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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD face a difficult decision 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 can affect the foetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed. Risk/Benefit Analysis Women who are pregnant and take ADHD medication must consider the benefits of taking it versus the risks to the baby. The doctors don't have the information to give clear advice, but 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 in early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large population-based study of case control to compare the incidence of major structural defects in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate classification of the cases and to reduce the chance of bias. The study conducted by the researchers had some limitations. The researchers were unable, in the first place, to separate the effects of the medication from the disorder. This limitation makes it difficult for researchers to determine if the few associations observed between the exposed groups were due to the use of medication or if they were affected by comorbidities. Additionally, the researchers did not look at long-term offspring outcomes. The study did find that infants whose mothers took ADHD medications during pregnancy were at slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This increase was due to central nervous system-related disorders and the higher risk of admission was not found to be influenced by the stimulant medication was used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having to have a caesarean section or one whose baby scored low on the Apgar scale (less than 7). add medication uk didn't appear to be affected by the type of medication that was used during pregnancy. The researchers suggest that the risk of a small amount with the use of ADHD medications during early pregnancy may be offset by the higher benefit to both mother and child of continued treatment for the woman's condition. Physicians should speak with their patients about this issue and, if possible, help them develop coping skills that could reduce the impact of her disorder in her daily functioning and her relationships. Interactions with Medication More and more doctors are confronted with the dilemma of whether to continue treatment or stop as more women are diagnosed with ADHD. Often, these decisions are made in the absence of solid and reliable evidence either way, so physicians have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests about the subject as well as their own judgments for each patient. Particularly, the issue of potential risks for the baby can be tricky. The research on this subject is based on observations instead of controlled studies and many of the findings are in conflict. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can cause abortion or termination of the pregnancy. The study discussed in the journal club addresses these shortcomings by analyzing information on deceased and live births. The conclusion The conclusion: While certain studies have demonstrated that there is a positive correlation between ADHD medications and the risk of certain birth defects, other studies have found no such relationship, and most studies have a neutral or slightly negative effect. In every case it is imperative to conduct a thorough evaluation of the risks and benefits must be performed. It can be difficult, if not impossible, for women with ADHD to stop taking their medication. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of isolation. A decrease in medication could affect the ability to drive safely and to perform work-related tasks which are vital aspects of normal life for those suffering from ADHD. She suggests women who are uncertain about whether to keep or discontinue medication due to their pregnancy consider informing family members, friends and colleagues on the condition, its effects on daily functioning, and the advantages of continuing the current treatment plan. It can also aid in ensuring that the woman feels supported in her struggle with her decision. Certain medications can be passed through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it's important to be aware that the drug may be transferred to her infant. Birth Defects and Risk of As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases as does the concern about the potential effects of these drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication use was associated with slightly higher risk of specific heart defects like ventriculoseptal defect. The authors of the study didn't find any association between early use of medication and congenital anomalies such as facial deformities or club feet. The results are in line with previous studies that have shown the existence of a slight, but significant increase in the number of cardiac malformations among women who started taking ADHD medication before the time of pregnancy. The risk was higher during the latter part of pregnancy, when many women begin to discontinue their medication. Women who took ADHD medication during the first trimester were more likely require a caesarean delivery and also have an insufficient Apgar after delivery, and have a baby who needed breathing assistance at birth. The authors of the study were not able to remove bias in selection since they restricted the study to women who did not have any other medical conditions that could have contributed to the findings. Researchers hope that their study will provide doctors with information when they see pregnant women. They advise that while the discussion of the benefits and risks is important however, the decision to stop or maintain treatment should be based on the woman's requirements and the severity of her ADHD symptoms. The authors warn that, although stopping the medication is a possibility to consider, it is not recommended due to the high prevalence of depression and mental health issues in women who are expecting or recently gave birth. Additionally, the research suggests that women who decide to stop their medications are more likely to have a difficult time adapting to life without them following the birth of their baby. Nursing The responsibilities of a new mom can be overwhelming. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy. The risk for breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk in low amounts. However, the frequency of exposure to medication by the newborn can vary depending on dosage, how often it is administered and at what time it is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't fully understood. Some doctors may decide to stop stimulant medication during a woman’s pregnancy due to the absence of research. This is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the risk to the embryo. Until more information becomes available, GPs may ask pregnant patients whether they have an background of ADHD or if they plan to take medication in the perinatal phase. A growing number of studies have proven that women can continue their ADHD medication during pregnancy and while 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 outweigh any risks. Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should review their medications with their doctor and discuss the pros and cons of continued treatment, including non-pharmacological management strategies. Psychoeducation is also required to help women with ADHD recognize their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, monitoring of indicators of deterioration, and, if needed adjustments to the medication regimen.