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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 is a lack of information about how long-term exposure to these medications may affect the foetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during utero do not develop neurological developmental disorders like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge the need for more high-quality research. Risk/Benefit Analysis Pregnant women who use ADHD medications must weigh the benefits of taking them against potential risks to the foetus. Physicians don't have the data to provide clear recommendations however they 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 took ADHD medication in early pregnancy were not at a higher risk of fetal malformations, or structural birth defects. adhd medication list conducted a large, population-based case-control study to evaluate the incidence of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy, as well as those who had not. Clinical geneticists, pediatric cardiologists and other experts looked over the cases to confirm that the classification was correct and to minimize any bias. However, the researchers' study had its limitations. Researchers were unable to, in the first place, to separate the effects of the medication from the disorder. This makes it difficult to know whether the small differences observed in the exposed groups are due to the use of medication or comorbidities that cause confusion. In addition the study did not examine the long-term effects of offspring on their parents. The study did reveal that infants whose mothers had taken ADHD medication during pregnancy were at a more risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or had stopped their medications before or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission was not found to be influenced by which stimulant medications were taken during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have a caesarean section or a baby that scored low on the Apgar scale (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy. The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefits to both the mother and child from continued treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if 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. Interactions with Medication As more women than ever before are being diagnosed with ADHD and treated with medication, the issue of whether to keep or stop treatment during pregnancy is one that more and more physicians have to face. Often, these decisions are made in the absence of clear and authoritative evidence regardless, so doctors must weigh their knowledge, the experiences of other doctors, and what the research suggests about the subject as well as their best judgment for each individual patient. The issue of risk for infants can be difficult to determine. The research on this subject is based on observations rather than controlled studies and many of the findings are conflicting. In addition, most 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 shortcomings by analyzing information on deceased and live 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 most studies have a neutral or slightly negative effect. In each case it is imperative to conduct a thorough evaluation of the risks and benefits should be conducted. It can be challenging, if not impossible for women suffering from ADHD to stop taking their medication. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of being isolated. In addition, a decrease in medication can interfere with the ability to do jobs and drive safely which are essential aspects of daily life for many people with ADHD. She recommends women who are unsure about whether to keep or stop medication in light of their pregnancy, consider the possibility of educating friends, family members and colleagues about the condition, its effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also help women feel supported in her decision. Certain medications can be passed through the placenta. If a woman 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 Risk As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the medications could have on the fetuses. A study that was published in the journal Molecular Psychiatry adds to the existing knowledge on this subject. With two massive data sets researchers were able examine more than 4.3 million pregnancies and see whether stimulant medication use increased the risk of birth defects. While the overall risk remains low, the scientists discovered that the first-trimester exposure to ADHD medications was linked to an increased risk of certain heart defects, such as ventriculo-septal defect (VSD). The researchers behind the study found no association between early medication use and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies showing an increase, but not significant, in the risk of developing cardiac malformations in women who started taking ADHD medications before the time of pregnancy. The risk increased in the latter half of pregnancy when a large number of women stopped taking their medication. Women who were taking ADHD medication in the first trimester were more likely require a caesarean birth, have a low Apgar after birth and have a baby who needed help breathing at birth. The researchers of the study were unable to eliminate selection bias because they restricted the study to women with no other medical conditions that might have contributed to the findings. The researchers hope their research will aid in the clinical decisions of doctors who encounter pregnant women. The researchers suggest that while discussing risks and benefits are important, the choice about whether to continue or stop medication should be made based on the severity of each woman's ADHD symptoms and the needs of the woman. The authors also caution that, while stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health issues for women who are expecting or recently post-partum. Further, the research suggests that women who choose to stop taking their medication are more likely to experience difficulties adjusting to life without them following the birth of their baby. Nursing The responsibilities that come with being a new mom can be overwhelming. adhd medication list with ADHD are often faced with a number of difficulties when they have to manage their symptoms, go to doctor appointments and prepare for the birth of a child and adjust to new routines. As such, many women decide to continue taking their ADHD medications throughout pregnancy. The risk to breastfeeding infant is not too high since the majority of stimulant medications passes through breast milk at low levels. The rate of exposure to medication can vary depending upon the dosage, frequency of administration and time of day. Additionally, different medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn isn't yet fully understood. Due to the absence of evidence, some doctors may recommend stopping stimulant medications during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the potential risks to the foetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and whether they plan or are taking to take medication during the perinatal period. Numerous studies have demonstrated that women can continue to take their ADHD medication without risk during pregnancy and breast-feeding. In the end, many patients choose to do so and, after consulting with their doctor, they have found that the benefits of continuing their current medication exceed any risk. Women who suffer from ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation is also necessary to help pregnant women with ADHD recognize the signs and the underlying disorder. They should also be informed about treatment options and build coping mechanisms. This should be a multidisciplinary process with the GPs, obstetricians, 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 modifications to the medication regime.