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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD face a difficult decision about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There are few data regarding how exposure over time may affect a foetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. how to treat adhd without medication in adults acknowledge the need for more high-quality research. Risk/Benefit Analysis Pregnant women who take ADHD medications must weigh the benefits of using them against the risks to the fetus. Physicians don't have the data to provide clear recommendations, but can provide information on the risks and benefits to assist pregnant women to make informed decisions. A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major structural birth defects. Researchers conducted a large sample-based case control study to assess the frequency of major structural defects in infants born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure an accurate classification of the cases and to reduce the possibility of bias. The study conducted by the researchers was not without limitations. Most important, they were unable to separate the effects of the medication from the effects of the disorder that is underlying. This limitation makes it difficult for researchers to determine whether the small associations observed among the groups exposed were due to the use of medications, or if they were affected by comorbidities. Researchers also did not study the long-term effects for the offspring. The study did show that infants whose mothers had taken ADHD medication during pregnancy were at slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than those who whose mothers did not take any medication or cut back on their medications prior to or during pregnancy. The reason for this was central nervous system disorders. The increased risk of admission was not influenced by the stimulant medication used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases appear to be independent of the type of medication used during pregnancy. Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages could be offset by the greater benefits for mother and baby of continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them improve coping skills which can lessen the effects of her disorder on her daily functioning and her relationships. Medication Interactions Many doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. Most of the time, these decisions are made in the absence of solid and reliable evidence in either case, which means that doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests on the subject, along with their best judgment for each patient. Particularly, the issue of possible risks to the baby can be a challenge. The research on this issue is based on observation rather than controlled studies and a lot of the results are conflicting. In addition, most studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by examining data on both live and deceased births. The conclusion is that while some studies have found that there is a positive correlation between ADHD medications and the risk of certain birth defects, others have found no connection and the majority of studies demonstrate a neutral or slight negative effect. Therefore, a careful risk/benefit assessment is required in every instance. It isn't easy, but 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 increase depression, feelings of isolation, and family conflict for patients with ADHD. Additionally, the loss of medication may affect the ability to perform job-related tasks and drive safely that are crucial aspects of daily life for a lot of people with ADHD. She suggests that women who are unsure whether to continue taking medication or stop it due to their pregnancy should educate family members, coworkers and friends about the condition, its impact on daily functioning and the advantages of staying on the current treatment plan. In addition, educating them can help the woman feel supported in her struggle with her decision. Certain medications can be passed through the placenta. If the patient decides to stop taking her ADHD medication while breastfeeding, it's important to be aware that the medication could be passed on to her infant. Birth Defects and Risk of As the use of ADHD medications to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs might have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Researchers used two massive data sets to examine over 4.3 million pregnant women and determine if stimulant medication use caused birth defects. Researchers discovered that, while the risk overall is low, first-trimester ADHD medication exposure was associated with slightly higher risk of specific heart defects like ventriculoseptal defect. The researchers of the study did not discover any link between early medication usage and congenital anomalies like facial deformities, or club feet. The results are in agreement with previous studies that have shown an insignificant, but small increase in the number of cardiac malformations among women who began taking ADHD medication before pregnancy. This risk increased during the latter part of pregnancy when many women began to stop taking their medication. Women who were taking ADHD medication during the first trimester were more likely to need a caesarean or have a low Apgar after birth and had a baby that required help breathing after birth. The researchers of the study were not able to eliminate bias due to selection because they limited the study to women with no other medical conditions that might have contributed to the findings. Researchers hope that their study will inform physicians when they encounter pregnant women. The researchers advise that while discussing benefits and risks are important, the choice about whether to continue or stop medication should be in light of the severity of each woman's ADHD symptoms and her requirements. The authors caution that, while stopping the medication is an option to look into, it is not recommended due to the high prevalence of depression and other mental problems among women who are pregnant or recently gave birth. Additionally, research suggests that women who stop taking their medications will have a harder adjustment to life without them after the baby is born. Nursing It can be a challenge to become a mother. Women with ADHD who have to manage their symptoms while attending physician appointments as well as preparing for the arrival of a baby and adjusting to new household routines can experience severe challenges. Therefore, many women elect to continue taking their ADHD medication throughout the pregnancy. The majority of stimulant medicines are absorbed through breast milk in small amounts, so the risk to infant who is breastfeeding is low. The rate of medication exposure will vary based on the dosage and frequency of administration as well as the time of day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn isn't well understood. Due to the absence of research, some doctors may be inclined to discontinue stimulant medication during the pregnancy of a woman. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication with the potential dangers to the fetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal time. Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and breast-feeding. This has led to an increasing number of patients opt to do this, and in consultation with their doctor they have found that the benefits of keeping their current medication far exceed 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 prescriber and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and underlying disorder. They should also learn about treatment options and strengthen strategies for coping. This should be a multidisciplinary approach, which includes the GP doctors, obstetricians and psychiatrists. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for indicators of deterioration, and, if necessary modifications to the medication regimen.