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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. Little data exists about how to get prescribed adhd medication uk long-term exposure to these medications could affect the fetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to strattera adhd medication medication during pregnancy do not develop neurological disorders like 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 expecting and taking ADHD medication must consider the benefits of taking it versus the risks for the foetus. Physicians don’t have the information needed to make unequivocal recommendations but they can provide information regarding benefits and risks that can assist 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 higher risk of fetal malformations or structural birth defects. The researchers used a large 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. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to limit the possibility of bias.
The study conducted by the researchers had some limitations. In particular, they were not able to differentiate the effects of the medication from the effects of the underlying disorder. This makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to medication use, or if they were confounded by comorbidities. Additionally, the researchers did not examine the long-term effects of offspring on their parents.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy.
Women who were taking stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases didn’t appear to be affected by the kind of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefits to both mother and child of continuing treatment for the woman’s condition. Doctors should discuss with their patients about this and as much as possible, assist them develop coping strategies that can lessen the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
More and more doctors are faced with the decision of whether to continue treatment or stop as more women are diagnosed with ADHD. Often, these decisions are taken in the absence of solid and reliable evidence either way, so physicians must weigh what they know about their experiences, the experiences of other doctors, and what the research suggests about the subject, along with their own judgments for each individual patient.
Particularly, the issue of potential risks to the baby can be tricky. The research that has been conducted on this topic is based on observations instead of controlled studies and many of the findings are contradictory. The majority of studies restrict their analysis to live-births, which could underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in the journal club addresses these issues, by examining both data on live and deceased births.
The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, others have found no such relationship and the majority of studies demonstrate a neutral or slight negative effect. Therefore an accurate risk-benefit analysis is required in every case.
It isn’t easy, but not impossible for women suffering from ADHD to stop taking their medication. In fact, in an article recently published in Archives of Women’s Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for patients with ADHD. In addition, a decrease in medication can affect the ability to do job-related tasks and drive safely that are crucial aspects of a normal life for many people with best adhd medication uk.
She suggests that women who are unsure about whether to keep or stop taking medication because of their pregnancy consider informing family members, friends and colleagues about the condition, its impact on daily functioning, and the benefits of keeping the current treatment regimen. It can also make the woman feel more comfortable as she struggles with her decision. It is important to note that some medications are able to pass through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the drug can be transferred to the child.
Risk of Birth Defects
As the use and misuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the potential adverse effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Researchers used two huge datasets to analyze more than 4.3 million pregnant women and determine if the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was associated with an increased risk of certain heart defects, like ventriculo-septal defects (VSD).
The researchers of the study found no connection between early medication use and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies revealing a small but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications before the birth of their child. The risk increased in the latter part of pregnancy, when a lot of women began to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery, have a low Apgar after delivery, and have a baby who needed breathing assistance after birth. The researchers of the study were not able to eliminate selection bias because they restricted the study to women without other medical conditions that could have contributed to the findings.
Researchers hope their research will inform physicians when they see pregnant women. They recommend that, while discussing the risks and benefits is crucial but the decision to stop or keep medication should be based on the woman’s requirements and the severity of her ADHD symptoms.
The authors caution that, even though stopping the medication is an option to consider, it is not recommended due to the high rate depression and other mental disorders for women who are pregnant or recently gave birth. Research has also shown that women who stop taking their medications will have a tough transitioning to life without them after the baby is born.
Nursing
It can be a stressful experience to become a mother. Women with ADHD who must work through their symptoms while attending doctor appointments as well as making preparations for the arrival of their child and getting used to new routines at home can experience severe challenges. Many women decide to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed through breast milk in small quantities, so the risk for infant who is breastfeeding is low. However, the rate of exposure to medication by the infant can differ based on the dosage, frequency it is taken and at what time the medication is administered. In addition, various medications are introduced into the baby’s system via the gastrointestinal tract or breast milk. The impact on a newborn’s health is not fully known.
Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the absence of research. It is a difficult decision for the woman who must weigh the benefits of taking her medication as well as the potential risks to the fetus. As long as more information is available, GPs may inquire about pregnant patients whether they have an background of ADHD or if they intend to take medication in the perinatal period.
A increasing number of studies have shown that women can continue taking their ADHD medication during pregnancy and breastfeeding. In the end, an increasing number of patients are choosing to do so, and in consultation with their doctor they have found that the benefits of continuing their current medication far exceed any risk.
It’s important for women with ADHD who are thinking of breastfeeding to seek out a specialist psychiatrist’s advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continuing treatment. This includes non-pharmacological strategies. Psychoeducation should also be provided to help pregnant women suffering from buy adhd medication online uk understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should include an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, as well as monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regimen.
