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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medication during pregnancy and nursing is challenging for women with the condition. There aren't enough data on how long-term exposure may affect a fetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for higher-quality research. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the foetus. Physicians don't have the data needed to make unequivocal recommendations, but they can provide information about benefits and risks that can assist pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at greater 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 reviewed the cases to ensure correct classification of the cases and to reduce the possibility of bias. However, the study was not without its flaws. In particular, they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This limitation makes it difficult for researchers to determine if the small differences observed between the groups exposed were due to medication use or affected by the presence of comorbidities. In addition the researchers did not study long-term offspring outcomes. The study did show that infants whose mothers took ADHD medication during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or had stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having an emergency caesarean section or having one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be independent of 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 may be offset by the greater benefits to both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and try to help them improve coping skills which can lessen the effects of her disorder on her daily life and relationships. Interactions with Medication More and more doctors are confronted with the dilemma of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. The majority of these decisions are made without any evidence that is clear and definitive either way, so physicians must weigh their knowledge about their experiences, the experiences of other doctors, and what the research suggests on the subject as well as their best judgment for each individual patient. The issue of risk for infants can be particularly tricky. The research on this issue is based on observations rather than controlled studies and the results are in conflict. Most studies limit their analysis to live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study discussed in this journal club addresses these issues by examining data on both 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 an unintended, or slightly negative, impact. In all cases, a careful evaluation of the risks and benefits should be conducted. For adhd medication uk buy online with ADHD and ADD, the decision to discontinue medication can be difficult, if not impossible. 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 those suffering from the disorder. Furthermore, a loss of medication may affect the ability to do jobs and drive safely which are essential aspects of a normal life for a lot of people with ADHD. She suggests that women who are unsure about whether or not to discontinue medication due to their pregnancy, consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily life, and the advantages of continuing the current treatment regimen. In addition, educating them can help the woman feel supported in her struggle with her decision. It is important to remember that some medications can pass through the placenta, so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware that traces of the drug can be transferred to the infant. Birth Defects and Risk of As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) is increasing, so does concern about the possible effects of the drugs on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this subject. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the risk overall is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect. The researchers behind the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are consistent with previous studies that have shown a small but significant increase in the risk of heart malformations among women who started taking ADHD medications prior to the time of the birth of their child. This risk increased during the latter stages of pregnancy when many women began to stop taking their medication. Women who took ADHD medications in the first trimester of their pregnancies were also more likely to experience a caesarean section, a low Apgar score following delivery, and a baby who required breathing assistance at birth. However the researchers of the study were not able to eliminate selection bias by limiting 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 help inform the clinical decisions of physicians who treat pregnant women. The researchers advise that, while discussing benefits and risks are crucial, the decision on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs. The authors warn that, even though stopping the medication is an option to look into, it is not advised because of the high incidence of depression and other mental problems in women who are expecting or recently gave birth. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience a difficult time adapting to life without them following the baby's arrival. Nursing It can be a challenge to become a mom. Women who suffer from ADHD who have to manage their symptoms while attending physician appointments, preparing for the arrival of a child and getting used to new routines at home can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy. The majority of stimulant drugs pass through breast milk in low amounts, therefore the risk to the nursing infant is very low. The rate of medication exposure will vary based on the dosage and frequency of administration as well as the time of day. In addition, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The impact of these medications on the health of a newborn is not fully known. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal period. A increasing number of studies have proven that most women can safely continue taking their ADHD medication during pregnancy and breastfeeding. As a result, more and more patients choose to do so and in consultation with their physician, they have discovered that the benefits of continuing their current medication far outweigh any potential risks. Women who suffer from ADHD who plan to breastfeed should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician as well as the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation is also required to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and reinforce strategies for coping. This should involve a multidisciplinary approach, which includes the GP as well as obstetricians, psychiatry and obstetricians. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of signs of deterioration and, if needed adjustments to the medication regime.