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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medications during pregnancy and nursing is challenging for women with the condition. There aren't enough adhd and depression medication on how long-term exposure may affect a pregnant fetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological disorders like impaired vision or hearing seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed. Risk/Benefit Analysis Women who are expecting and taking ADHD medication need to consider the benefits of taking it against the possible risks for the baby. Doctors don't have enough data to provide clear recommendations but they can provide information on risks and benefits to assist pregnant women to make an informed decision. A study published in Molecular Psychiatry concluded that women who took ADHD medication in early pregnancy were not at a greater risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to ensure that the classification was correct and to reduce any bias. However, the researchers' study had its limitations. Researchers were unable, in the first place to distinguish the effects of the medication from the disorder. That limitation makes it difficult to know whether the small associations observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. The researchers did not look at long-term outcomes for offspring. The study found that babies whose mothers had taken ADHD medication during pregnancy had a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to those whose mothers did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having to have a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases didn't appear to be influenced by the kind of medication used during pregnancy. Researchers suggest that the minor risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman's condition. Physicians should discuss this with their patients and, when they are able, assist them in developing strategies for improving their coping skills that can lessen the effects of her disorder on her daily life and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and treated with medication, the dilemma of whether or not to stop treatment during pregnancy is a question that more and more doctors have to face. Often, these decisions are made without solid and reliable evidence regardless, so doctors must weigh what they know from their own experiences, those of other doctors, and what the research suggests on the subject, along with their own judgments for each individual patient. Particularly, the issue of potential risks for the baby can be a challenge. The research that has been conducted on this topic is based on observation rather than controlled studies, and a lot of the results are in conflict. Most studies restrict their analysis to live births, which may underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these issues by analyzing data on live and deceased births. Conclusion: While some studies have found an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. The majority of studies show that there is a neutral, or somewhat negative, effect. In all cases, a careful analysis of the risks and benefits must be performed. For a lot of women with ADHD, the decision to stop medication can be 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 increase depression and feelings of isolation. A decrease in medication could affect the ability to safely drive and to perform work-related tasks which are vital aspects of everyday life for those with ADHD. She recommends women who are uncertain about whether or not to discontinue medication due to their pregnancy, consider informing family members, friends and colleagues about the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. It can also help the woman feel supported in her struggle with her decision. It is important to remember that some 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 the effects of the drug can be passed on to the baby. Birth Defects and Risk of As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers utilized two massive datasets to analyze over 4.3 million pregnancies and determine if stimulant medication use caused birth defects. Researchers found that while the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect. The authors of the study found no connection between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are consistent with previous studies that have shown an increase, but not significant, in the risk of cardiac malformations among women who began taking ADHD medications prior to the time of the time of pregnancy. This risk increased in the latter half of pregnancy, as many women decide to stop taking their ADHD medication. Women who were taking ADHD medication during the first trimester were more likely to require a caesarean delivery and also have an insufficient Apgar after birth and had a baby that required breathing assistance after birth. However the authors of the study were unable to eliminate selection bias by restricting the study to women who did not have other medical issues that could have contributed to these findings. Researchers hope that their research will provide doctors with information when they encounter pregnant women. They advise that while the discussion of risks and benefits is important but the decision to stop or maintain treatment should be based on the woman's needs and the severity of her ADHD symptoms. adhd and depression medication warn that even though stopping the medication is an option, it isn't a recommended practice because of the high prevalence of depression and other mental health issues for women who are expecting or recently post-partum. Research has also shown that women who stop taking their medication will have a harder transitioning to life without them after the baby is born. Nursing The responsibilities of a new mother can be overwhelming. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments, prepare for the birth of a child and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy. The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage and frequency of administration as well as the time of the day. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact on the health of a newborn isn't fully comprehended. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the lack of research. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication against the potential dangers to the embryo. Until more information becomes available, doctors may ask pregnant patients if they have a background of ADHD or if they are planning to take medication during the perinatal phase. A growing number of studies have revealed that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are choosing to do so. They have concluded after consulting with their physicians that the benefits of retaining their current medication outweigh possible risks. It's important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be offered to help pregnant people with ADHD understand their symptoms and the root cause and learn about treatment options and strengthen existing coping strategies. This should involve a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counselling should include the discussion of a treatment plan for both the mother as well as the child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.