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ADHD Medication During Pregnancy and Breastfeeding The choice of whether to stop or continue ADHD medication during breastfeeding and pregnancy is a challenge for women suffering from the condition. There isn' her response on how long-term exposure to these drugs could affect the foetus. A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders like hearing loss or impaired vision seizures, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication should weigh the benefits of taking it against the possible risks to the fetus. The doctors don't have the information to provide clear recommendations however they can provide information on risks and benefits to aid pregnant women in making informed choices. 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 massive population-based study of case control to examine the prevalence of structural defects that were major in infants who were 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 chance of bias. However, the researchers' study had its limitations. In particular, they were not able to differentiate the effects of the medication from those of the disorder at hand. This limitation makes it difficult for researchers to establish whether the small differences observed between the groups exposed were due to the use of medications or if they were caused by co-morbidities. Researchers also did not study long-term outcomes for the offspring. The study revealed that infants whose mother had taken ADHD medication during pregnancy had a higher risk of admission to the neonatal care unit (NICU) as compared to those whose mothers did not take any medication during pregnancy or quit taking the medication prior to or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy. Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having a caesarean section or one whose baby scored low on the Apgar scale (less than 7). These increases appear to be unrelated to the type of medication taken during pregnancy. The researchers suggest that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefit for both mother and child from continued treatment for the woman's disorder. Physicians should discuss this with their patients and, if possible, assist them in developing strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships. Medication Interactions As more women than ever are being diagnosed with ADHD and treated with medication, the issue of whether to keep or end treatment during pregnancy is a question that more and more doctors face. These decisions are usually made without clear and reliable evidence. Instead, doctors have to consider their own expertise in conjunction with the experiences of other doctors, and the research on the subject. Particularly, the issue of possible risks to the infant can be difficult. Many studies on this subject are based on observations rather than controlled research and their conclusions are often contradictory. The majority of studies restrict their analysis to live births, which may underestimate the severity of teratogenic effects leading to abortions or terminations of pregnancy. The study discussed in this journal club addresses these limitations by examining data on both 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 found a correlation. Most studies have shown a neutral, or even slight negative impact. In all cases, a careful evaluation of the benefits and risks must be performed. It can be difficult, if not impossible for women suffering from ADHD to stop taking their medication. In an article 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 these patients. The loss of medication can also impact the ability to safely drive and complete work-related tasks, which are essential aspects of normal life for people with ADHD. She suggests women who are unsure about whether to keep or discontinue medication due to their pregnancy consider educating family members, friends and colleagues on the condition, its effects on daily functioning, and on the benefits of keeping the current treatment regimen. It will also help a woman feel supported in her decision. adult adhd medication is important to note that some drugs can pass through the placenta, so if a woman decides to discontinue 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. Risk of Birth Defects As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns over the impact that these medications could have on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers utilized two massive data sets to study over 4.3 million pregnancy and determine if stimulant medication use caused birth defects. Although the risk overall remains low, the researchers found that exposure in the first trimester to ADHD medications was linked to a slightly higher rate of specific heart defects, such as ventriculo-septal defect (VSD). The authors of the study did not discover any connection between early use of medication and other congenital anomalies such as facial deformities or club feet. The results are in line with previous studies revealing an increase, but not significant, in the risk of developing cardiac malformations in women who started taking ADHD medications before pregnancy. This risk increased during the latter stages of pregnancy, when a lot of women stopped taking their medication. Women who were taking ADHD medication during the first trimester were more likely require a caesarean delivery and also have an insufficient Apgar after birth and have a baby that needed breathing assistance when they were born. The authors of the study were unable to remove bias in selection since they limited their study to women who did not have any other medical conditions that could have contributed to the findings. Researchers hope their research will help doctors when they see pregnant women. The researchers suggest that while discussing the risks and benefits are important, the choice on whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her requirements. The authors also caution that even though stopping the medication is an alternative, it is not an option to consider due to the high rate of depression and other mental health problems among women who are pregnant or recently post-partum. Furthermore, research suggests that women who decide to stop taking their medications are more likely to have a difficult time adapting to life without them after the baby's arrival. Nursing It can be a stressful experience to become a mother. Women with ADHD who must work through their symptoms while attending physician appointments and getting ready for the arrival of a baby and adjusting to new household routines are often faced with a number of difficulties. Many women choose to continue taking their ADHD medication during pregnancy. The risk for breastfeeding infant is minimal because the majority of stimulant medications passes through breast milk in low amounts. However, the amount of exposure to medications by the newborn may differ based on the dosage, frequency it is taken and the time of day the medication is administered. Additionally, individual 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 known. Because of the lack of research, some physicians may recommend stopping stimulant drugs during a woman's pregnancy. It is a difficult decision for the mother, who must weigh the advantages of continuing her medication against the risks to the fetus. In the meantime, until more information is available, doctors should ask all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal time. Numerous studies have proven that women can continue to take their ADHD medication without risk during pregnancy and breast-feeding. In response, an increasing number of patients are opting to continue their medication. They have discovered after consulting with their physicians that the benefits of retaining their current medication outweigh any risk. It is essential for women with ADHD who are considering 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 continued treatment, including non-pharmacological strategies. Psychoeducation is also required to help pregnant people with ADHD be aware of their symptoms and the underlying disorder and learn about treatment options and reinforce existing strategies for coping. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Pregnancy counseling should include a discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration and, if needed modifications to the medication regimen.