Is Your Company Responsible For The ADHD Medication Pregnancy Budget? 12 Top Ways To Spend Your Money
Is Your Company Responsible For The ADHD Medication Pregnancy Budget? 12 Top Ways To Spend Your Money
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ADHD Medication During Pregnancy and Breastfeeding
Women suffering from ADHD face a difficult decision regarding whether or not to stop taking ADHD medication during pregnancy and breastfeeding. There is a lack of information about how long-term exposure to these medications could affect the fetus.
A recent study published in Molecular Psychiatry shows that children exposed to ADHD medication during the uterus do not develop neurological developmental conditions like hearing or vision impairment seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are expecting and taking ADHD medication need to consider the benefits of taking it against the possible risks for the foetus. Physicians don't have the data to make unambiguous recommendations but they can provide information about risks and benefits to aid pregnant women in making informed choices.
A study published in Molecular Psychiatry concluded that women who took ADHD medication during their early pregnancy were not at greater risk of fetal malformations or structural birth defects. Researchers used a vast population-based study of case-control to evaluate the incidence of major structural birth defects in babies born to mothers who took stimulants during the early stages of pregnancy, and those who did not. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate classification of the cases and to reduce the possibility of bias.
However, the researchers' study was not without its flaws. The most important issue was that they were not able to differentiate the effects of the medication from the disorder that is underlying. That limitation makes it difficult to determine whether the limited associations observed in the exposed groups are due to the use of medication or confounding by comorbidities. The researchers also did not study long-term outcomes for the offspring.
The study revealed that infants whose mothers took ADHD medication during pregnancy had a higher chance of being admitted to the neonatal care unit (NICU) as compared to mothers who did not use any medication during pregnancy or had discontinued taking 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 medications used during pregnancy.
Women who took stimulant ADHD medications during pregnancy also had a higher risk of having caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases did not appear to be influenced by the kind of medication used during pregnancy.
The researchers suggest that the small risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefits for both mother and child of continued treatment for the woman's disorder. Physicians should speak with their patients about this and as much as possible, assist them improve coping skills which could reduce the impact of her disorder in her daily functioning and her relationships.
Medication Interactions
As more women than ever before are being diagnosed with ADHD and treated with medication, the question of whether to continue or stop treatment during pregnancy is one that doctors are having to confront. The majority of these decisions are made in the absence of solid and reliable evidence in either case, which means that doctors have to weigh their experience, the experiences of other doctors, and what research suggests about the subject and their best judgment for each individual patient.
Particularly, the issue of potential risks for the infant can be difficult. The research on this subject is based on observations rather than controlled studies, and many of the findings are contradictory. In addition, most studies limit their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study discussed in the journal club addresses these limitations, by examining both data on live and deceased births.
Conclusion: While some studies have shown an association between ADHD medications and certain birth defects however, other studies haven't established a link. The majority of studies show a neutral, or even somewhat negative, effect. In the end, a careful risk/benefit analysis is required in every instance.
For a lot of women with ADHD who suffer from ADHD, the decision to stop taking medication is difficult if not impossible. In fact, in an article 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 these patients. Additionally, the loss of medication can affect the ability to complete work-related tasks and safely drive which are essential aspects of a normal life for many people with ADHD.
She suggests women who are uncertain 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 benefits of keeping the current treatment plan. It can also help women feel confident about her decision. It is important to note that some drugs can pass through the placenta so if a woman decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware that traces of the drug could be passed on to the baby.
Risk of Birth Defects
As the use of ADHD drugs to treat symptoms of attention deficit hyperactivity disorder (ADHD) grows as do concerns about what impact the drugs might have on the fetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this topic. Researchers used two huge data sets to study over 4.3 million pregnant women and determine if the use of stimulant medications increased the risk of birth defects. Although the risk overall remains low, the scientists found that exposure in the first trimester to ADHD medications was associated with an increase in the risk of certain heart defects, like ventriculo-septal defects (VSD).
The authors of the study found no association between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are in line with previous studies revealing the presence of a small, but significant increase in the risk of developing cardiac malformations in women who started taking ADHD medications prior to the time of the time of pregnancy. This risk increased in the later part 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 experience caesarean sections, a low Apgar score following delivery, and a baby that required help breathing at birth. The authors of the study could not eliminate selection bias because they limited the study to women who did not have any other medical conditions that could have contributed to the findings.
The researchers hope their study will serve to inform the clinical decisions of physicians who treat pregnant women. The researchers recommend that while discussing benefits and risks are crucial, the decision about whether to continue or stop medication should be made in light of the severity of each woman's ADHD symptoms and her needs.
The authors also caution that, while stopping the medication is an option, it is not a recommended practice because of the high rate of depression and other mental health problems for women who are expecting or who are recently post-partum. Additionally, the research suggests that women who choose to stop taking their medication are more likely to have difficulties adapting to life without them following the baby's arrival.
Nursing
It can be overwhelming to become a mother. Women with ADHD who have to manage their symptoms while attending doctor appointments as well as making preparations for the arrival of a child and adjusting to new household routines can experience severe challenges. Many women opt to continue taking their ADHD medication during pregnancy.
The majority of stimulant medicines are absorbed by breast milk in low amounts, so the risk for breastfeeding infant is minimal. However, the rate more info of exposure to medication by the infant can differ based on dosage, how often it is administered, and the time of day the medication is administered. Additionally, 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 fully comprehended.
Due to the absence of research, some physicians may recommend stopping stimulant medications during a woman's pregnancy. It's a difficult choice for the woman who must weigh the advantages of her medication against the potential risks to the fetus. In the meantime, until more information is available, doctors should inquire with all pregnant patients about their experience with ADHD and whether they are taking or planning to take medication during the perinatal time.
A growing number of studies have proven that the majority of women are able to safely continue taking their ADHD medication during pregnancy and breastfeeding. In response, a rising number of patients are opting to do this. They have found after consulting with their doctor that the benefits of retaining their current medication outweigh risk.
It 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 should also be offered to help pregnant women suffering from ADHD understand their symptoms and underlying disorder, learn about available treatment options and strengthen existing strategies for managing. This should be a multidisciplinary effort including obstetricians, GPs and psychiatrists. Pregnancy counseling should include discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if necessary adjustments to the medication regime.