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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There are few data on how exposure to ADHD for a long time could affect a foetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required. Risk/Benefit Analysis Women who are pregnant and take ADHD medication must weigh the benefits of taking it versus the dangers for the foetus. Physicians don't have the necessary data to make unequivocal recommendations, but they can provide information about benefits and risks that can assist pregnant women in making informed decisions. A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have an increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large sample-based case control study to examine the prevalence of major structural defects in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was correct and to reduce any bias. However, the researchers' study had its limitations. Researchers were unable in the beginning to distinguish the effects of the medication from the disorder. That limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. Researchers also did not look at the long-term effects for the 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 infants whose mothers had not taken any medication or had stopped their medications before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases did not appear to be affected by the type of medication that was used during pregnancy. Researchers suggest that the small risks posed by the use of ADHD medications in early pregnancies can be offset by more beneficial outcomes for both mother and baby of continuing treatment for the woman's disorder. Physicians should speak with their patients about this issue and, if possible, help them develop coping skills that can lessen the effects of her disorder on her daily functioning and her relationships. Medication Interactions More and more doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are usually made without clear and reliable evidence. Instead, doctors have to consider their own expertise and experience, as well as the experiences of other doctors and the research on the subject. The issue of risk for infants can be difficult to determine. The research on this issue is based on observation instead of controlled studies and a lot of the results are conflicting. In addition, most studies limit their analysis to live births, which may underestimate severe teratogenic effects that lead to abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births. Conclusion A few studies have revealed an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown an unintended, or slightly negative, impact. In every case an in-depth study of the potential 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 a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. The loss of medication can also affect the ability to drive safely and perform work-related tasks, which are essential aspects of daily life for those suffering from ADHD. She suggests women who are uncertain about whether or not to stop taking medication because of their pregnancy, consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and the benefits of keeping the current treatment plan. In addition, educating them can help the woman feel supported when she is struggling with her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it's important to be aware that the medication may be transferred to her infant. Birth Defects and Risk of As the use and use of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases as does the concern about the potential effects of these drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers utilized two massive data sets to study over 4.3 million pregnant women and determine if stimulant medication use increased the risk of birth defects. add medication uk found that while the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects. The authors of the study could not discover any link between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in agreement with previous studies that showed an insignificant, but small increase in cardiac malformations for women who started taking ADHD medication prior to the birth of their child. The risk increased in the latter stages of pregnancy when a large number of women decided to stop taking their medication. Women who used ADHD medications in the first trimester of their pregnancy were also more likely to undergo caesarean sections, a low Apgar score following delivery, and a baby that required breathing assistance at birth. However the authors of the study were not able to eliminate bias due to selection by restricting the study to women who did not have other medical issues that could have contributed to these findings. The researchers hope their research will help inform the clinical decisions of doctors who treat pregnant women. They recommend that, while discussing the risks and benefits is crucial however, the decision to stop or maintain medication must be based on each woman's needs and the severity of her ADHD symptoms. The authors also warn that even though stopping the medication is an alternative, it is not a recommended practice because of the high rate of depression and other mental health problems among women who are pregnant or post-partum. Additionally, visit the up coming website suggests that women who stop taking their medications will have a harder time adjusting to a life without them after the baby is born. Nursing The responsibilities of being a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments and preparing for the arrival of a child and adapting to new routines in the home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy. The majority of stimulant medications are absorbed through breast milk in low amounts, therefore the risk to infant who is breastfeeding is low. However, the rate of medication exposure to the newborn can vary depending on dosage, how often it is administered and at what time the medication is administered. In addition, individual medications enter the baby's system differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn infant is not well understood. Because of the lack of research, some physicians may recommend stopping stimulant medication during the course of pregnancy. It is a difficult decision for the woman who must weigh the benefits of her medication against the potential risks to the foetus. In the meantime, until more information is available, GPs can inquire about pregnant patients if they have a background of ADHD or if they intend to take medication during the perinatal period. Many studies have shown that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, a rising number of patients are opting to continue their medication. They have found through consultation with their doctors, that the benefits of keeping their current medication far outweigh any risk. Women who suffer from ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should review their medications with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD recognize their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for coping. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, monitoring of indicators of deterioration, and, if needed modifications to the medication regime.