ADHD Medication and Pregnancy
GPs can prescribe stimulants (methylphenidate dexamfetamine lisdexamfetamine) as well as nonstimulants like atomoxetine and modafinil to treat ADHD. These medications can enhance a patient's ability to manage their ADHD symptoms and keep regular appointments with a doctor and a specialist.
The majority of studies regarding the safety of ADHD medication during pregnancy limit the results to live births. This undervalues the severe teratogenic side effects that cause terminations and abortions. This is the first study to incorporate such information.
Risk/Benefit Discussion
Many women suffering from ADHD face a dilemma when using stimulants during pregnancy. On one side, they perform well with the aid of their medication, and stopping it could result in marital conflict as well as issues at school or at work and other serious consequences. On the other hand, they do not want to expose their baby to drugs for which little is known in terms of long-term effects.
While some doctors may advise their patients to quit using ADHD medications before they become pregnant, others have found a way to strike a balance between the presumed safety and the needs of each patient. These patients often consult their doctors, spouses or partners before making the decision. They strike the right balance between the need of a mother to take her medication and the possibility for serious symptoms, like depression and agitation when she stops taking the medication.
The majority of studies on ADHD medication and pregnancy focus on the impact of the first trimester's exposure to stimulant medication on the development of abnormalities in the fetus (eg, cardiac malformations). However, the current literature is not well-defined. The literature is inconclusive due to the fact that most studies do not provide data on outcomes other than live births (eg. terminations, miscarriages and stillbirths), nor do they take into account confounding variables such as calendar year, characteristics of pregnancy and sociodemographics of the mother.
The results of some studies indicate that there is no risk to the fetus through the use of stimulant medications during, before, and after the first trimester. Although the indicators for certain cardiac malformations, particularly VSD (ventricular septal defect), are strong but these findings require confirmation in larger studies with more precise and detailed data.
Insufficient evidence exists to support the link between methylphenidate and the use of atomoxetine by mothers and an increased prevalence of omphaloceles, gastroschisis and transverse limb deficiencies. Other medications could also be a cause of a higher risk for these kinds of birth defects, however the risks aren't clear from the limited information.
Avoid taking medications
Women suffering from ADHD who are pregnant are often confronted with a dilemma: Should they continue or discontinue their ADHD medication? This is a major life change that will affect both the mother and the baby. Many physicians feel that the best time to discuss this issue is when a patient informs her physician of her desire to have a baby in order to have the information she requires to make the right decision prior to becoming pregnant. This is not always possible and women could discover they are pregnant later in the pregnancy process, after it is too late to stop taking medication.
There are a few studies that examine the safety of stimulants during pregnant and breastfeeding. The majority of studies are based upon retrospective data analyses and do not take into account factors like the age of the mother at the time of exposure and chronic conditions, stimulant indications, cotreatment with pain and psychiatric medication, or other factors that could affect the risk. Although some studies have revealed minor increases in preeclampsia risk and premature birth due to the use of psychostimulants during pregnancy, these findings should be taken with a pinch of salt.
The use of stimulants during pregnancy has also been linked with a number of behavioral problems in infants. Most commonly, tics (abnormal muscle movements) are reported in children. Other behavioral issues that have been reported include a rise in aggression, irritability and resentment. The good news is that these symptoms generally improve after the medication is taken off.
Certain medications prescribed for ADHD interact with other drugs and can cause dangerous side effects when mixed especially with alcohol or other CNS stimulants (methylphenidate, amphetamine salts). These medications should not be combined with antidepressants or narcotics, including pain relievers. They should be avoided by people who are taking illicit drugs or nicotine products.
Some patients are able to reduce or stop taking ADHD medications during pregnancy, without significant functional impairment. In these instances it is important to inform the mother and child about the decision. Request their assistance in reducing symptoms recurrence. This could include locating local resources, seeking assistance from family or friends or seeking accommodations at work that can address symptoms-related impairments. It is also beneficial to find out about effective cognitive-behavioral therapies and coaching for ADHD which can be provided by certified professionals.
Considerations for Medicines
The decision to continue taking ADHD medication during pregnancy is a difficult one for both physicians and patients. It is a particularly difficult choice for those who suffer from co-occurring disorders of substance use due to the fact that many of the medications used to treat their addictions can have similar effects to commonly used ADHD medicines, including the possibility of causing high blood pressure and a recurrence of chest pain.
There aren't many alternatives for these patients and their doctors. The lack of research on how to treat someone suffering from ADHD and addiction disorders could lead some doctors to err on the side of caution, and advise patients to stop their medications during pregnancy.
Ideally, the question of whether to continue taking ADHD medication is discussed before making plans for the birth of a child. Many women with ADHD are shocked to find out they are pregnant. This typically happens in the first trimester of pregnancy, when growing fetus is the most vulnerable to exposure to drugs.
If the doctor and patient decide to continue taking medication in the first trimester, they should choose the lowest dose that is possible and closely monitor symptoms. The doctor may recommend that the woman take an immediate-release medication during the middle hours of the day to lower the fluctuation in the levels of medication in the bloodstream.
In the near future we hope that more research will be conducted on the best ways to manage both ADHD and addiction disorders in those who are breastfeeding or pregnant. In the meantime, those who are pregnant or attempting to be pregnant should be encouraged to talk with their GP and psychiatrist about the options that may be available for them such as psychotherapy geared towards ADHD symptoms, and how those might differ from a treatment-only approach. If they choose not to take medication and are not taking medication, they will have more difficulties at school, work as well as in maintaining a relationship. This will likely be a major influence on their children too.
Incorporate the use of Medications
Women who suffer from ADHD may use medication to manage symptoms such as inattention, hyperactivity, and the tendency to be impulsive. While studies on how these medications may impact pregnancy has been minimal, recent studies have shown that they are not likely to negatively affect the fetus and are safe for use during pregnancy.
This is a great development for the increasing number of women who rely on their ADHD medication and want to become mothers. Many women are concerned that they should not continue taking their medications while pregnant, especially when they are taking stimulant drugs like amphetamines and methylphenidate. The women and their medical professionals should discuss the potential risks and benefits of drug use according to the most recent research and recommendations.
Methylphenidate is one of the most frequently used ADHD medications prescribed to pregnant women, has been found to be safe when administered under the supervision of a health professional. Other commonly prescribed stimulant medications like atomoxetine or amphetamine are also considered safe for women who are pregnant. However it is important to remember that both stimulant and non-stimulant medications should 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 pregnancy had no adverse effects on the child's long-term growth or development. These findings are significant because they cover a larger population of patients than previous studies and take into account several confounding factors.
Additionally, the results show that the use of ADHD medication during pregnancy is not associated with any increased risk of complications for mothers such as anemia and hyperemesis gravidarum, iron deficiency, or TORCH infections. These findings are a major advancement in our understanding of how the use of ADHD medications during pregnancy can be successfully managed by obstetricians and psychiatrists.
uk adhd medication suffering from ADHD should continue to adhere to their treatment plan and work closely with their healthcare professional throughout their pregnancy. This can help ensure that their symptoms are effectively managed, allowing them benefit the most from their pregnancy. If you are unable or are unable to stop medications, there is various non-pharmacological treatments which can help ease symptoms and support overall well-being during pregnancy. These include: