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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 breast-feeding. There are few data on how exposure to ADHD for a long time could affect the pregnant fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge that further high-quality studies are required. Risk/Benefit Analysis Women who are pregnant and take ADHD medication need to evaluate the benefits of using it against the possible risks for the fetus. Physicians do not have the information needed to make unequivocal recommendations, but they can provide information about risks and benefits that help pregnant women make informed decisions. A study published in Molecular Psychiatry found that women who used ADHD medications in early pregnancy did not have a significantly higher risk of fetal cardiac malformations or major birth defects that are structural. adhd and depression medication used a large sample-based case control study to assess the frequency of structural defects that were major in infants who were born to mothers who took stimulants during pregnancy. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure an accurate classification of the cases and to reduce the chance of bias. The study of the researchers was not without limitations. The most important issue was that they were not able to differentiate the effects of the medication from the effects of the disorder at hand. This limitation makes it difficult for researchers to determine if the few associations observed between the groups exposed were due to the use of medications or if they were affected by comorbidities. Additionally the study did not study the long-term effects of offspring on their parents. The study revealed that infants whose mother took ADHD medication during pregnancy had a greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers didn't take any medication during pregnancy or stopped taking their medication before or during pregnancy. This was due to central nervous system disorders. The higher risk of admission was not influenced by the stimulant medications used during pregnancy. Women who took stimulant ADHD medications during pregnancy also had a higher likelihood of having caesarean sections or a baby that scored low on the Apgar scale (less than 7). These risks did not seem to be influenced by the kind of medication used during pregnancy. Researchers suggest that the minor risks associated with the use ADHD medications during early pregnancies may be offset by the greater benefits to both mother and baby of continuing treatment for the woman's disorder. Physicians should talk to their patients about this issue and try to help them improve coping skills which may reduce the effects 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 question of whether to continue or discontinue treatment during pregnancy is a question that more and more physicians face. The majority of these decisions are made without clear and authoritative evidence regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what research suggests on the subject as well as their best judgment for each patient. Particularly, the subject of possible risks to the infant can be difficult. Many studies on this subject are based on observational data rather than controlled research and their findings are often contradictory. The majority of studies focus on live-births, which could underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study discussed in the journal club addresses these limitations by analyzing information on deceased and live births. medications for adhd uk have revealed an association between ADHD medications and certain birth defects, other studies have not found a correlation. Most studies have shown an unintended, or somewhat negative, impact. Therefore, a careful risk/benefit analysis is required in every case. For women suffering from ADHD and ADD, the decision to discontinue medication is difficult, if not impossible. 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 increase depression, feelings of isolation and family conflict for these patients. In addition, a decrease in medication may affect the ability to perform work-related tasks and safely drive, which are important aspects of daily life for many people suffering from ADHD. She suggests women who are unsure about whether to keep or discontinue medication due to their pregnancy should consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of continuing the current treatment plan. It will also help a woman feel more confident in her decision. Certain medications can pass through the placenta. If a patient decides not to take her ADHD medication while pregnant and breastfeeding, it is important to be aware that the medication could be passed on to her baby. Risk of Birth Defects 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 medications could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this topic. Using two massive data sets researchers were able to look at more than 4.3 million pregnancies to determine whether stimulant medications increased the risk of birth defects. Researchers found that while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect. The researchers of the study could not find any association between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in the same vein as previous studies that showed a small, but significant increase in cardiac malformations for women who started taking ADHD medication prior to pregnancy. The risk grew during the latter part of pregnancy, when a lot of women begin to discontinue their ADHD medication. Women who took ADHD medication in the first trimester of their pregnancies were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. The authors of the study were not able to eliminate bias due to selection because they limited their study to women with no other medical conditions that might have contributed to the findings. The researchers hope their study will help inform the clinical decisions of doctors who treat pregnant women. They advise that while the discussion of the risks and benefits is crucial, 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 caution that while discontinuing the medications is an option, it isn't an option that is recommended due to the high rate of depression and other mental health problems among women who are pregnant or who are recently postpartum. Research has also shown that women who stop taking their medication will have a harder adjustment to life without them once the baby is born. Nursing The responsibilities of a new mother can be overwhelming. adhd depression medication with ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a child and adjust to a new routine. Therefore, many women decide to continue taking their ADHD medications throughout pregnancy. The majority of stimulant medicines are absorbed through breast milk in very small quantities, so the risk to the infant who is breastfeeding is low. The rate of exposure to medication can vary depending upon the dosage the medication is administered, its frequency and the time of the day. Additionally, different medications enter the body of the baby differently through the gastrointestinal tract and breast milk and the impact of this on a newborn is not well understood. Due to the absence of research, some physicians may be inclined to discontinue stimulant medications during the pregnancy of a woman. This is a complicated decision for the patient, who must weigh the benefits of keeping her medication against the potential risks to the embryo. Until more information becomes available, GPs may ask pregnant patients whether they have a background of ADHD or if they are planning to take medication during the perinatal phase. A growing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are opting to do so. They have discovered after consulting with their doctors that the benefits of keeping their current medication far outweigh any potential risks. It is essential for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's advice prior becoming pregnant. They should discuss their medication with their prescriber and discuss the advantages and disadvantages of continuing treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant women suffering from ADHD be aware of the symptoms and underlying disorder. They should also be educated about treatment options and build strategies for coping. This should be an approach that is multidisciplinary, including the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother as well as the child, and monitoring for indicators of deterioration, and, if necessary, adjustments to the medication regimen.