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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medications during pregnancy and breastfeeding is a challenge for women suffering from the condition. There are few data regarding how exposure over time may affect the fetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological disorders like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality studies. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the fetus. Physicians don't have the data to make unambiguous recommendations however they can provide information about risks and benefits to help pregnant women make an informed decision. A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a large population-based study of case control to assess the frequency of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to reduce any bias. The study conducted by the researchers was not without its limitations. The researchers were not able, in the first place, to separate the effects caused by the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. In addition the researchers did not look at the long-term effects of offspring on their parents. The study did reveal that infants whose mothers took ADHD medication during pregnancy were at a greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not affected by the stimulant medication used during pregnancy. Women who used stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean birth or having a baby with low Apgar score (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy. The research suggests 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 benefits to both mother and child of continuing treatment for the woman's disorder. Physicians should talk to their patients about this and try to help them develop coping skills that may reduce the effects of her disorder on her daily life 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. These decisions are often taken without clear and authoritative evidence. Instead, doctors have to take into account their own experience and experience, as well as the experiences of other doctors and the research that has been conducted on the subject. Particularly, the issue of potential risks for the baby can be tricky. Many studies on this issue are based on observational evidence rather than controlled research, and their findings are often contradictory. In addition, most studies limit their analysis to live births, which may underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study discussed in this journal club addresses these limitations by looking at data from both live and deceased births. The conclusion is that while certain studies have demonstrated a positive association between ADHD medications and the risk of certain birth defects, others have found no connection, and most studies demonstrate a neutral or slightly negative impact. Therefore, a careful risk/benefit assessment is required in every case. For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is difficult, if not impossible. In fact, in a recent article in the 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 those suffering from the disorder. A decrease in medication could also impact the ability to safely drive and complete work-related tasks, which are vital aspects of normal life for those with ADHD. best adhd medication for adults uk suggests that women who aren't sure whether to take the medication or stop it due to their pregnancy, educate their family members, colleagues, and friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment regimen. It will also help a woman feel more confident in her decision. It is also worth noting that certain medications are able to be absorbed through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that the effects of the medication could be transferred to the child. Birth Defects and Risk of As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about what impact the medications could have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers utilized two massive data sets to examine over 4.3 million pregnancies and determine if the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, the first trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect. The researchers of the study found no association between early medication use and other congenital abnormalities, like facial clefting, or club foot. The results 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 the time of pregnancy. The risk increased in the latter stages of pregnancy, when a lot of women stopped taking their medication. Women who took ADHD medication during the first trimester were more likely need a caesarean or have an insufficient 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 limited their study to women with no other medical conditions that might have contributed to the findings. The researchers hope that their research will help inform the clinical decisions of doctors who see pregnant women. They recommend that, while the discussion of the benefits and risks is important however, the decision to stop or maintain medication should be based on the woman's needs and the severity of her ADHD symptoms. The authors also advise that, while stopping the medication is an option, it isn't an option to consider due to the high rate of depression and other mental health problems for women who are expecting or recently postpartum. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience difficulties adapting to life without them after the baby's arrival. Nursing It can be a challenge becoming a mother. Women suffering from ADHD may face a lot of challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to a new routine. As such, many women elect to continue taking their ADHD medication throughout the pregnancy. The risk for breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk at a low level. The rate of exposure to medication will vary based on the dosage, frequency of administration and time of day. In addition, various medications enter 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 may recommend stopping stimulant medication during the course of pregnancy. It's a difficult choice for the woman, who must weigh the advantages of her medication against the risk to the foetus. As long as there is no more information, GPs should ask all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal time. A increasing number of studies have proven that women can continue their ADHD medication during pregnancy and breastfeeding. As a result, an increasing number of patients are choosing to do so and, in consultation with their doctor they have discovered that the benefits of maintaining their current medication exceed any risk. adhd medication list who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and underlying disorder. They should also be educated about treatment options and strengthen coping mechanisms. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, and monitoring for indicators of deterioration, and, if needed modifications to the medication regime.