• 목록
• 답변
• 글쓰기
• 게시판 리스트 옵션
  • 수정
  • 삭제

ADHD Medication During Pregnancy and Breastfeeding

Women suffering from ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. Little data exists about how long-term exposure to these drugs may affect the foetus.

A recent study published in Molecular Psychiatry shows that children exposed to adhd Medication pregnancy medication in the uterus don't develop neurological developmental conditions like hearing loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge that further high-quality research is needed.

Risk/Benefit Analysis

Women who are expecting and taking ADHD medication need to weigh the benefits of taking it against the potential risks for the fetus. The doctors don't have the information to give clear advice however they can provide information about risks and benefits to help pregnant women make an informed decision.

A study published in Molecular Psychiatry concluded that women who took ADHD medication during early pregnancy did not have a higher risk of fetal malformations, or structural birth defects. Researchers conducted a large population-based case-control study to assess the risk of major structural birth defects in infants born to mothers who had taken stimulants during early pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists reviewed the cases to ensure correct case classification and to minimize the possibility of bias.

However, the study had its limitations. The researchers were not able in the beginning, to separate the effects caused by the medication from the disorder. This makes it difficult to determine whether the small differences observed in the exposed groups result from medication use or comorbidities that cause confusion. Researchers also did not look at the long-term effects for the offspring.

The study did show that babies whose mothers had taken ADHD medication during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or cut back on their medications prior to or during pregnancy. This increase was caused by central nervous system disorders. The increased risk of admission was not influenced by the stimulant medications used during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an elevated risk of having a caesarean section or having a child with a low Apgar score (less than 7). These increases didn't appear to be influenced by the type of medication that was used during pregnancy.

Researchers suggest that the minor risks posed by the use of ADHD medications during early pregnancies could be offset by the more beneficial outcomes for both mother and baby of continuing treatment for the woman’s disorder. Physicians should discuss this with their patients and, where to get prescribed adhd medication possible, help them develop strategies for improving their coping skills that may minimize the impact of her disorder on her daily functioning and relationships.

Medication Interactions

As more women than ever are being diagnosed with ADHD and treated with medication, the dilemma of whether to continue or end treatment during pregnancy is one that doctors are having to confront. The majority of these decisions are made without any evidence that is clear and definitive either way, so physicians must weigh what they know from their own experiences, those of other doctors, and what medications are prescribed for adhd the research suggests about the subject as well as their own judgments for each individual patient.

In particular, the issue of potential risks to the baby can be a challenge. The research on this issue is based on observations instead of controlled studies and many of the findings are conflicting. Most studies restrict their analysis to live births, which can underestimate the teratogenic impact which can cause abortions or terminations of pregnancy. The study discussed in the journal club addresses these issues by analyzing both information on deceased and live births.

The conclusion The conclusion: While some studies have found a positive association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link, and most studies demonstrate a neutral or slightly negative impact. In each case it is imperative to conduct a thorough evaluation of the risks and benefits is required.

It isn't easy, but not impossible for women suffering from ADHD to stop taking their medication. In a recent piece published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of loneliness. Additionally, the loss of medication may affect the ability to do work-related tasks and safely drive which are essential aspects of a normal life for many people with ADHD.

She recommends women who are uncertain about whether or not to discontinue medication due to their pregnancy consider informing family members, friends and colleagues on the condition, its impact on daily functioning, and on the advantages of continuing the current treatment plan. In addition, educating them can help the woman feel supported in her struggle with her decision. It is also worth noting that certain medications can pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware that the effects of the drug can 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, so do concerns over the impact that these drugs could have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge regarding this issue. Utilizing two huge data sets researchers were able analyze more than 4.3 million pregnancies to determine whether the use of 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 defects.

The researchers of the study found no connection between the use of early medications and congenital abnormalities like facial clefting, or club foot. The results are in line with previous studies that showed an insignificant, but small increase in the number of cardiac malformations among women who started taking ADHD medication before pregnancy. The risk increased in the latter part of pregnancy when many women decided to stop taking their medication.

Women who took ADHD medication during the first trimester were more likely to require a caesarean delivery, 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 not able to eliminate selection bias by restricting the study to women who didn't have other medical issues that could have contributed to these findings.

The researchers hope that their research will serve to inform the clinical decisions of doctors who see pregnant women. The researchers advise that, while discussing risks and benefits are crucial, the decision regarding whether or not to stop medication should be made in light of the severity of each woman's ADHD symptoms and the needs of the woman.

The authors also caution that even though stopping the medication is an option, it isn't a recommended practice because of the high incidence of depression and other mental health problems for women who are expecting or postpartum. Further, research shows that women who stop taking their medication will have a harder adjustment to life without them after the baby is born.

Nursing

The responsibilities of being a new mom can be overwhelming. Women suffering from adhd depression medication are often faced with a number of difficulties when they have to manage their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to new routines. As such, many women choose to continue taking their ADHD medications throughout the course of pregnancy.

The risk to breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk in low amounts. However, the rate of medication exposure to the infant can differ based on the dosage, frequency it is administered, and the time of the day the medication is administered. In addition, various drugs enter the infant's system via the gastrointestinal tract or breast milk. The effect on the health of a newborn isn't completely comprehended.

Because of the lack of research, some physicians may be inclined to discontinue stimulant drugs during the course of pregnancy. It's a difficult choice for the woman, who must weigh the advantages of continuing her medication against the potential risks to the embryo. Until more information becomes available, GPs may inquire about pregnant patients if they have a history of ADHD or if they intend to take medication in the perinatal phase.

A growing number of studies have revealed that most women can safely continue their ADHD medication while they are pregnant and nursing. In the end, more and more patients opt to do this, and in consultation with their doctor they have found that the benefits of maintaining their current medication far outweigh any potential risks.

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 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 strengthen coping mechanisms. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. The pregnancy counselling should consist of 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, if necessary, adjustments to the medication for adhd regimen.