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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD must make a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There aren't many studies regarding how exposure over time may affect a fetus. A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues like hearing loss or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies. Risk/Benefit Analysis Pregnant women who take ADHD medications need to balance the benefits of taking them against potential risks to the fetus. Physicians don't have the data to give clear advice, but can provide information about risks and benefits to aid pregnant women in making an informed decision. A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not face a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy and those who had not. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure an accurate case classification and to limit the possibility of bias. The research conducted by the researchers was not without its limitations. The researchers were not able to, in the first place to distinguish the effects triggered by the medication from the disorder. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or the confounding effect of comorbidities. medication for add adults did not examine long-term outcomes for the offspring. The study revealed that babies whose mothers took ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU) in comparison to mothers who didn't take any medication during pregnancy or had stopped taking their medication before or during pregnancy. This increase was due to central nervous system disorders, and the higher risk of admission did not appear to be affected by the type of stimulant medications were used during pregnancy. Women who used stimulant ADHD medication during pregnancy also had an elevated chance of having a caesarean birth or having a baby born with a low Apgar score (less than 7). These increases appear to be unrelated to the type of medication used during pregnancy. The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy may be offset by the greater benefits for both mother and child of continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships. Interactions with Medication Many doctors are confronted with the dilemma of whether to keep treatment or stop as more women are diagnosed with ADHD. Most of the time, these decisions are made without clear and authoritative evidence either way, so physicians have to weigh their experience about their experiences, the experiences of other doctors, and what research says on the topic and their best judgment for each patient. The issue of possible risks for infants can be extremely difficult. The research that has been conducted on this topic is based on observations instead of controlled studies and many of the findings are contradictory. Additionally, the majority of studies limit their analysis to live births, which could undervalue the serious teratogenic effects that can lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these issues by examining data on both live and deceased births. Conclusion A few studies have shown an association between ADHD medications and certain birth defects, other studies have not shown such a relationship. Most studies have shown a neutral, or even slight negative effect. Therefore, a careful risk/benefit analysis must be done in each case. For women suffering from ADHD who suffer from ADHD, the decision to discontinue medication is difficult if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can cause depression, feelings of loneliness, and family conflict for patients with ADHD. Furthermore, a loss of medication can interfere with the ability to do work-related tasks and safely drive which are essential aspects of a normal life for many people with ADHD. She suggests that women who aren't sure whether to continue taking medication or stop due to pregnancy, educate their family members, coworkers and acquaintances about the condition, the impact on daily functioning and the advantages of staying on the current treatment. In addition, educating them can make the woman feel more comfortable when she is struggling with her decision. It is important to remember that certain drugs can pass through the placenta so if the patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the infant. Birth Defects and Risk of As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) increases there are concerns about the effects that the drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. With two massive data sets researchers were able analyze more than 4.3 million pregnancies to determine whether stimulant medication use increased the risk of birth defects. While the overall risk remains low, the scientists found that exposure in the first trimester to ADHD medicines was associated with an increased risk of specific heart defects, like ventriculo-septal defects (VSD). The authors of the study found no link between the use of early medications and other congenital abnormalities, such as facial clefting or club foot. The findings are in line with previous studies that have shown the presence of a small, but significant increase in the risk of cardiac malformations among women who began taking ADHD medications prior to the birth of their child. The risk increased in the latter stages of pregnancy when a large number of women decided to stop taking their medication. Women who took ADHD medication in the first trimester were more likely to need a caesarean or have a low Apgar after delivery and have a baby that needed help breathing when they were born. However the authors of the study were unable to eliminate selection bias by restricting the study to women who didn't have any other medical issues that could be a contributing factor to these findings. Researchers hope that their study will provide doctors with information when they encounter pregnant women. The researchers advise that while discussing the risks and benefits are important, the choice regarding whether or not to stop taking medication should be according to the severity of each woman's ADHD symptoms and her requirements. The authors caution that, even though stopping the medication is a possibility to think about, it isn't advised due to the high prevalence of depression and mental health issues 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 once the baby is born. Nursing It can be a stressful experience to become a mother. Women who suffer from ADHD are often faced with a number of difficulties when they must deal with their symptoms, go to doctor appointments, prepare for the birth of their child and adjust to a new routine. As such, many women choose to continue taking their ADHD medication throughout the pregnancy. The majority of stimulant medicines are absorbed by breast milk in small quantities, so the risk to infant who is breastfeeding is low. However, the amount of exposure to medication by the infant can differ based on dosage, frequency it is administered, and the time of day the medication is administered. In addition, various medications enter the baby’s system through the gastrointestinal tract or breast milk. The impact on a newborn's health is not fully known. Due to the absence of evidence, some doctors might be tempted to stop taking stimulant drugs during a woman's pregnancy. It's a difficult choice for the woman, who must weigh the benefits of continuing her medication against the risks to the foetus. In the meantime, until more information is available, doctors may ask pregnant patients whether they have any history of ADHD or if they are planning to take medication during the perinatal period. Many studies have shown that women can continue taking their ADHD medication in a safe manner during pregnancy and while breast-feeding. As a result, more and more patients choose to do so, and in consultation with their doctor they have discovered that the benefits of maintaining their current medication exceed any risk. It's important for women with ADHD who are contemplating breastfeeding to seek out a specialist psychiatrist's guidance prior to becoming pregnant. They should review their medications with their doctor and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the underlying disorder and learn about treatment options and reinforce existing strategies for managing. This should involve an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Counselling for pregnancy should include the discussion of a plan for management for both the mother as well as the child, as well as monitoring for signs of deterioration and when necessary, making adjustments to the medication regimen.