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ADHD Medication During Pregnancy and Breastfeeding Women with ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There are few data on how exposure to ADHD for a long time could affect a pregnant fetus. A study recently published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge the need for higher-quality studies. Risk/Benefit Analysis Women who are pregnant and taking ADHD medication must consider the benefits of taking it against the potential dangers for the baby. Physicians do not have the necessary data to make unequivocal recommendations however they can provide information on risks and benefits that aid pregnant women in making informed decisions. A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at greater 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 took stimulants during early pregnancy, and those who did not. Clinical geneticists, pediatric cardiologists and other experts reviewed the cases in order to make sure that the classification was correct and to minimize any bias. The research conducted by the researchers was not without its limitations. In particular, they were unable to separate the effects of the medication from the effects of the underlying disorder. This limitation makes it difficult for researchers to determine whether the few associations observed between the groups that were exposed to the use of medications or if they were caused by the presence of comorbidities. In addition the researchers did not study the long-term effects of offspring on their parents. The study did reveal that infants whose mothers took ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who were born without any medication or stopped their medications before or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission was not found to be influenced by which stimulant medication was used during pregnancy. Women who were taking stimulant ADHD medication during pregnancy also had an increased risk of having a caesarean section or having a child with low Apgar score (less than 7). These increases didn't appear to be affected by the kind of medication used during pregnancy. The researchers suggest that the risk of a small amount with the use of ADHD medications during the early stages of pregnancy could be offset by the higher benefit for both mother and child of continuing treatment for the woman's disorder. Physicians should discuss the issue with their patients and, if possible, help them develop strategies to improve coping skills which can reduce the impact of her disorder on her daily functioning and relationships. Interactions with Medication Many doctors are faced with the decision of whether to maintain treatment or stop as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must weigh their own knowledge and experience, as well as the experiences of other doctors and the research that has been conducted on the subject. In particular, the issue of possible risks to the infant can be difficult. The research that has been conducted on this topic is based on observation instead of controlled studies and a lot of the results are contradictory. Furthermore, most studies restrict their analysis to live births, which can underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study discussed in the journal club addresses these issues, by examining both information on deceased and live births. Conclusion: While some studies have revealed a positive correlation between ADHD medications and certain birth defects However, other studies haven't established a link. Most studies have shown a neutral, or even somewhat negative, impact. In each case, a careful evaluation of the potential risks and benefits should be conducted. It isn't easy, but not impossible, for women suffering from ADHD to stop taking their medication. In an article recently published in 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 those suffering from the disorder. Furthermore, a loss of medication can affect the ability to perform job-related tasks and drive safely which are essential aspects of daily life for many people suffering from ADHD. She suggests that women who are unsure whether to continue taking medication or discontinue it due to pregnancy should educate family members, coworkers and acquaintances about the condition, its effects on daily functioning, and the benefits of continuing the current treatment. Educating them can also make the woman feel more comfortable as she struggles with her decision. It is important to remember that certain medications can pass through the placenta, therefore, if a patient 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 child. Birth Defects and Risk of As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases, so do concerns about what impact the drugs might have on fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers used two massive data sets to study over 4.3 million pregnancies and determine if stimulant medication use increased birth defects. Although the risk overall is low, the researchers found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects such as ventriculoseptal defect (VSD). The researchers of the study didn't find any association between the use of early medications and other congenital anomalies, like facial deformities, or club feet. The results are consistent with previous studies showing an increase, but not significant, in the risk of cardiac malformations among women who started taking ADHD medications prior to the time of pregnancy. The risk was higher in the later part of pregnancy, when a lot of women decide to stop taking their ADHD medications. Women who took ADHD medication during the first trimester were more likely to require a caesarean birth and also have a low Apgar after delivery, 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 didn't have other medical issues that could have contributed to the findings. Researchers hope their research will help doctors when they see pregnant women. They recommend that, while the discussion of risks and benefits is important but the decision to stop or continue treatment must be based on each woman's needs and the severity of her ADHD symptoms. The authors also advise that while discontinuing the medications is an alternative, it is not a recommended practice because of the high rate of depression and other mental health issues in women who are pregnant or recently postpartum. Further, adult add medications suggests that women who decide to stop taking their medication are more likely to have difficulties adjusting to life without them following the birth of their baby. Nursing It can be overwhelming to become a mother. Women with ADHD who have to deal with their symptoms while attending physician appointments, making preparations for the arrival of their child and adapting to new routines in the home may face a lot of challenges. Therefore, many women decide to continue taking their ADHD medication throughout the pregnancy. The risk for breastfeeding infant is not too high since the majority of stimulant medications is absorbed through breast milk at a low level. However, the rate of exposure to medication by the newborn can vary depending on the dosage, frequency it is administered and the time of the day it 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 isn't fully known. Because of the lack of research, some doctors may be inclined to discontinue stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication against the possible risks to the fetus. Until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and if they are taking or planning to take medication during the perinatal period. A increasing number of studies have proven that most women can safely continue to take their ADHD medication during pregnancy and while breastfeeding. In response, a rising number of patients are choosing to do this. They have found after consulting with their physicians that the benefits of continuing their current medication outweigh risk. adult adhd treatments is crucial for women suffering from ADHD who are thinking of breastfeeding to seek a specialist psychiatrist's advice prior to becoming pregnant. They should review their medications with their prescriber and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also needed to help pregnant women with ADHD understand the symptoms and underlying disorder. They should also be informed about treatment options and build strategies for coping. This should be a multidisciplinary process together with obstetricians, GPs, and psychiatrists. Pregnancy counseling should consist of a 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 regime.