What's The Current Job Market For ADHD Medication Pregnancy Professionals Like?
What's The Current Job Market For ADHD Medication Pregnancy Professionals Like?
Blog Article
ADHD Medication During Pregnancy and Breastfeeding
The decision to stop or keep ADHD medications during pregnancy and nursing is a difficult decision for women suffering from the condition. There aren't many studies on how exposure to ADHD for a long time could affect the pregnant fetus.
A study recently 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 the need for more high-quality research.
Risk/Benefit Analysis
Women who are pregnant and taking ADHD medication must weigh the benefits of taking it against the potential risks for the baby. Physicians don't have the data to make unambiguous recommendations, but can provide information about risks and benefits to assist pregnant women to make an informed decision.
A study published in Molecular Psychiatry concluded that women who were taking ADHD medication during their early pregnancy were not at higher risk of fetal malformations or structural birth defects. Researchers conducted a large sample-based case control study to compare the incidence of major structural defects in infants born to mothers who were taking stimulants during pregnancy. Clinical geneticists and pediatric cardiologists looked over the cases to ensure an accurate case classification and to limit the chance of bias.
The study of the researchers was not without limitations. The most important issue was that they were unable to distinguish the effects of the medication from those of the underlying disorder. This makes it difficult for researchers to establish whether the small associations observed among the groups exposed were due to the use of medications, or if they were affected by co-morbidities. In addition, the researchers did not study the long-term outcomes of offspring.
The study showed that infants whose mother had taken ADHD medication during pregnancy were at a slightly higher risk of admission to the neonatal care unit (NICU), compared to mothers who didn't take any medication during pregnancy, or had discontinued taking their medication prior to or during pregnancy. This was due to central nervous system-related disorders, and the increased risk for admission was not found to be affected by the type of stimulant medication was used during pregnancy.
Women who took stimulant ADHD medication during pregnancy were also at an increased risk of having a caesarean section or having a child with an low Apgar score (less than 7). These increases appeared to be unrelated to the type of medication used during pregnancy.
Researchers suggest that the minor risks associated with the use ADHD medication during pregnancies in the early stages may be offset by the greater benefits to both mother and baby of continuing treatment for the woman's condition. Physicians should discuss this with their patients and, where possible, assist them in developing strategies to improve coping skills that may minimize the negative impact of her condition on her daily life and relationships.
Medication Interactions
More and more doctors are confronted with the dilemma of whether to keep treatment or stop it during pregnancy as more women are diagnosed with ADHD. These decisions are frequently made without clear and authoritative evidence. Instead, doctors must consider their own expertise, the experience of other doctors, and the research that has been conducted on the subject.
The issue of possible risks to the infant can be extremely difficult. The research on this subject is based on observation instead of controlled studies and the results are conflicting. Furthermore, most studies restrict their analysis to live births, which could underestimate severe teratogenic effects that cause abortion or termination of the pregnancy. The study that is discussed in this journal club addresses these limitations by examining data on both live and deceased births.
Conclusion A few studies have shown a positive correlation between ADHD medications and certain birth defects however, other studies haven't established a link. Most studies have shown that there is a neutral, or slightly negative, impact. In the end an accurate risk-benefit analysis must be done in each situation.
It isn't easy, but not impossible, for women with ADHD to stop taking their medication. In a recent article in the Archives of Women's Mental Health by psychologist Jennifer Russell, she notes that stopping ADHD medications during pregnancy can increase depression and feelings of being isolated. Additionally, the loss of medication can affect the ability to complete work-related tasks and safely drive that are crucial aspects of a normal life for many people suffering from ADHD.
She suggests women who are unsure about whether to continue or stop taking medication because of their pregnancy should consider informing family members, friends and colleagues on the condition, its effects on daily functioning, and the benefits of keeping the current treatment plan. It will also help a woman feel confident about her decision. It is important to remember that some drugs can pass through the placenta so if the patient decides to stop her ADHD medication during pregnancy and breastfeeding, she must be aware of the possibility that traces of the medication could be transferred to the child.
Birth Defects and Risk of
As the use of ADHD medication to treat the symptoms of attention deficit hyperactivity disorder (ADHD) grows, so do concerns about what impact the drugs might have on fetuses. A recent study published in the journal Molecular Psychiatry adds to the body of knowledge about this subject. Utilizing two huge data sets researchers were able to look at more than 4.3 million pregnancies and see whether stimulant medications increased the risk of birth defects. Researchers discovered that, while the overall risk is low, the first trimester ADHD medication use was associated with slightly higher rates of certain heart defects, like ventriculoseptal defect.
The researchers behind the study found no association between early use of medication and congenital abnormalities such as facial clefting or club foot. The results are consistent with previous studies showing a small but significant increase in the risk of cardiac malformations among women who began taking ADHD medications before pregnancy. The risk grew during the latter part of pregnancy, as many women decide to stop taking their ADHD medications.
Women who took ADHD medication during the first trimester were more likely to need a caesarean, have a low Apgar after delivery, and have a baby that needed breathing assistance after birth. However, the authors of the study were not able to eliminate bias due to selection by restricting the study to women who didn't have any other medical conditions that could be a contributing factor to these findings.
Researchers hope their research will inform physicians when they see pregnant women. They recommend that, while the discussion of risks and benefits is important however, the decision to stop or keep treatment should be based on the woman's needs and the severity of her ADHD symptoms.
The authors warn that, while stopping the medication is a possibility to consider, it is not advised due to the high rate depression and other mental problems in women who are expecting or have recently given birth. Research has also shown that women who stop taking their medications will have a harder transitioning to life without them once the baby is born.
Nursing
The responsibilities that come with being a new mother can be overwhelming. Women who suffer from ADHD may face a lot of challenges when they must deal with their symptoms, go to doctor appointments and prepare for the birth of a baby and adjust to new routines. Many women choose to continue taking their ADHD medication during pregnancy.
The risk for breastfeeding infant is not too high since the majority of stimulant medication is absorbed through breast milk at a low level. However, the frequency of medication exposure to the newborn can vary depending on dosage, how often it is administered and at what time the medication is administered. Additionally, individual medications enter the baby's system differently through the gastrointestinal tract and breast milk. The impact of this on a newborn infant is not well understood.
Some physicians may discontinue stimulant medication during a woman’s pregnancy due to the lack of research. It's a difficult choice for the woman, who must weigh the benefits of taking her medication as well as the risks to the embryo. Until more information is available, doctors should inquire with all pregnant patients about their history of ADHD and if they are planning or taking to take medication during the perinatal period.
Many studies website have shown that women can continue to take their ADHD medication safely during pregnancy and breast-feeding. In response, a growing number of patients are choosing to do so. They have discovered through consultation with their doctors that the benefits of retaining their current medication far outweigh any possible risks.
It's important for women with ADHD who are considering breastfeeding to seek a specialist psychiatrist's guidance prior to becoming pregnant. They should discuss their medication with their physician and discuss the pros and cons of continued treatment, including non-pharmacological strategies. Psychoeducation is also necessary to help pregnant women with ADHD be aware of the symptoms and the underlying disorder. They should also be informed about treatment options and reinforce strategies for coping. This should be a multidisciplinary approach with the GPs, obstetricians and psychiatry. Pregnancy counseling should consist of a discussion of a treatment plan for the mother and child, and monitoring for indicators of deterioration, and, if needed adjustments to the medication regimen.