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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during pregnancy and nursing is a challenge for women suffering from the condition. There is a lack of information about how long-term exposure to these drugs 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 impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication need to weigh the benefits of taking it against the potential dangers for the baby. Doctors don't have the information needed to provide clear recommendations however they can provide information about benefits and risks that can aid pregnant women in making informed decisions. A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers used a vast population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants during the early stages of 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 accurate and to reduce any bias. However, the study was not without its flaws. The researchers were unable to, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult to determine whether the limited associations observed in the groups that were exposed result from medication use or the confounding effect of comorbidities. In addition, the researchers did not look at long-term offspring outcomes. The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had taken off their medication prior to or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy. Women who took stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean birth or having a baby born with low Apgar score (less than 7). These increases 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 early pregnancy could be offset by the higher benefit to both mother and child of continuing treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them improve coping skills which may reduce the impact of her disorder in her daily functioning and her relationships. Medication Interactions As more women than ever are being diagnosed with ADHD and treated with medication, the question of whether to continue or discontinue treatment during pregnancy is one that doctors are having to have to face. Most of the time, these decisions are taken in the absence of any evidence that is clear and definitive in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests on the subject, along with their own judgments for each individual patient. The issue of possible risks for infants can be extremely difficult. link webpage on this issue are based on observational evidence rather than controlled research and their findings are often contradictory. Most studies focus on live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study presented in the journal club addresses these limitations, by examining both information on deceased and live births. Conclusion A few studies have shown an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies show a neutral, or even slight negative impact. In each case it is imperative to conduct a thorough evaluation of the potential risks and benefits should be conducted. For women suffering from ADHD who suffer from ADHD, the decision to stop taking medication is difficult, if not impossible. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness and family conflict for patients with ADHD. The loss of medication can also impact the ability to drive safely and perform work-related tasks, which are vital aspects of everyday life for those with ADHD. She suggests that women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider informing family members, friends, and coworkers on the condition, its effects on daily functioning, and on the advantages of staying on the current treatment regimen. In addition, educating them can help the woman feel supported when she is struggling with her decision. It is also worth noting that certain medications can be absorbed through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the drug can be passed on to the baby. Risk of Birth Defects As the use and use of ADHD medication to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD), increases the concern over the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive 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. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increased risk of specific heart defects, such as ventriculo-septal defect (VSD). The authors of the study found no link between early use of medication and other congenital anomalies, like facial clefting, or club foot. The findings are in line with previous studies that have shown a small but significant increase in the risk of cardiac malformations among women who started taking ADHD medications prior to pregnancy. The risk grew during the latter part of pregnancy, as many women decide to stop taking their ADHD medication. 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 had a baby that required help breathing at birth. The authors of the study could not remove bias in selection since they limited the study to women without other medical conditions that might have contributed to the findings. The researchers hope that their research will aid in the clinical decisions of doctors who treat pregnant women. They advise that while a discussion of the risks and benefits is crucial however, the decision to stop or keep treatment should be based on the woman's needs and the severity of her ADHD symptoms. The authors also advise that even though stopping the medication is an option, it isn't a recommended practice because of the high incidence of depression and other mental health issues in women who are pregnant or recently postpartum. Additionally, research suggests that women who stop taking their medication will have a tough adjustment to life without them after the baby is born. Nursing The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments as well as getting ready for the arrival of their child and adapting to new routines in the home are often faced with a number of difficulties. Many women decide to continue taking their ADHD medication during pregnancy. relevant web page to a breastfeeding infant is minimal because the majority of stimulant medication is absorbed through breast milk in low amounts. The rate of medication exposure can vary depending upon the dosage, frequency of administration and the time of the day. In addition, various medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The impact of these medications on the health of a newborn is not fully understood. Some physicians may discontinue stimulant medications during a woman's pregnancy due to the lack of research. It's a difficult choice for the mother, who must weigh the benefits of her medication against the risk to the fetus. Until more information is available, doctors should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal period. A increasing number of studies have shown that the majority of women are able to safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to continue their medication. They have discovered through consultation with their doctor, that the benefits of continuing their current medication outweigh possible risks. Women with ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their physician and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also needed to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and strengthen strategies for coping. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Counselling for pregnancy should include discussion of a management plan for both mother and child, monitoring for signs of deterioration, and the need for adjustments to the medication regimen.