14 Smart Strategies To Spend Extra ADHD Medication Pregnancy Budget
14 Smart Strategies To Spend Extra ADHD Medication Pregnancy Budget
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ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or continue ADHD medications during pregnancy and breastfeeding is a difficult decision for women suffering from the condition. Little data exists about how long-term exposure to these drugs can affect the foetus.
A recent study published in Molecular Psychiatry demonstrates that children exposed to ADHD medication during pregnancy do not develop neurological issues such as impaired hearing or vision, febrile seizures or IQ impairment. The authors acknowledge the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and take ADHD medication should weigh the benefits of taking it against the possible dangers for the baby. The doctors don't have the information to provide clear recommendations 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 during their early pregnancy did not face a significantly increased risk of fetal heart malformations or major birth defects that are structural. Researchers conducted a large population-based study of case control to assess the frequency of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists examined the cases to ensure an accurate classification of the cases and to reduce the possibility of bias.
The research conducted by the researchers was not without its limitations. In particular, they were unable to distinguish the effects of the medication from the effects of the disorder at hand. This makes it difficult to know whether the limited associations observed in the groups that were exposed result from medication use or confounding by comorbidities. In addition the study did not look at the long-term effects of offspring on their parents.
The study did show that infants whose mothers had taken ADHD medication during pregnancy were at a slightly higher risk of being admitted to the neonatal intensive care unit (NICU) than those whose mothers had not taken any medication or taken off their medication prior to or during pregnancy. This was due to central nervous system disorders, and the increased risk of admission was not found to be affected by the type of stimulant medications were taken during pregnancy.
Women who were taking stimulant ADHD medications during pregnancy also had a higher chance of having to have caesarean sections or one whose baby scored low on the Apgar scale (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
The researchers suggest that the low risk associated with the use of ADHD medications during early pregnancy may be offset by the greater benefit for both mother and child from continued treatment for the woman's condition. Physicians should discuss the issue with their patients and, where possible, assist them in developing strategies to improve coping skills that may minimize the impact of her disorder on her daily life and relationships.
Medication Interactions
Doctors are increasingly faced with the decision of whether to maintain treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are often made without clear and reliable evidence. Instead, physicians must weigh their own knowledge in conjunction with the experiences of other physicians and the research on the subject.
Particularly, the issue of possible risks to the baby can be tricky. The research that has been conducted on this topic is based on observations rather than controlled studies, and a lot of the results are contradictory. The majority of studies focus on live births, which can underestimate the severity of teratogenic effects which can cause abortions or terminations of pregnancy. The study that is discussed in this journal club addresses these shortcomings by looking at data from both live and deceased births.
Conclusion Some studies have revealed an association between ADHD medications and certain birth defects however, other studies haven't found a correlation. Most studies have shown an unintended, or slightly negative, effect. In the end, a careful risk/benefit assessment is required in every instance.
For a lot of women with ADHD who suffer from ADHD, the decision to stop taking medication can be difficult, if not impossible. In a recent article published in Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can cause depression and feelings of isolation. A loss of medication may affect the ability to safely drive and complete work-related tasks, which are vital aspects of normal life for those suffering from ADHD.
She recommends women who are unsure about whether to keep or stop medication in light of their pregnancy consider educating family members, friends, and coworkers on the condition, its impact on daily functioning, and on the advantages of continuing the current treatment regimen. It can also help a woman feel supported in her decision. Certain medications can be passed through the placenta. If the patient decides not to take her ADHD medication while pregnant and breastfeeding, it's important to be aware that the drug could be transferred to the infant.
Risk of Birth Defects
As the use and abuse of ADHD medications to treat the symptoms of attention deficit hyperactivity disorder (ADHD) is increasing the concern over the possible effects of the drugs on foetuses. Recent research published in the journal Molecular Psychiatry has added to the body of knowledge on this issue. Researchers used two huge datasets to analyze more than 4.3 million pregnancy and determine if stimulant medication use caused birth defects. Researchers discovered that although the overall risk is low, first-trimester ADHD medication use was associated with slightly higher risk of certain heart defects, such as ventriculoseptal defect.
The authors of the study found no association between early use of medication and congenital abnormalities like facial clefting, or club foot. The results are in agreement with previous studies that have shown the existence of a slight, but significant increase in cardiac malformations for women who began taking ADHD medication before pregnancy. The risk increased in the latter part of pregnancy when many women decided to stop taking their medication.
Women who took ADHD medication during the first trimester were more likely to need a caesarean, have an insufficient Apgar after birth and have a baby that needed breathing assistance at birth. However the researchers of the study were not able to eliminate selection bias by limiting the study to women who didn't have any other medical issues that could have contributed to the findings.
Researchers hope that their study will help doctors when they meet pregnant women. They advise that while the discussion of the benefits and risks is important however, the decision to stop or continue medication should be based on the woman's needs and the severity of her ADHD symptoms.
The authors warn that, although stopping the medication is a possibility to consider, it is not recommended because of the high incidence of depression and other mental problems among women who are pregnant or who have recently given birth. Additionally, research suggests 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 being a new mom can be overwhelming. Women with ADHD are often faced with a number of difficulties when they must manage their symptoms, attend doctor appointments, prepare for the birth of a baby and adjust to a new routine. Many women choose to continue taking their ADHD medication during pregnancy.
The risk to a nursing infant is low because the majority of stimulant medications is absorbed through breast milk at a low level. The amount of exposure to medications will vary based on the dosage and frequency of administration as well as the time of the day. Additionally, different medications enter the infant's system differently through the gastrointestinal tract and breast milk, and the effect of this on a newborn is not fully known.
Some doctors may stop taking stimulant medications during a woman's pregnancy due to the absence of research. It's a difficult choice for the woman who must weigh the advantages of taking her medication as well as the potential risks to the foetus. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are taking or planning to take medication during the perinatal period.
A growing number of studies have revealed that women can continue taking their ADHD medication while they are pregnant and nursing. In response, an increasing number of patients are choosing to do this. They have discovered after consulting with iampsychiatry.com their doctors, that the benefits of continuing their current medication outweigh any possible risks.
It is essential for women with ADHD who are contemplating breastfeeding to seek out 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 management strategies. Psychoeducation is also required to help pregnant women with ADHD recognize the signs and underlying disorder. They should also learn about treatment options and build the coping mechanisms. This should be a multidisciplinary approach with the GP doctors, obstetricians and psychiatrists. The pregnancy counselling should consist of the discussion of a plan for management for both the mother and child, and monitoring for signs of deterioration, and the need for adjustments to the medication regimen.