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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There isn't much information on how long-term exposure to these medications can affect the foetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are needed. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication should weigh the benefits of taking it versus the dangers for the fetus. The doctors don't have the information to provide clear recommendations however they can provide information on risks and benefits to aid pregnant women in making informed choices. A study published in Molecular Psychiatry found that women who used ADHD medications during their early pregnancy did not have a significantly increased risk of fetal heart malformations or major birth defects that are structural. The researchers used a large population-based study of case-control to assess the risk of major structural birth defects in infants born to mothers who took stimulants during the early stages of pregnancy and those who had not. Clinical geneticists, pediatric cardiologists and other experts examined the cases to ensure that the classification was accurate and to eliminate any bias. However, the researchers' study was not without its flaws. Researchers were unable, in the first place to differentiate the effects of the medication from the disorder. This makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to the use of medication or if they were caused by the presence of comorbidities. Additionally the researchers did not examine long-term offspring outcomes. The study did find that infants whose mothers took ADHD medications during pregnancy were at slightly greater 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. The higher risk of admission was not affected by the stimulant medication that was used during pregnancy. Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean birth or having a baby with an low Apgar score (less than 7). These increases did not appear to be affected by the kind of medication used during pregnancy. adhd and medication suggest that the minor risk of using ADHD medications in early pregnancies can be offset by greater benefits for mother and baby from continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, if possible, help them develop strategies to improve their coping abilities that may minimize the negative impact of her condition on her daily functioning and relationships. Medication Interactions As more women than ever before are being diagnosed with ADHD and being treated with medication, the dilemma of whether to continue or discontinue treatment during pregnancy is a question that doctors are having to confront. These decisions are frequently taken without clear and authoritative evidence. Instead, physicians must take into account their own experience and experience, as well as the experiences of other physicians and the research that has been conducted on the subject. The issue of risk to infants is difficult to determine. The research that has been conducted on this topic is based on observation rather than controlled studies and the results are contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could result in abortion or termination of the pregnancy. The study that is discussed in the journal club addresses these limitations, by examining both data on live and deceased births. Conclusion: While some studies have found a positive correlation between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown an unintended, or somewhat negative, effect. In every case an in-depth analysis of the benefits and risks must be performed. It can be difficult, if not impossible for women with ADHD to stop taking their medication. In a recent piece published in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can lead to depression and feelings of being isolated. Additionally, the loss of medication can interfere with the ability to do work-related tasks and safely drive, which are important aspects of daily life for many people with ADHD. She suggests women who are uncertain about whether to keep or discontinue medication due to their pregnancy consider the possibility of educating friends, family members and colleagues on the condition, its impact on daily functioning, and on the advantages of continuing the current treatment regimen. It will also help a woman feel confident about her decision. Some medications can pass through the placenta. If a woman decides not to take her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication could be transferred to the baby. Risk of Birth Defects As the use and use of ADHD medications to treat the symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the possible effects of the drugs on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this topic. Researchers used two huge data sets to study more than 4.3 million pregnancies and determine if the use of stimulant medications caused birth defects. Although the risk overall remains low, the researchers discovered that the first-trimester exposure to ADHD medications was associated with a slightly higher rate of certain heart defects such as ventriculo-septal defect (VSD). The authors of the study did not discover any connection between the use of early medications and congenital anomalies such as facial deformities or club feet. The findings are in line with previous studies showing the presence of a small, but significant increase in the risk of developing cardiac malformations among women who started taking ADHD medications before the birth of their child. This risk increased in the latter half of pregnancy, as many women decide to stop taking their ADHD medication. Women who took ADHD medication during the first trimester were more likely need a caesarean or have a low Apgar after delivery, and had a baby that required help breathing when they were born. However the authors of the study were not able to eliminate selection bias by restricting the study to women who didn't have any other medical issues that could have contributed to these findings. Researchers hope their research will help doctors when they encounter pregnant women. The researchers suggest that, while discussing risks and benefits are important, the choice regarding whether or not to stop medication should be made based on the severity of each woman's ADHD symptoms and her requirements. The authors also advise that while discontinuing the medications is an alternative, it is not an option to consider due to the high incidence of depression and other mental health problems for women who are expecting or recently post-partum. Additionally, the research suggests that women who choose to stop taking their medication are more likely to experience a difficult time getting used to life without them following the birth of their baby. Nursing The responsibilities of being a new mother can be overwhelming. Women with ADHD can face severe challenges when they must manage their symptoms, attend doctor appointments, prepare for the birth of their child and adjust to a new routine. Many women opt to continue taking their ADHD medication during pregnancy. The risk to a nursing infant is low because the majority of stimulant medications passes through breast milk in low amounts. However, the rate of exposure to medication by the newborn can vary depending on dosage, frequency it is administered and at what time it is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not fully known. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. It is a difficult decision for the mother, who must weigh the benefits of continuing her medication against the risks to the fetus. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period. Many studies have shown that women can continue to take their ADHD medication safely while breastfeeding and during pregnancy. In response, a growing number of patients are choosing to continue their medication. They have discovered through consultation with their doctors that the benefits of continuing their current medication outweigh possible risks. It is crucial for women suffering from ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons for continuing treatment. This includes non-pharmacological strategies. Psychoeducation is also needed to help pregnant women suffering from ADHD be aware of the symptoms and the underlying disorder. They should also be educated about treatment options and build the coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatrists. Counselling for pregnancy should include discussion of a management plan for both the mother as well as the child, as well as monitoring for signs of deterioration, and, if necessary, adjustments to the medication regimen.