ADHD Medication And Pregnancy: It's Not As Difficult As You Think
ADHD Medication and Pregnancy
GPs might prescribe stimulants to treat ADHD (methylphenidate, dexamfetamine and lisdexamfetamine), as well as non-stimulants, such as modafinil or Atomoxetine. These medications can help patients manage their ADHD symptoms, and also attend regular appointments with an GP or a specialist.
The majority of studies on pregnancy safety of ADHD medication limit results to live births, which means underestimating severe teratogenic effects that result in abortions and terminations. This is the first study that includes such data.
Risk/Benefit Discussion
The use of ADHD stimulants during pregnancy is a frequent problem for women suffering from the disorder. On one hand, they function with the help of their medication, and stopping it could result in marital strife, issues at school or at work and other serious consequences. On the other hand, they don't wish to expose their unborn baby to drugs whose long-term consequences are not known.
While some doctors counsel their patients to stop taking ADHD medication prior to becoming pregnant, others have found a compromise between the assumed safety and the requirements of each patient. Patients often consult their doctors, spouses or partners before making a decision. They find a balance between a mother's need to take her medication and the possibility for severe symptoms, such as depression and agitation in the event that she stops taking the medication.
The majority of studies regarding ADHD medication and pregnancy focus on the effects of first-trimester stimulant exposure on the development malformations of the fetus. However, the research available is not well-defined. The literature is inconclusive due to the fact that most studies do not provide information on outcomes other than live births (eg. terminations, miscarriages and stillbirths) neither do they take into account factors that can cause confusion, such as the calendar year, characteristics of pregnancy and maternal sociodemographics.
Nevertheless, the results of some of the available studies suggest that there is no significant risk increase for the fetus due to the use of the most commonly prescribed stimulant medications prior to and during the first trimester. The signals for certain cardiac malformations are strong. This is particularly true for VSD (ventricular defect). However these findings need to be confirmed in larger studies that provide more precise information.
There is also insufficient evidence to suggest a link between the use of methylphenidate (MPH) and atomoxetine (ATO) and a higher prevalence of omphalocele, gastroschisis and transverse limb deficiencies. These birth defects could be caused by other medications, however the risks remain unclear due to the limited information available.
Do not take medication.
Women with ADHD who are expecting face a difficult choice to make: Should they continue taking their ADHD medication or stop taking it? This is a major change that affects both the mother and the foetus. Many doctors believe that the ideal time to discuss this topic is when a woman tells her doctor that she wants to start a new family. This will give her the necessary information to make a decision prior to when she is pregnant. It is not always feasible and women could discover they are pregnant after the time of their the pregnancy process, after it is too late to stop taking medication.
There are a few studies on the safety of stimulants during pregnant 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 the time of first exposure to the drug and chronic conditions, the stimulants' indications, cotreatment with pain and psychiatric medications as well as other factors that influence the risk. A number of studies have revealed a small increase in the chance of preeclampsia or premature birth when psychostimulants are used during pregnancy. However, these findings should be taken with caution.
A few behavioral problems in infants have been related to the use of stimulants in pregnant women. Most commonly, tics (abnormal movements of the muscles) are reported by children. Other behavioral issues that have been observed include an increase in irritability and impulsivity. The good news is that these symptoms generally improve once the medication is stopped.
Some ADHD medications can interact with other substances which can cause adverse side effects that can be dangerous, especially when they are combined with alcohol or CNS stimulants like methylphenidate and amphetamines salts. These medications should not comprise antidepressants, narcotics or pain relief medications. They should also be avoided by people who use nicotine or illegal drugs.
Some patients are able to reduce or eliminate ADHD medications during pregnancy without significant impairment in their functioning. In such cases it is important to inform the mother and child about this decision. Request buy adhd medication uk in minimizing symptoms recurrence. This could include identifying local resources, asking for assistance from family or friends, or seeking workplace accommodations that can address symptoms-related impairments. It is also useful to know about cognitive-behavioral therapy and coaching for ADHD which can be offered by trained professionals.
Considerations for the use of medications
Both doctors and patients have a difficult time deciding whether or not to continue taking ADHD medication during pregnancy. It's a tough decision for patients suffering from co-occurring disorders as many of the drugs they use to treat their addictions share similar effects to common ADHD medications. These include the possibility of high blood pressure or chest pain attacks.
There aren't many alternatives for these patients and their physicians. The lack of research on how to safely manage those who suffer from both ADHD and a substance use disorder makes it easy for certain doctors to err on the side of caution and advise their patients to quit their medication during pregnancy.
Ideally, the decision of whether to continue taking ADHD medication is discussed well before making plans for the family. However, many women suffering from ADHD discover they are expecting unexpectedly. This typically happens in the first trimester, when growing fetus is the most vulnerable to drug exposure.
If the doctor and patient decide to continue with medication during the first trimester of pregnancy, it is recommended to select the dose that is most effective and monitor closely for symptoms. The doctor may suggest that the woman take immediate-release medication during the middle of the day to help lower the fluctuation in the levels of medication in the bloodstream.
In the near future we hope that more research will be done on the best way to manage both ADHD and substance use disorders in people who are nursing or pregnant. In the meantime, women who are pregnant or are planning to become pregnant, should speak with their doctor about the options they may have, such as psychotherapy that focuses on ADHD symptoms and how it might differ from a medication-only approach. They should be informed that if they do not opt to take medication, they will likely have more difficulty at work and school and may struggle to keep a relationship. This will likely have a significant impact on their children as well.
Incorporate the use of Medications
Women with ADHD may take medication to manage symptoms such as inattention, hyperactivity and an impulsiveness. While studies on how these medications can affect pregnancy has been limited Recent studies have revealed that they do not appear to affect the fetus in any way and are safe for continued use during pregnancy.
This is good news for women who are planning to become mothers and rely on their ADHD medication. Many women are worried that they should not continue taking their medication during pregnancy, particularly those who are taking stimulant medications such as amphetamines and methylphenidate. Women should talk to their healthcare professionals about the risks and benefits associated with medication use, based on current research and recommendations.
Methylphenidate is among the most common ADHD medications prescribed to pregnant women, is safe when used under the supervision of a health professional. Other stimulant medications that are commonly prescribed like atomoxetine and amphetamine are also considered safe for pregnant women. However, it is important to keep in mind that both non-stimulant and stimulant medications should be closely monitored during pregnancy.
A recent study of data from the Danish national registers has revealed that children born to mothers taking ADHD medication during pregnancy did not have adverse impacts on their child's neurodevelopment or long-term growth. These findings are significant as they include a much greater number of patients than previous research and take into account many potential confounding factors.
The results also show that taking ADHD medication during pregnancy does not increase the risk of developing maternal complications, including iron deficiency, anemia or hyperemesis. These findings represent a major improvement in our understanding of how obstetricians are able to safely manage the use of ADHD medication during pregnancy.
It is vital that women with ADHD continue to follow their treatment plans and work closely with their healthcare professionals throughout their pregnancy. This will ensure that symptoms are managed correctly, allowing women make the most of their pregnancy. If you are unable or choose not to discontinue medication, there are a variety of non-pharmacological interventions that can ease symptoms and support overall well-being during pregnancy. These include: