What's The Job Market For ADHD Medication Pregnancy Professionals Like?
What's The Job Market For ADHD Medication Pregnancy Professionals Like?
Blog Article
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 breast-feeding. There are few data on how exposure to ADHD for a long time could affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological problems such as impaired hearing or vision, febrile seizures, or IQ impairment. The authors acknowledge that more high-quality studies are needed.
Risk/Benefit Analysis
Pregnant women who take ADHD medications need to balance the benefits of taking them against the potential risks to the foetus. The doctors don't have the information to give clear advice 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 used ADHD medications in early pregnancy did not have a significantly increased risk of fetal heart malformations or major birth defects that are structural. The researchers used a large, population-based case-control study to assess the risk of major structural birth defects in babies born to mothers who had taken stimulants during early pregnancy and those who had not. Pediatric cardiologists, clinical geneticists and other experts examined the cases to ensure that the classification was accurate and to minimize any bias.
The research conducted by the researchers was not without its limitations. The researchers were unable in the beginning, to separate the effects of 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 medication use, or if they were affected by the presence of comorbidities. The researchers also did not study long-term outcomes for the offspring.
The study did reveal that infants whose mothers had taken ADHD medications during pregnancy were at a higher risk of being admitted to the neonatal intensive care unit (NICU) than those who were born without any medication or had taken off their medication prior to or during pregnancy. The reason for this was central nervous system disorders. The higher risk of admission was not influenced by the stimulant medication that was used during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher risk of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases didn't seem to be influenced by the type of medication that was used during pregnancy.
Researchers suggest that the small risks posed by the use of ADHD medication during pregnancies in the early stages may be offset by the greater benefits for baby and mother of continued treatment for the woman's condition. Physicians should speak with their patients about this issue and, if possible, help them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships.
Medication Interactions
As more women than ever are diagnosed with ADHD and treated with medication, the issue of whether to continue or discontinue treatment during pregnancy is a question that more and more physicians face. Most of the time, these decisions are made in the absence of any evidence that is clear and definitive regardless, so doctors must weigh their knowledge from their own experiences, those of other doctors, and what research suggests about the subject and their own judgments for each individual patient.
Particularly, the issue of possible risks to the infant can be difficult. Many studies on this issue are based on observational data rather than controlled research, and their conclusions are often contradictory. Most studies focus on live births, which can underestimate the teratogenic impact that can lead to terminations or abortions of pregnancy. The study that is discussed in this journal club addresses these limitations by analyzing data on live and deceased births.
The conclusion The conclusion: While certain studies have demonstrated an association between ADHD medications and the risk of certain birth defects, others have found no connection, and most studies show a neutral or even slightly negative impact. As a result, a careful risk/benefit analysis must be done in each case.
For many women with ADHD and ADD, the decision to stop medication can be difficult, if not impossible. In an article recently published in Archives of Women's Mental Health, psychologist Jennifer Russell notes that stopping ADHD medication during pregnancy can lead to increased depression, feelings of isolation and family conflict for these patients. A loss of medication may affect the ability to safely drive and perform work-related tasks, which are vital aspects of normal life for 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 on the condition, its effects on daily functioning, and the advantages of continuing the current treatment regimen. It can also make the woman feel more comfortable when she is struggling with her decision. It is important to remember that certain drugs can pass through the placenta so if a woman decides to stop her ADHD medication during pregnancy and breastfeeding, she should be aware of check here the possibility that traces of the medication could be passed on to the baby.
Birth Defects Risk
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) increases as do concerns about the effects that the drugs might have on foetuses. A study that was published in the journal Molecular Psychiatry adds to the body of knowledge on this subject. With two massive data sets, researchers were able to examine more than 4.3 million pregnancies and see whether the use of stimulant medications increased the risk of birth defects. Researchers discovered that although the overall risk is low, the first trimester ADHD exposure to medication was associated with slightly higher risk of certain heart defects, like ventriculoseptal defects.
The researchers of the study did not find any association between early use of medication and other congenital anomalies like facial deformities, or club feet. The findings are in line with previous studies showing an increase, but not significant, in the risk of cardiac malformations in women who started taking ADHD medications prior to the birth of their child. This risk increased during the latter part of pregnancy when a large number of women decided to stop taking their medication.
Women who took ADHD medication in the first trimester of their pregnancies were also more likely to experience caesarean sections, a low Apgar score after delivery and a baby who needed help breathing at birth. However the authors of the study were unable to eliminate bias due to selection by limiting the study to women who did not have other medical issues that could have contributed to these findings.
Researchers hope their research will help doctors when they see pregnant women. They recommend that, while discussing risks and benefits is important but the decision to stop or continue treatment should be based on each woman's needs and the severity of her ADHD symptoms.
The authors also warn that even though stopping the medication is an alternative, it is not an option that is recommended due to the high incidence of depression and other mental health issues among women who are pregnant or who are recently post-partum. Furthermore, research suggests that women who choose to stop taking their medication are more likely to have a difficult time adapting to life without them following the birth of their baby.
Nursing
It can be a stressful experience becoming a mother. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, attend doctor appointments and prepare for the birth of their child and adjust to a new routine. As such, many women choose to continue taking their ADHD medications throughout pregnancy.
The risk for breastfeeding infant is minimal because the majority of stimulant medication passes through breast milk in low amounts. The amount of exposure to medications will vary based on the dosage, frequency of administration and the time of day. In addition, different drugs enter the infant's system through the gastrointestinal tract, or through breast milk. The impact on the health of a newborn isn't completely comprehended.
Some physicians may discontinue stimulant medication during a woman's pregnancy due to the absence of research. It is a difficult decision for the woman who must weigh the benefits of continuing her medication against the risks to the fetus. In the meantime, until more information is available, GPs can ask pregnant patients if they have a history of ADHD or if they intend to take medication in the perinatal stage.
Numerous studies have demonstrated that women can continue taking their ADHD medication without risk during pregnancy and while breast-feeding. In response, an increasing number of patients are choosing to do this. They have discovered after consulting with their doctor that the benefits of keeping their current medication far outweigh any risk.
Women with ADHD who are planning to breastfeed should seek the advice of a specialist psychiatrist before becoming pregnant. They should discuss the medication they are taking with their physician and discuss the pros and cons of continuing treatment. This includes non-pharmacological methods. Psychoeducation should also be provided to help pregnant people with ADHD recognize their symptoms and the underlying disorder Learn about the available treatment options and reinforce existing coping strategies. This should be a multidisciplinary approach with the GP, obstetricians and psychiatry. Pregnancy counseling should include a discussion of a treatment plan for the mother and child, monitoring of signs of deterioration, and, if necessary modifications to the medication regime.