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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD have to make a difficult choice about whether to continue or stop taking ADHD medication during pregnancy and breastfeeding. There aren't enough data on how exposure to ADHD for a long time could affect a foetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological developmental disorders such as hearing loss or impaired vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality research. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the fetus. Doctors don't have the information needed to give clear guidelines but they can provide information on the risks and benefits to help pregnant women make informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers used a large population-based study of case control to examine the prevalence of major structural defects in infants who were born to mothers who took stimulants during pregnancy. Pediatric cardiologists, clinical geneticists and other experts examined the cases to confirm that the classification was accurate and to eliminate any bias. However, the study had its limitations. The researchers were unable to, in the first place to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to determine if the small differences observed between the groups that were exposed to medication use or caused by comorbidities. In addition the study did not examine the long-term effects of offspring on their parents. The study revealed that infants whose mother had taken ADHD medication during pregnancy were at a slightly higher chance of being admitted to the neonatal care unit (NICU) in comparison to those whose mothers didn't take any medication during pregnancy, or had quit taking the medication prior to 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 took stimulant ADHD medications during pregnancy also had a higher chance of having caesarean sections or a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be affected by the type of medication that was used during pregnancy. The research suggests that the risk of a small amount with the use of ADHD medications during early pregnancy could be offset by the higher benefit to both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them develop coping strategies that can lessen the impact of her disorder in her daily functioning and her relationships. Interactions with Medication Many doctors are faced with the decision of whether to continue treatment or stop during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, physicians must weigh their own knowledge in conjunction with the experiences of other doctors, and the research on the topic. Particularly, the subject of potential risks to the baby can be tricky. Many of the studies on this topic are based on observations rather than controlled research, and their findings are often contradictory. Additionally, the majority of studies limit their analysis to live births, which may 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 issues by analyzing both data on live and deceased births. Conclusion Some studies have revealed a positive correlation between ADHD medications and certain birth defects, other studies have not shown such a relationship. The majority of studies show an unintended, or somewhat negative, effect. Therefore an accurate risk-benefit analysis is required in every instance. It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In fact, in an article published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can increase depression, feelings of loneliness and family conflict for those suffering from the disorder. A loss of medication may also impact the ability to safely drive and perform work-related tasks, which are essential aspects of daily life for people with ADHD. She suggests women who are unsure about whether to keep or stop taking medication because of their pregnancy consider educating family members, friends, and coworkers on the condition, its impact on daily functioning, and the advantages of continuing the current treatment regimen. Educating them can also make the woman feel more comfortable when she is struggling with her decision. It is also worth noting that certain medications are able to pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the medication could be transferred to the child. Risk of Birth Defects As the use and use of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the potential effects of these drugs on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. With add in adults medication , researchers were able to analyze more than 4.3 million pregnancies to 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 exposure was associated with slightly higher rates of specific heart defects such as ventriculoseptal defect. The researchers of the study did not discover any link between early use of medication and congenital anomalies like facial deformities or club feet. The results are in agreement with previous studies that showed a small, but significant increase in cardiac malformations for women who began taking ADHD medication before pregnancy. The risk increased in the latter half of pregnancy when many women began to stop taking their medication. Women who took ADHD medication in the first trimester of their pregnancy were also more likely to undergo caesarean sections, a low Apgar score after delivery and a baby that required breathing assistance at birth. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could have contributed to the findings. Researchers hope that their research will inform physicians when they encounter pregnant women. They advise that while the discussion of the risks and benefits is crucial however, the decision to stop or continue treatment should be based on the woman's needs and the severity of her ADHD symptoms. The authors also advise that, while stopping the medication is an alternative, it is not a recommended practice because of the high prevalence of depression and other mental health problems among women who are pregnant or postpartum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have difficulties getting used to life without them following the baby's arrival. Nursing It can be a stressful experience to become a mom. Women who suffer from ADHD may face a lot of challenges when they have to 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 breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk at low levels. The rate of medication exposure can vary depending upon the dosage the medication is administered, its frequency and the time of the day. In addition, different medications enter the baby’s system via the gastrointestinal tract or breast milk. The effect on the health of a newborn is not fully understood. Some doctors may stop taking stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult choice for the patient, who must weigh the benefits of continuing her medication against the possible dangers to the fetus. Until more information becomes available, GPs can ask pregnant patients whether they have a background of ADHD or if they plan to take medication in the perinatal phase. Many studies have shown that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to continue their medication. They have discovered after consulting with their doctor that the benefits of retaining their current medication outweigh any risk. It is essential for women with ADHD who are contemplating breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should review their medications with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD be aware of their symptoms and underlying disorder Learn about the available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both the mother as well as the child, monitoring for signs of deterioration and, if necessary, adjustments to the medication regimen.