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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how exposure to ADHD for a long time could affect a foetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues 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 evaluate the benefits of using it against the potential risks for the baby. Doctors don't have the necessary data to make unequivocal recommendations, but they can provide information regarding risks and benefits that assist pregnant women in making informed choices. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy were not at a higher risk of fetal malformations or structural birth defects. The researchers used a large population-based case-control study to determine the prevalence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct classification of the cases and to reduce the possibility of bias. The study of the researchers had some limitations. The researchers were unable, in the first place to differentiate the effects triggered by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small associations observed among the groups that were exposed to medication use or if they were confounded by the presence of comorbidities. Researchers also did not study long-term outcomes for offspring. The study did find that infants whose mothers had taken ADHD medication during pregnancy were at a slightly more risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission did not appear to be influenced by the stimulant medications were used during pregnancy. Women who took stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean delivery or having a baby born with a low Apgar score (less than 7). These increases didn't appear to be influenced by the kind of medication used during pregnancy. Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies may be offset by the greater benefits to both mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve coping skills that may minimize the effects of her disorder on her daily functioning and relationships. Medication Interactions Doctors are increasingly faced with the decision of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are usually taken without clear and authoritative evidence. Instead, doctors must 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. The issue of possible risks for infants can be particularly tricky. The research on this issue is based on observations instead of controlled studies and a lot of the results are in conflict. The majority of studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects that can lead to abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues by analyzing both data on live and deceased births. Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects, other studies have not found a correlation. The majority of studies show an unintended, or slight negative impact. Therefore an accurate risk-benefit analysis must be conducted in every situation. It can be difficult, if not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published in 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 those suffering from the disorder. In addition, a decrease in medication may affect the ability to complete work-related tasks and safely drive which are essential aspects of a normal life for a lot of people with ADHD. She suggests that women who aren't sure whether to continue taking medication or stop due to pregnancy should educate family members, coworkers and their friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment plan. It will also help a woman feel more confident in her decision. It is also worth noting that certain medications are able to pass through the placenta, therefore, if a patient decides to discontinue her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the infant. Birth Defects Risk As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about what impact the medications could have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Researchers used two huge data sets to study over 4.3 million pregnancy and determine whether stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD). The researchers of the study did not find any association between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are in line with previous studies revealing a small but significant increase in the risk of developing cardiac malformations among women who began taking ADHD medications before the time of pregnancy. This risk increased during the latter part of pregnancy, when many women are forced to stop taking their ADHD medications. Women who used ADHD medication in the first trimester of pregnancy were also more likely to undergo caesarean section, low Apgar score following delivery, and a baby who required breathing assistance at birth. The researchers of the study were unable to remove bias in selection since they limited their study to women who did not have any other medical conditions that might have contributed to the findings. The researchers hope their study will help inform the clinical decisions of doctors who encounter pregnant women. They suggest that although a discussion of the benefits and risks is important however, the decision to stop or continue treatment should be based on the woman's requirements and the severity of her ADHD symptoms. The authors caution that, even though stopping the medication is a possibility to look into, it is not advised due to the high prevalence of depression and mental health issues among women who are pregnant or have recently given birth. Further, research shows that women who stop taking their medication will have a harder adjustment to life without them once the baby is born. Nursing The responsibilities that come with being a new mom can be overwhelming. Women with ADHD who have to manage their symptoms while attending doctor appointments, making preparations for the arrival of their child and adapting to new routines in the home can experience severe challenges. buy adhd medication uk choose to continue taking their ADHD medication during pregnancy. The risk for nursing infant is low because the majority of stimulant medications passes through breast milk at a low level. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and the time of day. In addition, different medications are introduced into the baby's system via the gastrointestinal tract, or through breast milk. The impact of these medications on a newborn's health is not fully understood. Because of the lack of research, some physicians may be inclined to discontinue stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must balance the benefit of continuing her medication with the potential risks to the foetus. As long as there is no more information, doctors should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal time. A increasing number of studies have proven that the majority of women are able to safely continue their ADHD medication while they are pregnant and nursing. In response, a rising number of patients are opting to do this. They have concluded through consultation with their doctor that the benefits of retaining their current medication outweigh any potential risks. Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to 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 strategies. Psychoeducation is also required to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also be educated about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach together with obstetricians, GPs, and psychiatry. The pregnancy counselling should consist of the discussion of a plan for management for both the mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.