자유게시판

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

ADHD Medication During Pregnancy and Breastfeeding

Women with ADHD have to make a difficult choice regarding whether or not to stop taking ADHD medication during pregnancy and breast-feeding. Little data exists about how long-term exposure to these drugs 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 loss or impaired vision seizures, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality studies.

Risk/Benefit Analysis

Pregnant women who take ADHD medications need to balance the benefits of using them against the risks to the fetus. Physicians do not have the data needed to make unequivocal recommendations, but they can provide information about benefits and risks that can assist pregnant women in making informed decisions.

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

The research conducted by the researchers was not without limitations. The researchers were not able to, in the first place to differentiate the effects of the medication from the disorder. That limitation makes it difficult to know whether the limited associations observed in the groups that were exposed result from medication use or comorbidities that cause confusion. Additionally the study did not study long-term offspring outcomes.

The study found that babies whose mothers had taken ADHD medication during pregnancy had a slightly greater risk of being admitted to the neonatal care unit (NICU), compared to those whose mothers did not use any medication given for adhd during pregnancy or stopped taking their medication before or during pregnancy. This increase was caused by central nervous system disorders. The higher risk of admission was not affected by the stimulant medications used during pregnancy.

Women who used stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean delivery or having a child with low Apgar score (less than 7). These risks did not appear to be influenced by the type of medication that was used during pregnancy.

The research suggests that the low risk associated with the use of ADHD medications during the early stages of pregnancy could be offset by the greater benefit to both the mother and child of continued treatment for the woman's condition. Physicians should talk to their patients about this issue and as much as possible, assist them develop coping strategies that may reduce the effects of her disorder on her daily life and relationships.

Medication Interactions

More and more doctors are faced with the decision of whether to continue treatment or stop it during pregnancy as more women are diagnosed with mild adhd medication. Often, these decisions are made without solid and reliable evidence regardless, so doctors have to weigh their experience about their experiences, the experiences of other doctors, and what the research suggests about the subject as well as their own judgments for each individual patient.

The issue of risk to infants is difficult to determine. A lot of studies on this subject are based on observations rather than controlled research, and their conclusions are often contradictory. Most studies restrict their analysis to live births, which can underestimate the teratogenic impact leading to abortions or terminations of pregnancy. The study presented in the journal club addresses these shortcomings, by examining both the data from deceased and live births.

The conclusion: While certain studies have demonstrated a positive association between ADHD medications and the possibility of certain birth defects, other studies have not found any evidence of a link and the majority of studies show a neutral or even slight negative effect. In the end, a careful risk/benefit analysis is required in every instance.

For women suffering from ADHD, the decision to stop 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 best medication for adhd and anxiety during pregnancy can lead to increased depression, feelings of loneliness and family conflict for those suffering from the disorder. A loss of medication may affect the ability to safely drive and to perform work-related tasks which are crucial aspects of daily life for those suffering from ADHD.

She suggests women who are unsure about whether to continue or stop medication in light of their pregnancy should consider informing family members, friends, and coworkers on the condition, its impact on daily life, and the advantages of continuing the current treatment regimen. Educating them can also aid in ensuring that the woman feels supported as she struggles with her decision. It is important to note that certain drugs can be absorbed through the placenta therefore, if a patient decides to stop taking her ADHD medication during pregnancy and breastfeeding, she should be aware of the possibility that traces of the medication could be transferred to the child.

Risk of Birth Defects

As the use and use of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD), increases as does the concern about the potential effects of these drugs on the fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of information on this topic. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies to determine whether the use of stimulant medications increased the risk of birth defects. While the overall risk is low, the researchers did find that first-trimester exposure to ADHD medicines was associated with a slightly higher rate of specific heart defects, such as ventriculo-septal defect (VSD).

The researchers of the study could not discover any link between the use of early medications and other congenital anomalies such as facial deformities or club feet. The findings are in line with previous studies showing a small but significant increase in the risk of heart malformations among women who began taking ADHD medications before pregnancy. This risk increased during the latter part of pregnancy, when many women begin to discontinue their ADHD medication.

Women who took ADHD medication in the first trimester were more likely to require a caesarean birth, have an insufficient Apgar after delivery and had a baby that required help breathing at birth. The authors of the study could not eliminate selection bias because they limited their study to women who did not have any other medical conditions that might have contributed to the findings.

Researchers hope their research will help doctors when they encounter pregnant women. They recommend that, while discussing the benefits and risks is important but the decision to stop or maintain medication should be based on the woman's requirements and the severity of her ADHD symptoms.

The authors warn that, even though stopping the medication is a possibility to look into, it is not recommended due to the high prevalence of depression and other mental disorders for women who are pregnant or who have recently given birth. Further, research shows that women who stop taking their medication will have a harder transitioning to life without them after the baby is born.

Nursing

The responsibilities of a new mom can be overwhelming. Women who suffer from ADHD are often faced with a number of difficulties when they must manage their symptoms, go to doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women decide to continue taking their ADHD medication during pregnancy.

The risk to breastfeeding infant is not too high since the majority of stimulant medication passes through breast milk in low amounts. However, the frequency of exposure to medications by the newborn may differ based on dosage, how often it is administered and at what time it is administered. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn is not yet fully understood.

Because of the lack of evidence, some doctors may recommend stopping stimulant medications during the course of pregnancy. This is a difficult choice for the patient, who must weigh the benefit of continuing her medication against the possible dangers to the foetus. As long as more information is available, GPs may ask pregnant patients whether they have any history of ADHD or if they intend to take medication in the perinatal stage.

A growing number of studies have proven that women can continue to take their ADHD medication while they are pregnant and nursing. This has led to many patients are choosing to do so, and in consultation with their physician, they have found that the benefits of keeping their current medication far outweigh any potential risks.

Women who suffer from ADHD who are planning to nurse should seek advice from a specialist psychiatrist prior to becoming pregnant. They should discuss their medication with their doctor and discuss the advantages and disadvantages of continued treatment, including non-pharmacological management strategies. Psychoeducation should also be offered to help pregnant women suffering from ADHD understand their symptoms and the underlying disorder and learn about treatments and to reinforce existing strategies for managing. This should include a multidisciplinary approach, which includes the GP, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and the child, as well as monitoring for signs of deterioration, and, if needed adjustments to the medication regimen.