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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how long-term exposure may affect a foetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus don't develop neurological developmental conditions like hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies. Risk/Benefit Analysis Women who are pregnant and take ADHD medication should consider the benefits of taking it against the possible risks for the foetus. Doctors don't have enough data to give clear advice however they can provide information on the risks and benefits to assist pregnant women to make informed choices. A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a massive sample-based case control study to compare the incidence of major structural defects in infants born to mothers who used stimulants during pregnancy. Clinical geneticists, pediatric cardiologists and other experts examined the cases to make sure that the classification was accurate and to reduce any bias. However, the researchers' study had its limitations. Researchers were unable to, in the first place to differentiate the effects caused by the medication from the disorder. That limitation makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or the confounding effect of comorbidities. In addition the study did not examine the long-term outcomes of offspring. The study found that infants whose mother took ADHD medication during pregnancy had 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 stopped taking their medication before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication used during pregnancy. Women who used stimulant ADHD medication during pregnancy were also at an elevated chance of having a caesarean section or having a baby with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication taken during pregnancy. The research suggests that the low risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit for both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies for improving their coping skills that may minimize the impact of her disorder on her daily functioning and relationships. Interactions with Medication As more women than ever before are being diagnosed with ADHD and being treated with medication, the issue of whether to continue or stop treatment during pregnancy is a question that more and more doctors confront. These decisions are frequently made without clear and reliable evidence. Instead, doctors have to consider their own expertise in conjunction with the experiences of other physicians and the research on the subject. The issue of possible risks to the infant can be extremely difficult. The research on this issue is based on observations rather than controlled studies and many of the findings are in conflict. Most studies focus on live births, which may underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues by analyzing the data from deceased and live births. Conclusion: While some studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't shown such a relationship. The majority of studies show a neutral, or even somewhat negative, effect. In every case an in-depth evaluation of the risks and benefits should be conducted. For a lot of women with ADHD who suffer from ADHD, the decision to stop medication is difficult if not impossible. In a recent article in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of being isolated. Additionally, the loss of medication can interfere with the ability to do work-related tasks and safely drive that are crucial aspects of a normal life for many people suffering from ADHD. add medication uk suggests that women who aren't sure whether to take the medication or stop it due to their pregnancy educate family members, coworkers, and acquaintances about the condition, the impact on daily functioning and the benefits 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 drugs can be absorbed through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the drug could be passed on to the baby. Risk of Birth Defects As the use and misuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the potential adverse effects of the drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers utilized two massive data sets to study over 4.3 million pregnancy and determine if the use of stimulant medications increased birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects. The researchers behind the study found no association between early medication use and other congenital abnormalities, such as facial clefting or club foot. The results are in agreement with previous studies that showed the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication before pregnancy. This risk increased during the latter part of pregnancy when a large number of women stopped taking their medication. Women who were taking ADHD medication in the first trimester were more likely to require a caesarean birth and also have a low Apgar after delivery and have a baby that needed help breathing when they were born. However, the authors of the study were not able to eliminate selection bias by limiting the study to women who didn't have any other medical issues that could have contributed to the findings. Researchers hope their research will help doctors when they meet pregnant women. They suggest that although discussing the risks and benefits is crucial but the decision to stop or keep medication should be based on each woman's needs and the severity of her ADHD symptoms. The authors caution that, while stopping the medication is a possibility to look into, it is not recommended because of the high incidence of depression and mental health issues in women who are expecting or who have recently given birth. Additionally, the research suggests that women who decide to stop taking their medications are more likely to experience a difficult time adjusting to life without them after the birth of their baby. Nursing It can be overwhelming to become a mother. Women with ADHD are often faced with a number of difficulties when they must deal with their symptoms, attend doctor appointments, prepare for the birth of a child and adjust to new routines. Many women opt to continue taking their ADHD medication during pregnancy. The majority of stimulant drugs pass through breast milk in very small amounts, therefore the risk to breastfeeding infant is minimal. However, the amount of exposure to medications by the infant can differ based on dosage, frequency it is administered and the time of the day it is administered. Additionally, different drugs enter the infant's system through the gastrointestinal tract or through breast milk. The effect on the health of a newborn isn't fully understood. Due to the absence of research, some physicians might be tempted to stop taking stimulant medication during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the advantages of taking her medication as well as the risk to the embryo. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal period. A increasing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication while they are pregnant and nursing. As a result, an increasing number of patients choose to do so, and in consultation with their doctor they have discovered that the benefits of keeping their current medication far outweigh any potential risks. It's important for women with ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss their medication with their prescriber, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the root cause and learn about treatment options and reinforce existing coping strategies. This should be an approach that is multidisciplinary, including the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if needed modifications to the medication regime.