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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during breastfeeding and pregnancy is a challenge for women suffering from the condition. There aren't many studies regarding how exposure over time may affect the pregnant fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality studies are required. Risk/Benefit Analysis Women who are expecting and taking ADHD medication should evaluate the benefits of using it versus the risks for the baby. Physicians do not have the information needed to provide clear recommendations however they can provide information regarding benefits and risks that can aid pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers used a vast, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, as well as those who had not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure correct case classification and to minimize the chance of bias. However, the researchers' study had its limitations. Most important, they were not able to differentiate the effects of the medication from those of the underlying disorder. This makes it difficult to know whether the small associations observed in the groups that were exposed are due to medication use or the confounding effect of comorbidities. The researchers also did not examine long-term outcomes for the offspring. The study did find that babies whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or cut back on their medications prior to 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 took stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean section or having a baby born with low Apgar score (less than 7). These increases did appear to be unrelated to the type of medication used during pregnancy. The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both mother and child from continued treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, help them develop strategies for improving their coping skills that may minimize the effects of her disorder on her daily functioning and relationships. Medication Interactions Doctors are increasingly confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of clear and authoritative evidence regardless, so doctors must weigh their knowledge about their experiences, the experiences of other doctors, and what research suggests on the subject, along with their own best judgment for each individual patient. The issue of possible risks to infants is difficult to determine. The research on this subject is based on observation rather than controlled studies, and the results are conflicting. Most studies focus on 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 shortcomings, by examining both the data from deceased and live births. The conclusion: While certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slightly negative impact. In every case an in-depth study of the benefits and risks must be performed. For a lot of women with ADHD who suffer from ADHD, the decision to stop taking 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 lead to depression and feelings of loneliness. Furthermore, a loss of medication may affect the ability to complete jobs and drive safely which are essential aspects of a normal life for many people 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 will also help a woman feel supported in her decision. Certain medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be transferred 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 drugs could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculoseptal defect (VSD). The authors of the study found no association between early medication use and other congenital anomalies, such as facial clefting or club foot. The results are in the same vein as previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication prior to pregnancy. The risk increased in the latter half of pregnancy when many women decided to stop taking their medication. Women who used ADHD medications during the first trimester of their pregnancy were also more likely to experience caesarean sections, a low Apgar score following delivery, and a baby who needed breathing assistance during birth. The researchers of the study were not able to eliminate bias due to selection because they limited the study to women who did not have any other medical conditions that could have contributed to the findings. The researchers hope that their research will serve to inform the clinical decisions of physicians who see pregnant women. The researchers advise that, while discussing risks and benefits are crucial, the decision on whether to continue or stop taking medication should be based on the severity of each woman's ADHD symptoms and the needs of the woman. The authors warn that, while stopping the medication is an option to look into, it is not advised because of the high incidence of depression and other mental problems among women who are pregnant or recently gave birth. Further, the research suggests that women who choose to stop taking their medications are more likely to experience difficulties adjusting to life without them following the birth of their baby. Nursing It can be overwhelming to become a mom. Women suffering from ADHD are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to a new routine. Therefore, many women choose to continue taking their ADHD medications throughout pregnancy. The majority of stimulant medicines are absorbed by breast milk in small quantities, so the risk for infant who is breastfeeding is low. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of day. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or through breast milk. The impact on the health of a newborn isn't fully understood. Due to the absence of evidence, some doctors might be tempted to stop taking stimulant medication during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication with the potential risks to the embryo. In the meantime, until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period. adhd medication for adults have proven that women can continue taking their ADHD medication in a safe manner while breastfeeding and during pregnancy. In response, a rising number of patients are choosing to do this. They have discovered, in consultation with their doctor that the benefits of retaining their current medication outweigh possible risks. It is essential for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD understand their symptoms and the underlying disorder, learn about available treatment options and reinforce existing coping strategies. This should be an approach that is multidisciplinary, including the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counselling should include the discussion of a treatment plan for both mother and child, monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.