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

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 aren't many studies regarding how exposure over time may affect the fetus.

A study recently published in Molecular Psychiatry shows that children exposed to ADHD medication in utero do not develop neurological disorders such as hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge that more high quality studies are required.

Risk/Benefit Analysis

Women who are pregnant and taking ADHD medications must weigh the benefits of using them against the risks to the fetus. Physicians don't have the data to make unambiguous recommendations however they can provide information on the risks and benefits to aid pregnant women in making informed choices.

A study published in Molecular Psychiatry found that women who took ADHD medications during their early pregnancy did not have an higher risk of fetal cardiac malformations or major birth defects that are structural. Researchers conducted a massive sample-based case control study to assess the frequency of structural defects that were major in infants born to mothers who used stimulants during pregnancy. Pediatric cardiologists and clinical geneticists reviewed the cases to ensure correct classification of the cases and to reduce the chance of bias.

However, the study had its limitations. The researchers were unable to, in the first place to distinguish the effects caused by the medication from the disorder. This limitation makes it difficult for researchers to determine whether the small associations observed among the exposed groups were due to the use of medications or affected by co-morbidities. In addition the researchers did not examine the long-term outcomes of offspring.

The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than infants who whose mothers did not take any medication or taken off their medication prior to or during pregnancy. This increase was due to central nervous system disorders, and the increased risk for admission did not appear to be influenced by the stimulant medication was used during pregnancy.

Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having a caesarean section or a baby that scored low on the Apgar scale (less than 7). These risks did not appear to be influenced by the kind of medication used during pregnancy.

The research suggests that the small risk associated with the use of ADHD medications during early pregnancy could be offset by the greater benefits to both mother and child of continued treatment for the woman's disorder. Physicians should discuss this with their patients and, where possible, assist them in developing strategies for improving their coping skills that may minimize the negative impact of her condition on her daily functioning and relationships.

Medication Interactions

As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to keep or discontinue treatment during pregnancy is one that doctors are having to confront. These decisions are frequently taken without clear and authoritative evidence. Instead, doctors have to weigh their own knowledge, the experience of other doctors and the research that has been conducted on the subject.

The issue of risk to infants is difficult to determine. A lot of studies on this topic are based on observational evidence rather than controlled research and their findings are often contradictory. In addition, most studies limit their analysis to live births, which could underestimate the severity of teratogenic effects that could lead to abortion or termination of the pregnancy. The study presented in this journal club addresses these limitations by analyzing data on live and deceased births.

The conclusion The conclusion: While some studies have shown an association between ADHD medications and the risk of certain birth defects, others have not found any evidence of a link and the majority of studies demonstrate a neutral or slightly negative effect. In all cases, a careful study of the risks and benefits is required.

It can be challenging, if not impossible for women with ADHD to stop taking their medication. In a recent article 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 isolation. Additionally, the loss of medication can interfere with the ability to do jobs and drive safely that are crucial aspects of daily life for many people with ADHD.

She recommends that women who are unsure about whether to continue or stop medication in light of their pregnancy, consider educating family members, friends and colleagues about the condition, its effects on daily functioning, and the advantages of staying on the current treatment regimen. It can also aid in ensuring that the woman feels supported when she is struggling with her decision. Certain medications can be passed through the placenta. If a patient decides to stop taking her ADHD medication while breastfeeding, it is crucial to be aware that the medication could be transferred to the baby.

Birth Defects and Risk of

As the use and abuse of ADHD medication to treat symptoms of attention deficit hyperactivity disorder (ADHD), increases the concern over the potential adverse effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body knowledge on this subject. Researchers utilized two massive datasets to analyze over 4.3 million pregnancy and determine if the use of stimulant medications caused birth defects. Although the risk overall is low, the researchers did find that first-trimester exposure to ADHD medicines was associated with an increase in the risk of certain heart defects, such as ventriculo-septal defect (VSD).

The researchers behind the study found no connection between early use of medication and other congenital abnormalities, like facial clefting, or club foot. The results are in line with previous studies showing a small but significant increase in the risk of cardiac malformations in women who started taking ADHD medications prior to pregnancy. This risk increased in the latter half of pregnancy, when a lot of women are forced to stop taking their ADHD medications.

Women who used ADHD medications during the first trimester of their pregnancy were also more likely to have caesarean sections, a low Apgar score following delivery, and a baby who required breathing assistance during birth. The researchers of the study were unable to remove bias in selection since they restricted the study to women who did not have any other medical conditions that might have contributed to the findings.

Researchers hope that their research will help doctors when they encounter pregnant women. The researchers suggest that, while discussing the risks and benefits are important, 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 also caution that even though stopping the medication is an option, it isn't an option that is recommended due to the high incidence of depression and other mental health problems for women who are expecting or recently postpartum. Further, research shows that women who stop taking their medication will have a tough transitioning to life without them once the baby is born.

Nursing

The responsibilities of being a new mother can be overwhelming. Women suffering from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of a baby and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.

The risk to a breastfeeding infant is not too high since the majority of stimulant medications prescribed for adhd is absorbed through breast milk at low levels. However, the rate of medication exposure to the newborn may differ based on the dosage, frequency it is taken and at what time the medication is administered. In addition, different medications are introduced into the baby's system through the gastrointestinal tract, or through breast milk. The impact on a newborn's health is not completely known.

Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. This is a difficult decision for the patient, who must balance the benefits of keeping her medication against the possible risks to the embryo. Until more information is available, GPs should ask all pregnant patients about their experience with ADHD and whether they are planning or taking to take medication during the perinatal time.

A growing number of studies have proven that the majority of women are able to safely continue to take their ADHD medication while they are pregnant and nursing. In response, a growing number of patients are opting to continue their medication. They have concluded through consultation with their physicians that the benefits of continuing their current medication outweigh any possible risks.

Women with ADHD who plan to breastfeed should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor, and the pros and cons for continuing treatment. This includes non-pharmacological methods. Psychoeducation is also necessary to help pregnant women with ADHD understand the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce strategies for coping. This should include a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should include discussion of a treatment plan for the mother and child, as well as monitoring for indicators of deterioration, and, if needed, adjustments to the medication regimen.