ADHD Medication and Pregnancy
GPs might prescribe stimulants to treat ADHD (methylphenidate dexamfetamine, methylphenidate, and lisdexamfetamine), as well as non-stimulants like modafinil and Atomoxetine. These medications can assist patients in managing their ADHD symptoms, and also attend regular appointments to see an GP or a specialist.
The majority of studies on the pregnancy safety of ADHD medication limit the outcomes to live births, thus underestimating the serious teratogenic effects which result in abortions and terminations. This is the first study to incorporate such information.
Risk/Benefit Discussion
Many women suffering from ADHD are faced with a dilemma when they are taking stimulants during pregnancy. On the other hand, they function using their medication but stopping it can result in marital strife as well as difficulties at school or at work and a host of other negative consequences. On the contrary, they don't want to expose their child to substances about which little is known about long-term effects.
Some doctors counsel their patients to stop taking ADHD medications before getting pregnant, while other have found a way to balance the assumption of safety and individual patient needs. These patients often consult their doctors, spouses or partners before making a decision. They find a balance between the mother's need to take her medication and the potential for severe symptoms, like depression and agitation when she stops taking the medication.
Most studies on ADHD medication and pregnancy focus on the effects of first-trimester stimulant exposure on the growth of abnormalities in the fetus. However, the literature is not well-defined. This is partly because most of the studies that are available do not include data on outcomes other than live births (eg, terminations, miscarriages and stillbirths) and because they fail to take into account a variety of confounding variables, such as the calendar year, pregnancy characteristics, maternal sociodemographics and indications for the medication for maternal physical and mental health status and proxies for various mental and medical conditions.
The results of some studies suggest that there is no risk to the fetus from the use of stimulant medications during, before, and after the first trimester. Although the indicators for certain cardiac malformations, including VSD (ventricular septal defect) are clear, these findings need confirmation in larger studies that have more precise and detailed data.
There isn't enough evidence to suggest a link between maternal use of methylphenidate (MPH) and atomoxetine (ATO) and a higher incidence of gastroschisis, omphalocele, and transverse limb deficiency. These birth defects can also be caused by other medications, however the risks remain unclear due the lack of data available.
Treatments to avoid
Women suffering from ADHD who become pregnant are often confronted with a difficult decision: Should they continue or discontinue their ADHD medication? This is a significant life change that will impact both the mother and the baby. Many doctors believe that the ideal time to discuss this subject is when a woman tells her doctor that she wants to start a new family. This will give her the information she needs to make a decision before she becomes pregnant. This is not always possible and women might discover they are pregnant later on in their the pregnancy process, after it is too late to safely stop taking medications.
Unfortunately, there are only Full Write-up that examine the safety of stimulants during pregnant and breastfeeding. The majority of studies are based upon retrospective data analysis and don't take into consideration factors like the mother's age at the time of exposure or chronic conditions, stimulant indications as well as co-treatment with pain and psychiatric medication, or other factors that can affect the risk. Numerous studies have demonstrated a small increase in the risk of preeclampsia and premature birth if psychostimulants are used during pregnancy. However these findings must be interpreted cautiously.
Some behavioral problems in infants have been related to the use of stimulants in pregnancy. The most commonly reported is the development of tics (abnormal muscle movements) in a few children. Other behavior issues that have been identified include increased impulsivity and irritability. The good news is that these symptoms generally improve once the medication is removed.
Certain medications prescribed for ADHD are incompatible with other drugs and may cause dangerous side effects when mixed especially with alcohol or other CNS stimulants (methylphenidate amphetamine salts). These medications should not be combined together with narcotics or antidepressants, including pain relievers, and should be avoided by those who are taking illegal drugs or nicotine products.
Some patients find it possible to reduce or stop taking ADHD medications during pregnancy, without significant functional impairment. In these cases it is crucial to educate the patient and her spouse or partner about this choice and seek their help in limiting recurrence of symptoms. This might include identifying local support resources, enlisting help from family members or friends or requesting accommodations at work that can treat symptom-related impairments. It is also helpful to know about cognitive-behavioral therapy and coaching for ADHD, which can be offered by trained professionals.
Considerations for Medications
The decision to remain on ADHD medication during pregnancy is a challenging one for patients and physicians. It is a particularly difficult decision for people who suffer from co-occurring disorders of substance use because many medications used to treat addictions may have the same effects as commonly used ADHD medications, including the possibility of causing high blood pressure and attacks of chest pain.
Unfortunately, there aren't a lot of options for these people and their physicians. Lack of research into how to treat a person with ADHD and addiction disorders could lead some doctors to err on the side of caution, and suggest that patients stop taking their medications during pregnancy.
Ideal is to discuss whether or not to continue taking ADHD medications well before planning a family. Many women suffering from ADHD are surprised to discover they are pregnant. This usually occurs during the first trimester when the growing fetus is the most vulnerable to exposure to drugs.
If the patient and doctor decide to keep taking the medication during the first trimester, they should choose the lowest dosage possible and closely monitor any symptoms. The doctor could also suggest that the woman supplement her dose with an immediate-release medication that is taken in the middle of the day, which can help decrease the ups and downs that are caused by fluctuating levels of medication in the bloodstream.
In the near future it is expected that more research to be conducted on the best to manage ADHD and other substance abuse disorders in nursing or pregnant women. In the meantime, people who are pregnant or attempting to get pregnant should be encouraged to talk with their doctor and psychiatrist about the options that may be available to them for psychotherapy that targets ADHD symptoms, and how those might differ from a treatment-only approach. If they decide not to take medication, it is likely that they will experience more difficulty at work, school and even maintaining a relationship. Read the Full Report could have a significant impact on their children as well.
Medicines to Incorporate
Women who suffer from ADHD may take medication to manage symptoms like inattention, hyperactivity, and an impulsiveness. While research on the effects of these medications on pregnancy has been limited, recent studies have shown that they don't appear to negatively affect the fetus and are safe for continued use during pregnancy.
This is fantastic news for the increasing number of women who depend on their ADHD medication and want to become mothers. Many women are worried about whether they should continue taking their medications while pregnant, especially if they take stimulant medications like amphetamines and methylphenidate. Women should discuss with their healthcare providers the risks and benefits associated with the use of medications in light of current research and guidelines.
Methylphenidate is among the most common ADHD medications prescribed to pregnant women, has been found to be to be safe when used under the supervision of a medical professional. Other stimulant medications that are commonly prescribed like atomoxetine or amphetamine are also considered safe for women who are pregnant. However it is crucial to note that both non-stimulant and stimulant medications must be closely monitored during 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 effects on their growth or development. These findings are significant since they encompass a significantly larger number of patients than prior research and consider many potential confounding factors.
The results also show that the use of ADHD medication during pregnancy does not increase the risk of maternal complications, such as iron deficiency, anemia or hyperemesis. These findings are a significant advancement in our understanding of how obstetricians are able to safely manage the use of ADHD medication during pregnancy.
It is essential that women with ADHD continue to adhere to their treatment plans and work closely with their healthcare providers throughout their pregnancy. This will ensure that symptoms are treated properly, allowing women to maximize their pregnancy. For those who cannot or do not want to stop taking medications, there is many non-pharmacological options that can improve symptoms and improve overall health during pregnancy. These include: