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ADHD Medication During Pregnancy and Breastfeeding The decision to stop or keep ADHD medication during pregnancy and breastfeeding is challenging for women with the condition. There is a lack of information about how long-term exposure to these drugs may affect the fetus. A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders such as hearing or vision impairment 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 need to balance the advantages of taking them against potential risks to the foetus. Doctors don't have enough data to make unambiguous recommendations but they can provide information on the risks and benefits to aid pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy did not have a greater risk of fetal malformations or structural birth defects. Researchers conducted a large sample-based case control study to compare the incidence of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists looked over the cases to ensure correct case classification and to limit the possibility of bias. The research conducted by the researchers was not without limitations. linked web page , they were unable to distinguish the effects of the medication from the disorder that is underlying. This makes it difficult for researchers to determine whether the small differences observed between the exposed groups were due to the use of medication or if they were confounded by the presence of comorbidities. Researchers also did not look at long-term outcomes for offspring. The study found that infants whose mothers took ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU) in comparison to mothers who did not take any medication during pregnancy or stopped taking their medication before or during pregnancy. The reason for this was central nervous system-related disorders and the increased risk for admission was not found to be influenced by the stimulant medication was used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher chance of having to have a caesarean section or one whose baby 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 may be offset by the greater benefit to both the mother and child from continued treatment for the woman's condition. Physicians should discuss this with their patients and, when possible, help them develop strategies for improving their coping skills that may minimize the impact of her disorder on her daily functioning and relationships. Interactions with Medication Many doctors are confronted with the dilemma of whether to continue treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to take into account their own experience and experience, as well as the experiences of other doctors, and the research on the subject. The issue of potential risks to the infant can be difficult to determine. A lot of studies on this issue are based on observational data instead of controlled research and their findings are often contradictory. In addition, most 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 that is discussed in the journal club addresses these shortcomings, by examining both data on live and deceased births. Conclusion A few studies have found a positive correlation between ADHD medications and certain birth defects However, other studies haven't shown such a relationship. The majority of studies show that there is a neutral, or somewhat negative, effect. In the end, a careful risk/benefit assessment must be done in each instance. It can be difficult, if not impossible for women with ADHD to stop taking their medication. In a recent article in 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 isolation. Furthermore, a loss of medication may affect the ability to complete jobs and drive safely that are crucial aspects of daily life for many people 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, coworkers, and friends about the condition, the effects on daily functioning, and the benefits of keeping the current treatment. In addition, educating them can aid in ensuring that the woman feels supported as she struggles with her decision. Certain medications can pass through the placenta. If a patient decides to not take her ADHD medication while breastfeeding, it is important to be aware that 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 what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. With two massive data sets, researchers were able to analyze more than 4.3 million pregnancies and determine whether stimulant medication use increased the risk of birth defects. Researchers discovered that, while the risk overall is low, the first trimester ADHD medication use was associated with slightly higher rates of specific heart defects like ventriculoseptal defects. The authors of the study did not discover any link between early use of medication and other congenital anomalies like facial deformities, or club feet. The results are consistent with previous studies revealing an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications prior to the time of pregnancy. The risk was higher during the latter part of pregnancy, as many women begin to discontinue their ADHD medications. Women who took ADHD medication in the first trimester were more likely need a caesarean, have a low Apgar after birth and have a baby who needed breathing assistance at birth. However the researchers of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have other medical issues that could have contributed to these findings. The researchers hope their study will help inform the clinical decisions of physicians who treat pregnant women. They suggest that although discussing the risks and benefits is crucial but the decision to stop or maintain treatment should be based on the woman's needs and the severity of her ADHD symptoms. The authors also warn that while discontinuing the medications is an option, it is not a recommended practice because of the high prevalence of depression and other mental health problems for women who are expecting or who are recently postpartum. Additionally, research suggests that women who stop taking their medication will have a harder adjustment to life without them after the baby is born. Nursing It can be a stressful experience to become a mother. Women who suffer from ADHD who must work through their symptoms while attending doctor appointments, making preparations for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy. The majority of stimulant medications pass through breast milk in low amounts, so the risk for infant who is breastfeeding is low. However, the frequency of exposure to medications by the newborn can vary depending on dosage, frequency it is taken and at what time the medication is administered. Additionally, individual medications enter the infant's system differently through the gastrointestinal tract as well as breast milk and the impact of this on a newborn is not well known. Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the absence of research. This is a difficult decision for the woman who must weigh the benefits of her medication against the risks to the embryo. In the meantime, until more information is available, GPs can ask pregnant patients if they have an background of ADHD or if they intend to take medication in the perinatal stage. A growing number of studies have shown that the majority of women are able to safely continue their ADHD medication during pregnancy and while breastfeeding. In the end, an increasing number of patients are choosing to do so and, after consulting with their doctor, they have found that the benefits of maintaining their current medication far outweigh any risks. Women with ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological management strategies. medication for add adults should also be provided to help women with ADHD be aware of their symptoms and the underlying disorder, learn about available treatment options and strengthen existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and the child, monitoring of signs of deterioration and, if necessary, adjustments to the medication regimen.