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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medications during breastfeeding and pregnancy is challenging for women with the condition. There aren't enough data regarding how exposure over time may affect the fetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in the uterus don't develop neurological developmental conditions like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are required. Risk/Benefit Analysis Pregnant women who take ADHD medications must weigh the benefits of using them against the risks to the foetus. Physicians don't have the information needed to give clear guidelines however they can provide information regarding risks and benefits that aid pregnant women in making informed decisions. A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. The researchers used a large population-based study of case-control to determine the prevalence of major structural birth defects in infants born to mothers who had taken stimulants in early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was correct and to eliminate any bias. The study of the researchers was not without limitations. In particular, they were unable to distinguish the effects of the medication from those of the disorder at hand. This limitation makes it difficult to determine whether the small differences observed in the exposed groups are due to medication use or confounding by comorbidities. In adult adhd treatments did not look at the long-term effects of offspring on their parents. The study revealed that babies whose mothers had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU), compared to mothers who did not take any medication during pregnancy, or had quit taking the medication 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 affected by the type of stimulant medications were taken during pregnancy. Women who took stimulant ADHD medication during pregnancy were also at an increased chance of having a caesarean delivery or having a child with low Apgar score (less than 7). These increases appeared to be independent of the type of medication used during pregnancy. Researchers suggest that the minor risk of using ADHD medications in early pregnancies could be offset by the greater benefits to both mother and baby from continuing treatment for the woman's condition. adhd medications uk should discuss this with their patients and, when they are able, assist them in developing strategies to improve their coping abilities that may minimize the effects of her disorder on her daily functioning and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and being treated with medication, the question of whether to continue or discontinue treatment during pregnancy is one that more and more physicians have to face. The majority of these decisions are taken in the absence of any evidence that is clear and definitive either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what research says on the topic and their best judgment for each patient. The issue of risk for infants can be difficult to determine. A lot of studies on this issue are based on observations rather than controlled research and their findings are often contradictory. The majority of studies limit their analysis to live-births, which could underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study presented in the journal club addresses these issues, by examining both the data from deceased and live births. The conclusion The conclusion: While some studies have found a positive association between ADHD medications and the risk of certain birth defects, others have found no connection and the majority of studies demonstrate a neutral or slightly negative effect. As a result an accurate risk-benefit analysis must be conducted in every instance. For women suffering from ADHD and ADD, the decision to discontinue medication is difficult if not impossible. In fact, 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 do work-related tasks and safely drive, which are important aspects of daily life for a lot of people with ADHD. She recommends women who are uncertain about whether or not to discontinue medication due to their pregnancy should consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily life, and the advantages of staying on the current treatment regimen. It can also help women feel supported in her decision. It is important to remember that certain medications can be absorbed through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug could be transferred to the child. Birth Defects and Risk of As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about what impact the drugs might have on fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of information on this topic. Researchers used two massive data sets to study more than 4.3 million pregnancies and determine whether stimulant medications increased birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects, such as ventriculoseptal defect (VSD). The authors of the study found no link between early use of medication and other congenital anomalies, such as facial clefting or club foot. The results are in agreement with previous studies which showed the existence of a slight, but significant increase in the number of cardiac malformations among women who began taking ADHD medication before the time of pregnancy. This risk increased during the latter half of pregnancy, when a lot of women began to stop taking their medication. adhd uk medication who were taking ADHD medication in the first trimester were more likely to require a caesarean birth, have an insufficient Apgar after birth and have a baby who needed help breathing at birth. The authors of the study could not eliminate bias due to selection because they restricted the study to women who did not have any other medical conditions that might have contributed to the findings. The researchers hope that their research will serve to inform the clinical decisions of physicians who encounter pregnant women. They advise that while discussing the benefits and risks is important however, the decision to stop or keep treatment should be based on each woman's needs and the severity of her ADHD symptoms. The authors caution that, even though stopping the medication is a possibility to consider, it is not advised because of the high incidence of depression and other mental problems in women who are expecting or have recently given birth. Research has also shown that women who stop taking their medications will have a difficult adjustment to life without them once the baby is born. Nursing The responsibilities of being a new mom can be overwhelming. Women with ADHD who must work through their symptoms while attending doctor appointments and getting ready for the arrival of a baby and getting used to new routines at home may face a lot of challenges. Many women opt to continue taking their ADHD medication during pregnancy. The majority of stimulant medications are absorbed by breast milk in very small amounts, therefore the risk to the infant who is breastfeeding is low. The rate of exposure to medication will vary based on the dosage the medication is administered, its frequency and the time of the day. In addition, various drugs enter the infant's system via the gastrointestinal tract or through breast milk. The effect on a newborn's health is not completely understood. Because of the lack of evidence, some doctors might be tempted to stop taking stimulant medications during the pregnancy of a woman. This is a complicated decision for the patient, who must weigh the benefits of continuing her medication with the potential risks to the foetus. In the meantime, until more information is available, 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 without risk during pregnancy and breast-feeding. In the end, more and more patients are choosing to do so and in consultation with their physician, they have found that the benefits of keeping their current medication outweigh any potential risks. It's important for women with ADHD who are considering breastfeeding to seek out a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary effort including obstetricians, GPs, and psychiatry. The pregnancy counselling should consist of the discussion of a treatment plan for both mother and child, as well as monitoring for signs of deterioration, and when necessary, making adjustments to the medication regimen.