidence. Instead, doctors have to consider their own expertise, the experience of other doctors and the research on the topic.

Particularly, the subject of potential risks to the baby can be tricky. Many studies on this subject are based on observational data rather than controlled research and their findings are often contradictory. Most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects leading to terminations or abortions of pregnancy. The study presented in the journal club addresses these limitations by analyzing information on deceased and live births.

The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have not found any evidence of a link, and most studies have a neutral or slightly negative effect. As a result, a careful risk/benefit assessment must be conducted in every instance.

It can be challenging, if not impossible for women with ADHD to stop taking their medication. In fact, in an article published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation, and family conflict for patients with ADHD. Additionally, the loss of medication can affect the ability to complete work-related tasks and safely drive that are crucial aspects of a normal life for many people with ADHD.

She suggests that women who are unsure whether to take the medication or stop it due to their pregnancy, educate their family members, coworkers and friends about the condition, the effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help a woman feel supported in her decision. It is also worth noting that some medications can be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be transferred to the infant.

Risk of Birth Defects

As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about the effects that the medications could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Utilizing two huge 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. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medicines was associated with a slightly higher rate of certain heart defects such as ventriculo-septal defect (VSD).

The authors of the study could not discover any connection between the use of early medications 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 cardiac malformations among women who began taking ADHD medications before the birth of their child. The risk increased in the latter half of pregnancy when many women decided to stop taking their medication.

Women who took ADHD medication in the first trimester were more likely to require a caesarean birth and also have an insufficient Apgar after birth and have a baby who needed breathing assistance after birth. The researchers of the study were not able to remove bias in selection since they limited their 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. The researchers recommend that while discussing risks and benefits are important, the choice on whether to continue or stop taking medication should be in light of the severity of each woman's ADHD symptoms and her requirements.

The authors also warn 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 for women who can prescribe adhd medication are expecting or recently postpartum. Further, research shows that women who stop taking their medications will have a difficult time adjusting to a life without them once the baby is born.

Nursing

It can be overwhelming to become a mother. 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 child and adjust to a new routine. This is why many women choose to continue taking their ADHD medication throughout the pregnancy.

The risk to a breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk at low levels. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of the day. Additionally, different types of adhd medication medications enter the baby’s system via the gastrointestinal tract or through breast milk. The impact on the health of a newborn isn't fully comprehended.

Because of the lack of evidence, some doctors may be inclined to discontinue stimulant drugs during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of her medication against the risk to the foetus. In the meantime, until more information is available, doctors can ask pregnant patients if they have a background of ADHD or if they intend to take medication during the perinatal stage.

Numerous studies have demonstrated that women can continue to take their ADHD medication safely while breastfeeding and during pregnancy. In response, a rising number of patients are choosing to do this. They have found after consulting with their doctor that the benefits of keeping their current medication outweigh risk.

Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also needed to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be educated about treatment options and strengthen strategies for coping. This should be an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration and, if necessary adjustments to the medication regimen.