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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs could affect the foetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus do not develop neurological conditions like impaired vision or hearing seizures, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required. Risk/Benefit Analysis Women who are pregnant and take ADHD medication should evaluate the benefits of using it against the potential dangers for the foetus. Physicians don't have the data to make unambiguous recommendations however they can provide information on the risks and benefits to help pregnant women make informed choices. 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 large population-based study of case control to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure correct classification of the cases and to reduce the possibility of bias. However, the study had its limitations. In particular, they were unable to separate the effects of the medication from the underlying disorder. This makes it difficult for researchers to establish whether the small differences observed between the groups exposed were due to the use of medication or if they were confounded by the presence of comorbidities. The researchers also did not examine long-term outcomes for offspring. The study revealed that babies whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) as compared to mothers who didn't take any medication during pregnancy, or had quit taking the medication prior to 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 were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have an emergency caesarean section or having a baby that scored low on the Apgar scale (less than 7). These increases did not seem to be influenced by the kind of medication used during pregnancy. Researchers suggest that the small risks associated with the use ADHD medication during pregnancies in the early stages can be offset by greater benefits for mother and baby of continuing treatment for the woman's disorder. Doctors should discuss with their patients about this and as much as possible, assist them improve coping skills which could reduce the effects of her disorder on her daily life and relationships. Interactions with Medication As more women than ever are being diagnosed with ADHD and treated with medication, the question of whether to continue or end treatment during pregnancy is a question that more and more physicians have to face. These decisions are often made without clear and reliable evidence. Instead, doctors have to weigh their own knowledge, the experience of other physicians and the research on the subject. The issue of risk to the infant can be difficult to determine. The research that has been conducted on this topic is based on observation rather than controlled studies and the results are contradictory. The majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study discussed in this journal club addresses these limitations by examining data on both live and deceased births. Conclusion A few studies have found an association between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. Most studies have shown an unintended, or slight negative impact. Therefore, a careful risk/benefit assessment is required in every case. For women suffering from ADHD and ADD, the decision to discontinue medication is difficult, if not impossible. In fact, in an article published 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 isolation and family conflict for patients with ADHD. The loss of medication can also affect the ability to safely drive and complete work-related tasks, which are essential aspects of everyday life for those suffering from ADHD. She recommends women who are unsure about whether to keep or stop medication in light of their pregnancy should consider educating family members, friends, and coworkers on the condition, its effects on daily life, and the advantages of staying on the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can be passed through the placenta. If the patient decides to not take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the drug could be passed on to her infant. Birth Defects and Risk of As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows there are concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this issue. With two massive data sets, researchers were able to look at more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, first-trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defects. The researchers of the study didn't discover any connection between early medication usage and other congenital anomalies, like facial deformities, or club feet. The findings are in line with previous studies showing a small but significant increase in the risk of developing cardiac malformations among women who began taking ADHD medications prior to the time of the birth of their child. The risk increased in the latter stages of pregnancy when a large number of women began to stop taking their medication. Women who took ADHD medications in the first trimester of pregnancy were also more likely to undergo caesarean section, low Apgar score after delivery and a baby who required help breathing at birth. However, the authors of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical issues that could have contributed to the findings. The researchers hope that their research will aid in the clinical decisions of physicians who see pregnant women. The researchers recommend that, while discussing risks and benefits are important, the decision about whether to continue or stop medication should be based on the severity of each woman's ADHD symptoms and her needs. The authors warn that, although stopping the medication is a possibility to look into, it is not recommended due to the high rate depression and other mental disorders in women who are expecting or who have recently given birth. Furthermore, research suggests that women who choose to stop taking their medications are more likely to have a difficult time getting used to life without them following the baby's arrival. Nursing The responsibilities that come with being a new mother can be overwhelming. Women suffering from ADHD can face severe challenges when they must manage their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to a new routine. As adhd medications uk , many women elect to continue taking their ADHD medications throughout pregnancy. The majority of stimulant medications pass through breast milk in very small amounts, therefore the risk to nursing infant is very low. However, the amount of medication exposure to the newborn may differ based on the dosage, frequency it is taken and the time of the day the medication is administered. Additionally, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The impact of these medications on a newborn's health is not completely understood. Some doctors may stop taking stimulant medications during a woman's pregnancy due to the lack of research. It is a difficult decision for the mother, who must weigh the benefits of taking her medication as well as the risks to the fetus. As long as there is no more information, 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. Numerous studies have demonstrated that women can continue taking their ADHD medication safely during pregnancy and while breast-feeding. In response, a rising number of patients are choosing to do this. They have found, in consultation with their doctors, that the benefits of retaining their current medication outweigh any risk. It's important for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach including obstetricians, GPs, and psychiatrists. Counselling for pregnancy should include the discussion of a treatment plan for both the mother as well as the child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.