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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medications during breastfeeding and pregnancy is a difficult decision for women suffering from the condition. There are few data on how long-term exposure may affect the fetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that more high-quality research is needed. Risk/Benefit Analysis Women who are expecting and taking ADHD medication should consider the benefits of taking it against the possible risks to the foetus. The doctors don't have the information to give clear advice, but can provide information on risks and benefits to aid pregnant women in making an informed decision. 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 sample-based case control study to assess the frequency of major structural defects in infants who were born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate case classification and to limit the chance of bias. The study conducted by the researchers was not without limitations. The most important issue was that they were unable to separate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult for researchers to determine if the small associations observed among the exposed groups were due to medication use, or if they were caused by comorbidities. Researchers also did not study the long-term effects for the offspring. The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or stopped their medications before or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not affected by the stimulant medication used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher risk of having a caesarean section or the baby was not scoring well on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy. The research suggests that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both the mother and child of continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, where they are able, assist them in developing strategies for improving their coping skills which can reduce the impact of her disorder on her daily life and relationships. Medication Interactions Many doctors are faced with the decision of whether to continue treatment or stop as more women are diagnosed with ADHD. These decisions are frequently 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 potential risks to infants is difficult to determine. The research on this subject is based on observation rather than controlled studies and many of the findings are contradictory. The majority of studies focus on live births, which may underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in this journal club addresses these limitations by looking at data from both live and deceased births. Conclusion Some studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies have shown an unintended, or slightly negative, impact. In every case an in-depth study of the benefits and risks must be performed. It can be challenging, if not impossible for women with ADHD to stop taking their medication. In a recent article in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of isolation and family conflict for those suffering from the disorder. Furthermore, a loss of medication can affect the ability to do job-related tasks and drive safely that are crucial aspects of a normal life for many people with ADHD. She suggests that women who are not sure whether to continue taking the medication or stop due to pregnancy should educate family members, coworkers and friends about the condition, the effects on daily functioning, and the benefits of continuing the current treatment regimen. It can also help women feel more confident in her decision. Certain medications can pass through the placenta. If a woman decides to not take her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be transferred to the infant. Birth Defects and Risk of As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing, so does concern about the possible effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing information on this topic. Utilizing two huge data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher risk of specific heart defects such as ventriculoseptal defect. The researchers of the study did not discover any connection between the use of early medications and congenital anomalies like facial deformities or club feet. The results are in the same vein as previous studies that have shown a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to pregnancy. The risk grew in the latter half of pregnancy, when many women are forced to stop taking their medication. Women who used ADHD medications in the first trimester of their pregnancy were also more likely to experience a caesarean section, a low Apgar score after delivery and a baby who required breathing assistance at birth. The authors of the study were not able to eliminate selection bias because they restricted the study to women without other medical conditions that might have contributed to the findings. Researchers hope that their study will provide doctors with information when they see pregnant women. They advise that while discussing risks and benefits is important but the decision to stop or maintain 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 an option to think about, it isn't recommended due to the high rate depression and other mental disorders among women who are pregnant or who have recently given birth. Further, the research suggests that women who decide to stop their medications are more likely to experience difficulties adjusting to life without them following the birth of their baby. Nursing It can be a stressful experience becoming a mother. Women with ADHD who must work through their symptoms while attending doctor appointments and making preparations for the arrival of a baby and getting used to new routines at home can experience severe challenges. This is why many women choose to continue taking their ADHD medications throughout pregnancy. The risk to breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at low levels. However, the rate of medication exposure to the newborn can vary depending on the dosage, frequency it is administered and the time of day the medication is administered. Additionally, different medications enter the baby's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not fully known. Some doctors may stop taking stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult decision for the woman, who must weigh the benefits of continuing her medication against the risks to the embryo. As long as there is no more information, GPs should ask all pregnant patients about their experience with ADHD and whether they plan or are taking to take medication during the perinatal time. Many studies have shown that women can continue taking their ADHD medication in a safe manner during pregnancy and breast-feeding. As adult adhd medication Iam Psychiatry , many patients choose to do so and, after consulting with their doctor, they have found that the benefits of keeping their current medication far outweigh any risks. Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist before becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD understand their symptoms and the underlying disorder Learn about the available treatment options and strengthen existing coping strategies. This should be a multidisciplinary process including obstetricians, GPs and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, and monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.