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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during pregnancy and nursing is challenging for women with the condition. There are few data on how long-term exposure may affect a pregnant fetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders like hearing or vision impairment, 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 should consider the benefits of taking it against the potential risks for the baby. Doctors don't have enough data to make unambiguous recommendations but they can provide information on the risks and benefits to aid pregnant women in making an informed decision. A study published in Molecular Psychiatry found that women who were taking ADHD medications in early pregnancy did not have an increased risk of fetal cardiac malformations or major structural birth defects. Researchers used a large sample-based case control study to examine the prevalence of major structural defects in infants born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure correct case classification and to limit the chance of bias. The research conducted by the researchers was not without its limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. This makes it difficult for researchers to establish whether the small differences observed between the groups that were exposed to the use of medication, or if they were caused by the presence of comorbidities. In addition the researchers did not examine long-term offspring outcomes. The study did find that infants whose mothers had taken ADHD medications during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or had taken off their medication prior to or during pregnancy. This increase was due to central nervous system-related disorders and the higher risk of admission was not found to be affected by the type of stimulant medications were taken during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy. The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the higher benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve their coping abilities that can lessen the negative impact of her condition on her daily functioning and relationships. Medication Interactions Doctors are increasingly confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. These decisions are often taken without clear and authoritative evidence. Instead, doctors must consider their own expertise in conjunction with the experiences of other doctors, and the research on the subject. The issue of possible risks for infants can be extremely difficult. Many studies on this issue are based on observational evidence rather than controlled research, and their conclusions are often contradictory. The majority of studies focus on live births, which may underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations, by examining both information on deceased and live births. adhd adults medication : While certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have not found any evidence of a link, and most studies demonstrate a neutral or slight negative effect. As a result an accurate risk-benefit analysis is required in every case. It can be challenging, if not impossible, for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's 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 affect the ability to safely drive and to perform work-related tasks which are vital aspects of normal life for people with ADHD. She suggests that women who are not sure whether to take the medication or discontinue it due to pregnancy, educate their family members, colleagues, and acquaintances about the condition, the impact on daily functioning and the benefits of continuing the current treatment regimen. It can also help women feel more confident in her decision. It is also worth noting that certain medications can pass through the placenta therefore, if a patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug can be passed on to the baby. Birth Defects and Risk of As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the drugs might have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge about this subject. Using two massive data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD exposure to medication was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect. The researchers 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 consistent with previous studies revealing a small but significant increase in the risk of heart malformations among women who began taking ADHD medications prior to the birth of their child. The risk was higher in the later part of pregnancy, when many women are forced to stop taking their ADHD medication. Women who used ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean section, low Apgar score following delivery, and a baby that required help breathing at birth. adhd medication adults of the study were unable to eliminate bias due to selection because they limited the study to women without other medical conditions that might have contributed to the findings. Researchers hope that their research will help doctors when they see pregnant women. They suggest that although discussing the benefits and risks is important but the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms. The authors caution that, even though stopping the medication is a possibility to think about, it isn't advised due to the high rate depression and mental health issues for women who are pregnant or have recently given birth. Additionally, the research suggests that women who choose to stop their medications are more likely to have a difficult time adapting to life without them after the birth of their baby. Nursing It can be a challenge to become a mother. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments as well as preparing for the arrival of a child and getting used to new routines at home may face a lot of challenges. Many women choose to continue taking their ADHD medication during pregnancy. The majority of stimulant medications are absorbed by breast milk in small amounts, therefore the risk to the breastfeeding infant is minimal. However, the amount of medication exposure to the newborn can vary depending on dosage, how often it is administered, and at what time it is administered. In addition, different medications are introduced into the baby's system via the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn is not completely understood. Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. It is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the potential risks to the fetus. As long as more information is available, GPs may ask pregnant patients if they have a history of ADHD or if they plan to take medication during the perinatal period. A growing number of studies have shown that women can continue taking their ADHD medication while they are pregnant and nursing. This has led to many patients choose to do so and after consulting with their doctor, they have found that the benefits of maintaining their current medication outweigh any risks. Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant people with ADHD be aware of their symptoms and underlying disorder, learn about available treatment options and strengthen existing coping strategies. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if needed, adjustments to the medication regimen.