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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD face a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how exposure to ADHD for a long time could affect the foetus. A recent study 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 the need for more high-quality research. Risk/Benefit Analysis Women who are pregnant and take ADHD medication should weigh the benefits of taking it against the potential dangers for the foetus. The doctors don't have the information to give clear advice however they can provide information on risks and benefits to assist pregnant women to make informed choices. 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 massive population-based case control study to examine the prevalence of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias. However, the researchers' study was not without its flaws. The most important issue was that they were unable to separate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups that were exposed to the use of medication or confounded by co-morbidities. The researchers did not look at long-term outcomes for the offspring. The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or had stopped their medications before or during pregnancy. This was due to central nervous system disorders, and the increased risk for admission was not found to be affected by the type of stimulant medication was used during pregnancy. Women who took stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean delivery or having a baby born with a low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication taken during pregnancy. Researchers suggest that the small risk of using ADHD medications during early pregnancies could be offset by the more beneficial outcomes for both mother and baby from continuing treatment for the woman's condition. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve their coping abilities which can reduce the effects of her disorder on her daily functioning and relationships. Interactions with Medication As more women than ever are diagnosed with ADHD and being treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is a question that doctors are having to face. The majority of these decisions are taken in the absence of solid and reliable evidence in either case, which means that doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests about the subject as well as their own judgments for each patient. In particular, the issue of potential risks to the baby can be a challenge. The research that has been conducted on this topic is based on observations instead of controlled studies and many of the findings are in conflict. Most studies restrict their analysis to live births, which can underestimate the teratogenic impact which can cause terminations or abortions of pregnancy. The study discussed in this journal club addresses these shortcomings by examining data on both live and deceased births. Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show that there is a neutral, or somewhat negative, effect. In the end, a careful risk/benefit assessment must be conducted in every situation. It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. 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 lead to depression and feelings of being isolated. medications for adhd in adults in medication could also impact the ability to safely drive and complete work-related tasks, which are vital aspects of daily life for those suffering from ADHD. She suggests that women who are unsure whether to take the medication or stop due to pregnancy educate family members, coworkers and friends about the condition, the impact on daily functioning and the benefits of continuing the current treatment. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the medication could be passed on to her infant. Risk of Birth Defects As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs might have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. Researchers used two massive data sets to study over 4.3 million pregnancy and determine whether stimulant medications increased birth defects. Although the risk overall is low, the researchers discovered that the first-trimester exposure to ADHD medicines was associated with a slightly higher rate of certain heart defects, such as ventriculoseptal defect (VSD). The authors of the study didn't discover any link between the use of early medications and congenital anomalies such as facial deformities or club feet. The results are in line with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication prior to pregnancy. The risk grew in the latter half of pregnancy, when a lot of women decide to stop taking their ADHD medication. Women who were taking ADHD medication in the first trimester were more likely require a caesarean delivery and also have a low Apgar after delivery, and have a baby that needed breathing assistance after birth. However, the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could have contributed to these findings. The researchers hope that their research will help inform the clinical decisions of doctors who treat pregnant women. The researchers advise that, while discussing benefits and risks are important, the decision about 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 advise that while discontinuing the medications is an option, it isn't an option to consider due to the high prevalence of depression and other mental health problems among women who are pregnant or who are recently postpartum. Further, research shows that women who stop taking their medications will have a difficult adjustment to life without them once the baby is born. Nursing It can be a challenge to become a mom. Women suffering from ADHD may face a lot of challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to a new routine. As such, many women decide to continue taking their ADHD medications throughout pregnancy. The majority of stimulant medications are absorbed by breast milk in very small quantities, so the risk for nursing infant is very low. However, the frequency of medication exposure to the newborn can vary depending on dosage, frequency it is administered and the time of the day the medication is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The effect on a newborn's health is not fully understood. Because of the lack of evidence, some doctors may be inclined to discontinue stimulant medication during a woman's pregnancy. This is a difficult decision for the mother, who must weigh the benefits of her medication against the potential risks to the embryo. As long as more information is available, doctors can inquire about pregnant patients if they have a history of ADHD or if they plan to take medication during the perinatal stage. Numerous studies have proven that women can continue to take their ADHD medication without risk while breastfeeding and during pregnancy. As a result, more and more patients are choosing to do so and after consulting with their doctor, they have found that the benefits of keeping their current medication far outweigh any risks. Women who suffer from ADHD who plan to breastfeed should seek advice from an expert 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 strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce the coping mechanisms. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a plan for management for both mother and child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.