Keep An Eye On This: How ADHD Medication And Pregnancy Is Gaining Ground, And What To Do
ADHD Medication and Pregnancy
GPs can prescribe stimulants (methylphenidate dexamfetamine lisdexamfetamine) and non-stimulants such as atomoxetine or modafinil to treat ADHD. These medications can aid patients in managing their ADHD symptoms, and attend regular appointments with an GP or a specialist.
Most studies on the safety of ADHD medication during pregnancy limit the outcomes to live births. This undervalues the severe Teratogenic side effects that can cause terminations and abortions. This is the first study to include such information.
Risk/Benefit Discussion
The use of ADHD stimulants during pregnancy is a typical treatment dilemma for many women with the disorder. On the one side, many women suffering from ADHD function well when they take their medication. If they stop, it could result in marital conflict, issues at work or school and other negative consequences. On the contrary, they don't want to expose their child to drugs for which little is known about long-term effects.
While some doctors counsel their patients to stop taking ADHD medications prior to becoming pregnant, other doctors have found a compromise between the assumed safety and the requirements of each patient. They usually make a decision in consultation with their spouse or physician and strike an equilibrium between the mother's need to take her medication and the potential of developing severe symptoms, such as agitation, depression, and trouble staying awake in the event of stopping the medication.
adhd treatment medication of ADHD medication and pregnancy focus on the impact of the first trimester's exposure to stimulant medications on the formation of fetal malformations (eg malformations of the heart). However, the research available is not well-defined. This is partly because most of the available studies don't include information on outcomes other than live births (eg terminations, miscarriages, terminations and stillbirths) and also because they fail to take into account a range of confounding factors including calendar year pregnant characteristics, sociodemographics of mothers as well as indications for the drugs for maternal physical and mental health status, and proxies for other mental and physical health illnesses.
Nevertheless, the results of a few studies indicate that there isn't any significant increase in risk for the fetus with the use of the most commonly used stimulant medications before and during the first trimester. While the signs for certain cardiac malformations, especially VSD (ventricular septal defect) are clear however, these findings require confirmation in larger studies with more precise and detailed information.
There isn't enough evidence to suggest a link between maternal use of methylphenidate (MPH) and Atomoxetine (ATO) and a greater prevalence of omphalocele, gastroschisis and transverse limb deficiency. These birth defects can be caused by other medications, but the risks are not clear due to the limited information available.
Treatments to avoid
Women with ADHD who are expecting confront a dilemma whether to continue their ADHD medication or stop taking it? This is a major change in life that affects both the mother and fetus. Many doctors believe that the best time to bring up this subject is when a woman tells her doctor she is planning to start a new family. This will provide her with the information needed to make a choice before she is pregnant. This isn't always the case, and women may discover that they are pregnant after the time of their pregnancy, when it is too late to safely stop taking medication.
Unfortunately, there are few studies on the safety of stimulants in pregnancy and breastfeeding. Currently, most studies have been conducted using retrospective analysis of data that do not properly control for factors like the age of the mother at first exposure to the drug and chronic conditions, the stimulants' indications, cotreatment with pain and psychiatric medications as well as other factors that impact the risk. While a few studies have found small increased risks of preeclampsia and premature births associated with psychostimulant use during pregnancy, these findings must be taken with a pinch of salt.
The use of stimulants during pregnancy has also been linked to a variety of behavior problems in infants. The most commonly reported is the development of tics (abnormal muscle movements) in some children. Other behavioral issues that have been reported include a rise in impulsivity, irritability, and resentment. The good part is that these symptoms generally improve when the medication is taken off.
Certain ADHD medications can interact with other drugs and cause adverse side effects that can be dangerous, especially when combined with alcohol or CNS stimulants like methylphenidate or amphetamines salts. These medications should not include antidepressants, narcotics, or pain relievers. They should be avoided by people who take nicotine or illegal drugs.
Some patients discover that a reduction or a cessation of ADHD medication during pregnancy is feasible without significant impairment to function. In these situations it is crucial to educate the patient and her partner or spouse about this decision and to solicit their assistance in minimizing symptom recurrence. This could include identifying local support resources, enlisting help from friends or family members or requesting workplace accommodations that treat impairments related to symptoms. It is also helpful to know more about effective cognitive-behavioral treatments and coaching for ADHD that can be offered by professionals who are trained.
Medicines to Beware of
Both doctors and patients have a difficult time deciding whether or not to continue taking ADHD medication during pregnancy. It's a difficult decision for patients suffering from co-occurring disorders, because many of the medications they use to treat their addictions have similar effects to the common ADHD medications. This includes the possibility of high blood pressure or chest pain attacks.
Unfortunately, these people and their physicians aren't given a lot of alternatives. Lack of research into how to treat someone suffering from ADHD and substance use disorder can lead some doctors to err on the side of caution, and advise patients to stop their medications during pregnancy.
Ideally, the issue of whether to continue taking ADHD medication is discussed prior to planning a family. Many women with ADHD are shocked to find out they are pregnant. This is usually in the first trimester of pregnancy, when the development of the fetus is susceptible to exposure to drugs.
If the patient and doctor decide to continue taking medication during the first trimester, they should select the lowest dosage possible and closely monitor any symptoms. The doctor might suggest that the patient supplement her dose with an immediate-release medication taken during the middle of the day. This can help decrease the ups and downs that are caused by the fluctuating levels of medication in the bloodstream.
In the near future, it is hoped that more research will be conducted on how to manage both ADHD and substance use disorders in people who are pregnant or breastfeeding. In the meantime, those who are expecting or trying to be pregnant should be encouraged to talk with their GP and psychiatrist about what options might be available for psychotherapy that targets ADHD symptoms and how they could differ from a medication-only strategy. They should be informed that if they don't choose to take medication, they may be more troubled in school and at work, and could even struggle to maintain relationships. This could also have a significant impact on their children.
Incorporate the use of medications
Women who suffer from ADHD might take medications to treat symptoms such as inattention hyperactivity, and impulsivity. While research into the effects of these medications on pregnancy has been minimal Recent studies have demonstrated that they are not likely to negatively affect the fetus and are safe for use during pregnancy.
This is great news for women who want to become mothers and rely on their ADHD medications. Many women are concerned that they should not continue taking their prescriptions while pregnant, particularly those who are taking stimulant medications like amphetamines and methylphenidate. These women and their health care providers must discuss the risks and benefits of medication use in accordance with the most recent research and guidelines.
Methylphenidate is among the most commonly prescribed ADHD medications and has been proven to be safe for pregnant women when under the supervision of a medical professional. Other stimulant medications that are commonly prescribed like atomoxetine or amphetamine are also considered safe for women who are pregnant. However, it is important to remember that both non-stimulant and stimulant medications must be closely monitored during pregnancy.
A recent study of data from Danish national registers showed that children born to mothers who took ADHD medication during their pregnancy had no adverse effect on the child's long-term growth or neurodevelopment. These findings are important because they cover a larger population of patients than previous studies, and take into consideration numerous confounding factors.
Furthermore, the results indicate that the use of ADHD medication during pregnancy does not result in an increased risk for maternal complications like anemia, iron deficiency, hyperemesis gravidarum or TORCH infections. These findings are a significant improvement in our understanding of how obstetricians are able to safely manage the use of ADHD medication during pregnancy.
Women suffering from ADHD should continue to adhere to their treatment plan and closely work with their healthcare provider throughout their pregnancy. This can help ensure that their symptoms are well managed, allowing them to benefit the most from their pregnancies. If you cannot or do not want to stop taking medications, there is a variety of non-pharmacological interventions that can ease symptoms and promote overall well-being during pregnancy. These include: