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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications may affect the foetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental disorders like hearing loss or impaired 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 benefits of taking them against the potential risks to the fetus. Physicians don't have the data needed to make unequivocal recommendations but they can provide information regarding risks and benefits that aid pregnant women in making informed choices. A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations, or structural birth defects. Researchers conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists looked over the cases to ensure an accurate classification of the cases and to reduce the possibility of bias. However, the study had its limitations. The researchers were not able, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or confounding by comorbidities. Researchers also did not study long-term outcomes for the offspring. The study did find that infants whose mothers took ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or taken off their medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission did not appear to be influenced by which stimulant medications were taken during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or the baby was not scoring well on the Apgar scale (less than 7). These increases appeared to be independent of the type of medication used during pregnancy. Researchers suggest that the small risk of using ADHD medication during pregnancies in the early stages could be offset by the greater benefits to both baby and mother of continued treatment for the woman's condition. adhd adults medication should discuss the issue with their patients and, when possible, assist them in developing strategies for improving their coping skills that may minimize the negative impact of her condition on her daily life and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether or not to stop treatment during pregnancy is one that doctors are having to face. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what research says on the topic as well as their best judgment for each individual patient. The issue of possible risks for infants can be difficult to determine. Many studies on this topic are based on observational data rather than controlled research and their findings are often contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these issues by analyzing data on live and deceased births. Conclusion Some studies have shown a positive correlation between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies have shown a neutral, or even slightly negative, effect. In every case, a careful study of the risks and benefits should be conducted. For women suffering from ADHD who suffer from ADHD, the decision to stop taking medication is difficult, if not impossible. In fact, in an article recently published 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. The loss of medication can also impact the ability to safely drive and complete work-related tasks, which are essential aspects of daily life for those suffering from ADHD. She suggests women who are unsure about whether or not to stop medication in light of their pregnancy, consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily life, and the benefits of keeping the current treatment regimen. It will also help a woman feel supported in her decision. Certain medications can be passed through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the drug could be transferred to the baby. Birth Defects Risk As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases, so does concern about the potential effects of these drugs on foetuses. 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 to examine more than 4.3 million pregnancies and determine whether stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists did find that first-trimester exposure to ADHD medicines was associated with an increased risk of certain heart defects such as ventriculo-septal defect (VSD). The researchers of the study found no connection between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in the same vein as previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the time of the time of pregnancy. This risk increased during the latter part of pregnancy when many women began to stop taking their medication. Women who were taking ADHD medication in the first trimester were more likely to require a caesarean delivery and also have a low Apgar after delivery and had a baby that required breathing assistance after birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who did not have any other medical issues that could be a contributing factor to these findings. Researchers hope their research will help doctors when they see pregnant women. They recommend that, while the discussion of the risks and benefits is crucial, the decision to stop or continue treatment should be based on each woman's requirements and the severity of her ADHD symptoms. The authors also warn that, while stopping the medication is an option, it isn't an option to consider due to the high incidence of depression and other mental health issues for women who are expecting or recently postpartum. Additionally, the research suggests that women who choose to stop their medications are more likely to have difficulties adapting to life without them following the baby's arrival. Nursing It can be a challenge to become a mother. Women with ADHD who must work through their symptoms while attending physician appointments, getting ready for the arrival of a child and adjusting to new household routines are often faced with a number of difficulties. Many women decide to continue taking their ADHD medication during pregnancy. The majority of stimulant medications pass through breast milk in very small amounts, therefore the risk to the nursing infant is very low. The amount of exposure to medications can vary depending upon the dosage, frequency of administration and time of day. In addition, 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 well understood. Some doctors may stop taking stimulant medication during a woman's pregnancy due to the absence of research. This is a complicated decision for the patient, who must balance the benefits of continuing her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors can ask pregnant patients whether they have an 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 to take their ADHD medication during pregnancy and while breastfeeding. In response, an increasing number of patients are opting to do this. They have concluded, in consultation with their doctor that the benefits of continuing their current medication outweigh any possible risks. It's important for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and underlying disorder, learn about available treatment options and reinforce existing strategies for managing. This should include a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Counselling for pregnancy should include the discussion of a treatment plan for both mother and child, monitoring for signs of deterioration, and the need for adjustments to the medication regimen.