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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. Little data exists about how long-term exposure to these drugs may affect the fetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians don't have the data to make unambiguous recommendations, but can provide information on risks and benefits to aid pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large sample-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was correct and to eliminate any bias. The research conducted by the researchers was not without its limitations. The most important issue was that they were unable to separate the effects of the medication from the underlying disorder. That limitation makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. In addition the study did not study long-term offspring outcomes. The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had cut back on their medications prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy. Women who used stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean delivery or having a baby with low Apgar score (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy. The research suggests that the small risk associated with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefit to both the mother and child of continuing treatment for the woman's condition. Physicians should talk to their patients about this issue and, if possible, help them develop coping strategies that could reduce the impact of her disorder in her daily life and relationships. Medication Interactions Many doctors are confronted with the dilemma of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of clear and authoritative evidence either way, so physicians have to weigh their experience, the experiences of other doctors, and what the research says on the topic as well as their own best judgment for each patient. In particular, the issue of potential risks for the baby can be tricky. The research on this subject is based on observations instead of controlled studies and a lot of the results are contradictory. Most studies focus on live births, which may underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in this journal club addresses these limitations by looking at data from both live and deceased births. Conclusion A few studies have shown an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. The majority of studies show a neutral, or even slightly negative, effect. In all cases an in-depth study of the benefits and risks is required. adhd medication uk buy online 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. A loss of medication may affect the ability to drive safely and perform work-related tasks, which are essential aspects of normal life for those suffering from ADHD. She recommends women who are uncertain about whether to keep or stop taking medication because of their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. It can also help women feel more confident in her decision. It is also worth noting that certain medications can be absorbed through the placenta so if a woman decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects 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) increases, so do concerns over the impact that these medications could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this subject. Researchers used two huge data sets to examine over 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Researchers found that while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects. The researchers of the study found no association between early medication use and other congenital anomalies, such as facial clefting or club foot. The findings are in line with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk was higher during the latter part of pregnancy, when a lot of women begin to discontinue their ADHD medications. Women who were taking ADHD medication in the first trimester were more likely to need a caesarean or have a low Apgar after birth and have a baby who needed breathing assistance after birth. The researchers of the study were unable to remove bias in selection since they limited the study to women without other medical conditions that could have contributed to the findings. The researchers hope that their research will aid in the clinical decisions of physicians who see pregnant women. They suggest that although a discussion of the risks and benefits is crucial 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 caution that, even though stopping the medication is an option to think about, it isn't advised due to the high prevalence of depression and other mental problems in women who are expecting or who have recently given birth. Furthermore, research suggests that women who choose to stop their medications are more likely to experience a difficult time getting used to life without them after the birth of their baby. Nursing The responsibilities that come with being a new mom can be overwhelming. Women who suffer from ADHD can face severe challenges when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to a new routine. This is why many women elect to continue taking their ADHD medications throughout the course of pregnancy. The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at low levels. However, the rate of medication exposure to the newborn can vary depending on dosage, frequency 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 through breast milk. The impact of these medications on a newborn's health is not fully comprehended. Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must balance the benefits of keeping her medication against the possible risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal time. Numerous studies have demonstrated that women can continue taking their ADHD medication safely during pregnancy and breast-feeding. As a result, many patients opt to do this and in consultation with their doctor they have discovered that the benefits of continuing their current medication far outweigh any potential risks. It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, as well as monitoring for signs of deterioration, and, if needed, adjustments to the medication regimen.