ADHD Medication and Pregnancy
GPs can prescribe stimulants (methylphenidate dexamfetamine Lisdexamfetamine) and non-stimulants like modafinil or atomoxetine to treat ADHD. These medications can assist patients in managing their ADHD symptoms and make regular appointments with the doctor or a specialist.
The majority of studies on pregnancy safety of ADHD medication limit the outcomes to live births, thus underestimating the serious teratogenic effects which result in abortions and terminations. This study is the first to include such information.
Risk/Benefit Discussion
Many women suffering from ADHD face a dilemma when taking stimulants during pregnancy. On one side, a lot of women with ADHD perform well when they take their medication. Removing it can result in marital conflict, issues at work or school and other serious repercussions. On the other hand, they don't want to expose their unborn child to substances about which little is known in terms of long-term effects.
Some doctors advise their patients to stop taking ADHD medications before having a baby, but others have found a way to balance the assumption of safety and individual patient needs. The latter often arrive at the decision after consulting with their physician and/or spouse and strike an appropriate balance between the mother's need for her medication and the possibility of developing severe symptoms, such as depression, agitation and trouble staying awake in the event of discontinuing 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 formation of malformations in the fetus (eg, cardiac malformations). The literature is inconsistant. The literature is inconsistent partly because the majority of studies don't provide data on outcomes other than live births (eg. terminations, miscarriages and stillbirths), nor do they consider confounding variables such as calendar year, characteristics of pregnancy and sociodemographics of the mother.
The results of some studies show that there is no risk to the fetus from the use of stimulant drugs during, before, and after the 1st trimester. The warning signs for certain cardiac malformations are clear. This is particularly applicable to VSD (ventricular defect). However these findings need to be confirmed by larger studies that provide more exact information.
There is not enough evidence to support the connection between methylphenidate and atomoxetine use by mothers and an increased prevalence of gastroschisis, omphaloceles, and transverse limb deficiencies. These birth defects can also be caused by other medications, but the risks are not clear due to the lack of data available.
Do not take medication.
Women suffering from ADHD who are pregnant are often confronted with a dilemma: Should they continue or stop taking their ADHD medication? This is a major shift in the life of both the mother and the fetus. Many physicians feel that the best time to discuss this issue is when patients inform their doctor of her plans to start a family in order to have the information she needs to make a decision prior to becoming pregnant. However, this is not always possible and women often discover that they are pregnant at a later point during the pregnancy, when it's too late to stop medications.
Unfortunately, there are only a few studies on the safety of stimulants in pregnancy and breastfeeding. Most studies are based on retrospective data analysis and do not consider factors such as the age of the mother at the time of exposure and chronic conditions, stimulant warnings, cotreatment with pain and psychiatric medication, or other factors that can affect the risk. While certain studies have shown small increased risks of preeclampsia and premature births associated with psychostimulant use during pregnancy, these findings should be taken with caution.
A few behavioral problems in infants have been related to the use of stimulants during pregnancy. The most frequently reported issue is the development of tics (abnormal muscle movements) in a few children. Other problems with behavior that have been observed include increased impulsivity and irritability. The good news is that these symptoms tend to improve after the medication is stopped.
Certain medications prescribed for ADHD can interact with other medications and can trigger dangerous side effects when mixed particularly 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 those who are using illicit drugs or nicotine products.
Some patients find it possible to reduce or stop taking ADHD medications during pregnancy, without significant functional impairment. In these instances, it is important to educate the patient and her partner or spouse about this decision and to ask them for help in limiting recurrence of symptoms. This could include identifying local resources, seeking assistance from family members or friends or seeking workplace accommodations that address impairments related to symptoms. It is also helpful to be aware of cognitive-behavioral treatments and coaching for ADHD, which can be provided by trained professionals.
Considerations for Medicines
Both doctors and patients find it difficult to decide whether or not to continue taking ADHD medication during pregnancy. It's a particularly difficult decision for people who suffer from co-occurring disorders of substance use because many medications used to treat their addictions may have the same effects as common ADHD medicines, including the possibility of creating high blood pressure and episodes of chest pain.
Unfortunately, these people and their doctors aren't given a lot of choices. Lack of research on how to treat a person suffering from ADHD and a substance use disorder can lead some doctors to err on the side of caution and suggest that patients stop taking their medications during pregnancy.
It is recommended to discuss whether or not to continue taking ADHD medications well before planning a family. However, a lot of women with ADHD discover they are pregnant in a sudden manner. This usually happens during the first trimester when the growth of the fetus is most susceptible to drug exposure.
If the physician and patient decide to continue with medication during the first trimester, it is recommended that they select the dose that is most effective and monitor closely for symptoms. The doctor may recommend that the woman take an immediate-release medication in the middle of the day to help decrease the fluctuations in medication levels in the bloodstream.
In the near future, more research is hoped to be conducted on how best to manage ADHD and other substance abuse disorders in pregnant or nursing women. In the meantime, women who are pregnant or are planning to become pregnant, should talk to their GP about the options they have, such as psychotherapy which targets ADHD symptoms and how it might differ from a medication-only approach. If they choose not to take medication and are not taking medication, they will experience more difficulty at work, school and even maintaining the relationship. This will also have a major impact on their children.
Incorporate Medications
Women with ADHD might take medication to manage symptoms such as inattention, hyperactivity, and an impulsiveness. Recent studies have proven that these medications don't affect the fetus in any way, and can be used during pregnancy.
This is a good thing for women who are planning to become mothers and depend on their ADHD medications. Many women are concerned about taking their prescriptions while pregnant, particularly when they are taking stimulant drugs such as amphetamines and methylphenidate. Women should consult with their healthcare providers about the risks and benefits associated with medication use, based on current research and guidelines.
Methylphenidate is one of the most frequently prescribed ADHD medication and has been found to be safe for women who are pregnant when used under the care of a medical professional. Amphetamine, atomoxetine and other stimulant medications are also safe for pregnant women. It is important to keep in mind that both stimulants and other drugs should be closely monitored in pregnancy.
A recent study of data from Danish nationwide registers found that children born to mothers who were taking ADHD medication during their pregnancy had no adverse effect on the child's long-term neurodevelopment or growth. These findings are significant as they cover a wider range of patients than previous research, and take into consideration several confounding factors.
Furthermore, the results indicate that the use of ADHD medication during pregnancy is not associated with any increased risk for maternal complications such as anemia and iron deficiency, hyperemesis gravidarum, or TORCH infections. These findings are a major improvement in our understanding of how ADHD medications during pregnancy can be safely managed by obstetricians and psychiatrists.
adhd treatment medication is vital that women with ADHD continue to follow their treatment plans and collaborate closely with their healthcare providers throughout their pregnancy. This will ensure that symptoms are managed effectively, allowing women to make the most of their pregnancy. For those who cannot or do not want to stop taking medication, there are many non-pharmacological options which can help ease symptoms and promote overall well-being during pregnancy. These include: