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ADHD Medication During Pregnancy and Breastfeeding Women suffering from ADHD must make a difficult decision on whether to keep or stop taking ADHD medication during pregnancy and breast-feeding. There aren't many studies on how long-term exposure may affect a fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological disorders such as hearing loss or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed. 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 foetus. Physicians don't have the data to give clear advice, but can provide information on the risks and benefits to assist pregnant women to make informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication in early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers used a vast, 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. Pediatric cardiologists, clinical geneticists and other experts reviewed the cases in order to confirm that the classification was correct and to reduce any bias. However, the researchers' study had its limitations. The researchers were unable, in the first place to distinguish the effects triggered by the medication from the disorder. This makes it difficult for researchers to establish whether the small differences observed between the groups that were exposed to the use of medication, or if they were caused by comorbidities. The researchers also did not study long-term outcomes for offspring. The study revealed that babies whose mothers took ADHD medication during pregnancy were at a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not use any medication during pregnancy or discontinued taking their medication prior to or during pregnancy. The reason for this was central nervous system disorders, and the increased risk for admission did not appear to be affected by the type of stimulant medications were used during pregnancy. Women who took stimulant ADHD medication during pregnancy also had an elevated risk of having a caesarean delivery or having a baby with low Apgar score (less than 7). These increases appear to be independent of the type of medication used during pregnancy. Researchers suggest that the minor risk of using ADHD medication during pregnancies in the early stages can be offset by more beneficial outcomes for both mother and baby from continuing treatment for the woman's condition. Physicians should discuss the issue with their patients and, when possible, help them develop strategies to improve their coping abilities that can lessen the effects of her disorder on her daily life and relationships. Medication Interactions Many doctors are confronted with the dilemma of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, physicians must weigh their own knowledge, the experience of other doctors, and the research on the topic. Particularly, the subject of potential risks to the baby can be tricky. Many studies on this subject are based on observations instead of controlled research and their conclusions are often contradictory. Furthermore, most studies restrict their analysis to live births, which could undervalue the serious teratogenic effects that can result in abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues by analyzing data on live and deceased births. Conclusion: While some studies have found an association between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies show a neutral, or even slight negative effect. In every case, a careful analysis of the risks and benefits is required. It can be difficult, if not impossible, for women with 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 increase depression and feelings of being isolated. Additionally, the loss of medication can interfere with the ability to complete job-related tasks and drive safely, which are important aspects of daily life for many people suffering from ADHD. She suggests that women who are unsure about whether or not to stop medication in light of their pregnancy should consider educating family members, friends and colleagues on the condition, its impact on daily functioning, and the advantages of staying on the current treatment regimen. It can also help the woman feel supported in her struggle with her decision. Certain medications can pass through the placenta. If a woman decides to stop taking her ADHD medication while pregnant and breastfeeding, it's important to be aware that the medication could be passed on to her baby. 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 over the impact that these medications could have on foetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. Researchers used two huge datasets to analyze more than 4.3 million pregnant women and determine if the use of stimulant medications caused birth defects. While the overall risk remains low, the researchers found that exposure in the first trimester to ADHD medications was associated with a slightly higher rate of certain heart defects, like ventriculo-septal defects (VSD). The researchers behind the study found no association between early use of medication and other congenital abnormalities, such as facial clefting or club foot. The results are in the same vein as previous studies which showed the existence of a slight, but significant increase in cardiac malformations for women who started taking ADHD medication prior to pregnancy. The risk grew in the latter half of pregnancy, when a lot of women are forced to stop taking their ADHD medication. Women who were taking ADHD medication during the first trimester were more likely to require a caesarean birth or have a low Apgar after birth and have a baby that needed breathing assistance when they were born. However the authors of the study were not able to eliminate bias due to selection by limiting the study to women who did not have any other medical issues that could be a contributing factor to these findings. Researchers hope their research will provide doctors with information when they meet pregnant women. The researchers advise that, while discussing benefits and risks are crucial, the decision regarding whether or not to stop taking medication should be according to the severity of each woman's ADHD symptoms and her needs. The authors warn that, although stopping the medication is an option to consider, it is not advised due to the high rate depression and other mental problems in women who are expecting or have recently given birth. Further, research shows that women who stop taking their medications will have a tough transitioning to life without them once the baby is born. Nursing It can be overwhelming becoming a mother. Women with ADHD can face severe challenges when they must deal with their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to new routines. This is why many women choose to continue taking their ADHD medication throughout the pregnancy. The risk to a nursing infant is low because the majority of stimulant medication passes through breast milk at a low level. However, the rate of exposure to medications by the newborn can vary depending on dosage, how often it is administered, and at what time the medication is administered. In addition, different medications are introduced into the baby's system through the gastrointestinal tract or breast milk. The effect on the health of a newborn is not completely understood. Some doctors may decide to stop stimulant medications during a woman's pregnancy due to the lack of research. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication against the potential risks to the embryo. As long as more information is available, doctors may ask pregnant patients whether they have a background of ADHD or if they plan to take medication in the perinatal stage. Numerous studies have demonstrated that women can continue to take their ADHD medication in a safe manner during pregnancy and while breast-feeding. In response, a growing number of patients are opting to continue their medication. They have concluded through consultation with their doctor, that the benefits of keeping their current medication outweigh risk. Women with ADHD who plan to breastfeed should seek the advice of an expert psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological strategies. medication for add adults is also needed to help pregnant women suffering from ADHD understand the symptoms and underlying disorder. They should also learn about treatment options and reinforce coping mechanisms. This should be a multidisciplinary approach with the GPs, obstetricians, and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother as well as the child, monitoring of signs of deterioration and, if needed, adjustments to the medication regimen.