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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or continue ADHD medication during pregnancy and breastfeeding is challenging for women with the condition. There aren't many studies on how exposure to ADHD for a long time could affect a pregnant fetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders like hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that further high-quality research is needed. Risk/Benefit Analysis Pregnant women who take ADHD medications must weigh the benefits of taking them against the potential risks to the fetus. Physicians do not have the information needed to provide clear recommendations but they can provide information on the risks and benefits to help pregnant women make informed decisions. A study published in Molecular Psychiatry found that women who used ADHD medications during early pregnancy did not face an increased risk of fetal heart malformations or major birth defects that are structural. Researchers used a large sample-based case control study to examine the prevalence of structural defects that were major in infants born to mothers who took stimulants during pregnancy. Pediatric cardiologists and clinical geneticists examined the cases to ensure an accurate case classification and to minimize the chance of bias. The study of the researchers had some limitations. The researchers were unable in the beginning to differentiate the effects of the medication from the disorder. That limitation makes it difficult to determine whether the limited associations observed in the groups that were exposed are due to the use of medication or confounding by comorbidities. Additionally the researchers did not examine long-term offspring outcomes. The study did show that babies whose mothers had taken ADHD medications during pregnancy were at a slightly greater risk of being admitted to the neonatal intensive care unit (NICU) than infants whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. This increase was caused by 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 risk of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These risks did not appear to be affected by the kind of medication used during pregnancy. Researchers suggest that the minor risk of using ADHD medications during early pregnancies may be offset by the greater benefits to both baby and mother of continued treatment for the woman's condition. Doctors should discuss with their patients about this and try to help them improve coping skills which could reduce the effects of her disorder on her daily life and relationships. Medication Interactions As more women than ever are diagnosed with ADHD and treated with medication, the issue of whether to keep or discontinue treatment during pregnancy is one that more and more doctors have to face. These decisions are usually made without clear and reliable evidence. Instead, physicians 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. Particularly, the subject of possible risks to the baby can be tricky. The research on this subject is based on observation rather than controlled studies and the results are contradictory. Additionally, the majority of studies limit their analysis to live births, which can underestimate the severity of teratogenic effects that could cause abortion or termination of the pregnancy. The study presented in the journal club addresses these limitations, by examining both the data from deceased and live births. The conclusion is that while certain studies have demonstrated an association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies have a neutral or slightly negative impact. In every case it is imperative to conduct a thorough analysis of the benefits and risks must be performed. add adult medications can be difficult, if not impossible for women with ADHD to stop taking their medication. In fact, in an article recently published in the Archives of Women's Mental Health psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of loneliness, and family conflict for those suffering from the disorder. A loss of medication may affect the ability to drive safely and perform work-related tasks, which are crucial aspects of normal life for those suffering from ADHD. She suggests that women who aren't sure whether to continue taking the medication or stop it due to their pregnancy educate family members, colleagues, and friends about the condition, the impact on daily functioning and the advantages of staying on the current treatment regimen. In addition, educating them can make the woman feel more comfortable as she struggles with her decision. Some medications can pass through the placenta. If a patient decides to stop taking her ADHD medication while pregnant and breastfeeding, it is crucial to be aware that the medication may be transferred to her infant. Birth Defects Risk As the use and abuse of ADHD drugs to treat symptoms of attention deficit disorder hyperactivity disorder (ADHD) increases the concern over the potential adverse effects of the drugs on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers utilized two massive data sets to study more than 4.3 million pregnancy and determine if the use of stimulant medications increased the risk of birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medicines was associated with an increase in the risk of specific heart defects, such as ventriculo-septal defect (VSD). The researchers of the study found no connection between early use of medication and other congenital anomalies, such as facial clefting or club foot. The results are in the same vein as previous studies which showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication prior to the time of the birth of their child. This risk increased during the latter stages of pregnancy when a large number of women decided to stop taking their medication. Women who took ADHD medications in the first trimester of their pregnancy were also more likely to have a caesarean section, a low Apgar score after delivery and a baby that required breathing assistance during birth. The authors of the study were unable to eliminate selection bias because they restricted the study to women who did not have any other medical conditions that could have contributed to the findings. The researchers hope that their research will serve to inform the clinical decisions of physicians who treat pregnant women. They recommend that, while discussing the risks and benefits is crucial, the decision to stop or keep medication should be based on each woman's requirements and the severity of her ADHD symptoms. The authors caution that, while stopping the medication is an option to consider, it is not advised due to the high rate depression and other mental disorders for women who are pregnant or who have recently given birth. Additionally, research suggests that women who stop taking their medications will have a harder time adjusting to a life without them after the baby is born. Nursing The responsibilities that come with being a new mother can be overwhelming. Women with ADHD can face severe challenges when they have to manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy. The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk in low amounts. However, the frequency of exposure to medications by the infant can differ based on the dosage, frequency it is taken and the time of day the medication is administered. In addition, individual medications enter the body of the baby differently through the gastrointestinal tract as well as breast milk. The impact of this on a newborn is not yet fully understood. Some doctors may decide to stop stimulant medication during a woman's pregnancy due to the absence of research. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the risks to the fetus. As long as more information is available, doctors can ask pregnant patients if they have a background of ADHD or if they intend to take medication in the perinatal period. A increasing number of studies have revealed that most women can safely continue their ADHD medication during pregnancy and while breastfeeding. In the end, 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 potential risks. Women with ADHD who plan to breastfeed should seek advice from an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help women with ADHD be aware of their symptoms and the underlying disorder Learn about the available treatments and to reinforce existing strategies for managing. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of discussion of a management plan for both mother and child, monitoring for signs of deterioration and the need for adjustments to the medication regimen.