Beware Of These "Trends" Concerning ADHD Medication And Pregnancy
ADHD Medication and Pregnancy
GPs might prescribe stimulants to treat ADHD (methylphenidate, dexamfetamine and Lisdexamfetamine) along with non-stimulants such as modafinil and Atomoxetine. These medications can help improve the ability of a patient to manage their ADHD symptoms and attend regular appointments with their GP and specialist.
Most studies of the pregnancy safety of ADHD medication restrict outcomes to live births, thereby underestimating severe teratogenic effects that can cause terminations and abortions. This study is the first to incorporate such information.
Risk/Benefit Discussion
Many women suffering from ADHD are faced with a dilemma when using stimulants during pregnancy. On one side, they perform well with the help of their medication and stopping it may result in marital strife, issues at school or at work and a host of other negative consequences. On the other hand they don't wish to expose their baby to medications whose long-term effects are not known.
While some doctors advise their patients to stop using ADHD medications before they become pregnant, others have found a way to strike a balance between assumed security and the needs of individual patients. The latter often arrive at an option after consulting with their physician and/or spouse, striking a balance between the mother's need for her medication and the possibility of severe symptoms such as depression, agitation and trouble staying awake in the event of discontinuing the drug.
Most studies on ADHD medication and pregnancy focus on the effects of the first trimester stimulant exposure on the growth of fetal malformations. However, the literature is inconclusive. This is due to the fact that most of the studies available do not provide data on outcomes other than live births (eg terminations, miscarriages, terminations, and stillbirths) and also because they fail to consider a range of confounding factors, including the calendar year, pregnancy characteristics, maternal sociodemographics and indications for the medication, maternal mental and physical health status, and proxies for other mental and medical ailments.
The results of a few studies indicate that there is no risk to the fetus through the use of stimulant medications before, during, or after the 1st trimester. Although the indicators for certain cardiac malformations, including VSD (ventricular septal defect) are clear however, these findings require confirmation in larger studies that have more precise and detailed information.
Insufficient evidence exists to support the link between methylphenidate and the use of atomoxetine by mothers and an increase in the incidence of gastroschisis, omphaloceles, and transverse limb deficiencies. Other medications could also put you at a higher risk for these types of birth defects, however the risks are unclear from the limited evidence.
Medicines to avoid
Women with ADHD who become pregnant are often confronted with a tough decision to decide whether or not to discontinue their ADHD medication? This is a significant life change that will impact both the mother and the baby. Many doctors believe that the ideal time to bring up this subject is when a woman tells her doctor she is planning to start a family. This will give her the information she needs to make a decision prior to when she becomes pregnant. However, this is not always the case and women often find out that they are pregnant at a later time in the pregnancy when it's too late to safely stop taking medication.
Unfortunately, there is a dearth of research into the safety of stimulants during breastfeeding and pregnancy. Currently, most studies have been based on retrospective analyses of data, and don't adequately consider factors such as maternal age at the time of first exposure to the drug, chronic conditions, indications for stimulants, cotreatment with psychiatric or pain medications, and other factors that impact risk. Several studies have shown an increase in the risk of preeclampsia and premature birth when psychostimulants are administered during pregnancy. However these findings should be interpreted cautiously.
The use of stimulants during pregnancy has also been linked with a number of behavioral problems in infants. The most frequently reported issue is the development of tics (abnormal muscle movements) in a few children. Other behavioral problems that have been identified include increased aggression, irritability and defiance. The good news is that these signs generally improve once the medication is taken off.
Some ADHD medications can interact with other drugs, causing dangerous side effects, especially when they are combined with alcohol or CNS stimulants like methylphenidate and amphetamines salts. These medications should not be taken with antidepressants or narcotics, including pain relievers, and should be avoided by people who are taking illicit drugs or nicotine products.
Some patients discover that a reduction or even the discontinuation of ADHD medication during pregnancy is possible with no significant functional impairment. In these instances it is crucial to inform the patient and her partner or spouse about this decision and to ask them for help in limiting recurrence of symptoms. This could include locating local resources, seeking assistance from family or friends or seeking accommodations at work which address impairments resulting from symptoms. It is also helpful to know more about effective cognitive-behavioral treatment and coaching for ADHD which can be provided by trained professionals.
Medications to Beware of
The decision to remain on ADHD medication during pregnancy can be a difficult one for patients and physicians. It is a particularly difficult decision for people who have co-occurring addiction disorders because many medications that treat addiction may have the same effects as common ADHD medicines, including the possibility of increasing blood pressure and episodes of chest pain.
There aren't a lot of alternatives for these patients and their physicians. The lack of research on how to safely manage a person with both ADHD and an addiction disorder can lead certain doctors to erron on the safe side and suggest that their patients discontinue their medication during pregnancy.
Ideal is to discuss whether or not you should continue taking ADHD medications before deciding to start making plans for a family. Many women suffering from ADHD are shocked to discover they are pregnant. This usually occurs during the first trimester of pregnancy, when fetal growth is most susceptible to drug exposure.
If the doctor and patient decide to continue with medication in the first trimester, it is recommended that they choose the lowest effective dose and closely monitor for any symptoms. The doctor may recommend that the woman take immediate-release medication in the middle of the day in order to lower the fluctuation in medication levels in the bloodstream.
In the near future there is a lot of research to be conducted on the best to manage ADHD and other addiction disorders in nursing or pregnant women. In the meantime women who are pregnant or planning to become pregnant, should speak with their doctor about the options they may have, such as psychotherapy that targets ADHD symptoms and how it might differ from a medication only approach. They should be informed that if they do not choose to take medication, they may have more difficulty at work and school and may even find it difficult to maintain a relationship. This could have a significant impact on their children, too.
The use of Medications in conjunction with
Women with ADHD frequently rely on medications as part of their treatment plan to manage symptoms like hyperactivity, inattention and the tendency to be impulsive. Recent studies have shown that these medications don't negatively impact the fetus, and are able to be used during pregnancy.
This is good news for women who are planning to become mothers and depend on their ADHD medication. However many women are worried about the security of keeping their medications during pregnancy, particularly those who take stimulant medications such as amphetamines and methylphenidate. adhd no medication should talk to their healthcare professionals about the potential risks and benefits associated with taking medication in light of current research and recommendations.
Methylphenidate is one of the most commonly prescribed ADHD medications and has been found to be safe for pregnant women when under the supervision of a medical professional. Amphetamine, atomoxetine and other stimulant medications are also safe for pregnant women. However it is important to keep in mind that both non-stimulant and stimulant medications must be closely monitored during pregnancy.
A recent study of data from Danish nationwide registers found that children born to mothers who took ADHD medication during their pregnancy had no adverse effects on the child's neurodevelopment or growth. These findings are significant as they cover a larger population of patients than previous studies, and take into consideration numerous confounding factors.
The results also show that the use of ADHD medication during pregnancy does not increase the risk of maternal complications, such as anemia, iron deficiency or hyperemesis. These findings are a major advancement in our understanding of how the use of ADHD medications during pregnancy can be effectively managed by obstetricians and psychiatrists.
Women suffering from ADHD must continue to follow their treatment plan and closely work with their healthcare provider throughout their pregnancy. This will ensure that their symptoms are properly controlled, allowing them to maximize the benefits of their pregnancies. There are a variety of non-pharmacological options available to those who don't want or wish to stop taking their medication. These treatments can help enhance symptoms and improve overall well-being. These include: