ADHD Medication and Pregnancy
GPs might prescribe stimulants to treat ADHD (methylphenidate, dexamfetamine and lisdexamfetamine) along with non-stimulants such as modafinil and atomoxetine. These medications can improve the ability of a patient to manage their ADHD symptoms and make regular appointments with their GP and a specialist.
The majority of studies on the safety of ADHD medication during pregnancy limit outcomes to live births. This undervalues the severe adverse teratogenic effects that can result in terminations and abortions. This is the first study to include these data.
Risk/Benefit Discussion
Many women suffering from ADHD are faced with a dilemma when using stimulants during pregnancy. On the one side, many women suffering from ADHD function well when they take their medication. Stopping it could lead to conflicts in the marriage, issues at school or work and other serious repercussions. On the other hand, they do not want to expose their unborn child to drugs about which very 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 assumed safety and individual patient needs. These patients usually consult their spouses and/or physicians before making the decision. They seek to strike the right balance between a mother's need to take her medication and the possibility for serious symptoms, like depression and agitation in the event that she stops taking the medication.
The majority of studies on ADHD medication and pregnancy concentrate on the effect of first-trimester exposure to stimulant medications on the formation of fetal malformations (eg malformations of the heart). The literature is not consistent. does adhd medication work is due to the fact that most of the studies available don't include information on outcomes other than live births (eg terminations, miscarriages, terminations, and stillbirths) and because they fail to consider a range of confounding factors, including the calendar year, pregnancy characteristics, sociodemographics of mothers and indications for the medication as well as physical and mental health status and proxies for various medical and psychiatric illnesses.
The results of some studies indicate that there is no risk to the fetus from the use of stimulant medications during, before, and after the 1st trimester. While the signs for certain cardiac malformations, including VSD (ventricular septal defect) are evident however, these findings require confirmation in larger studies that have more precise and detailed information.
Insufficient evidence exists to support the connection between methylphenidate atomoxetine use by mothers and a higher incidence of gastroschisis, omphaloceles and transverse limb deficiency. These birth defects can also be caused by other medications, however the risks remain unclear due the limited information available.
Avoid taking medications
Women with ADHD who are pregnant often have to make a difficult decision: Should they continue their ADHD medication or stop it? This is a major shift in life that will affect both the mother and the fetus. Many doctors believe that the ideal time to bring up this subject is when a woman tells her doctor she is planning to start a family. This will provide her with the necessary information to make a decision before she is pregnant. This isn't always the case and women could discover that they are pregnant later in the course of pregnancy, which is too late to safely stop taking medications.
Unfortunately, there are few studies on the safety of stimulants in the course of pregnancy and nursing. The majority of studies are based upon retrospective data analysis and do not take into account factors such as the age of the mother at the time of first exposure, chronic conditions, stimulant indications or co-treatment with pain medications and psychiatric medication, or other factors that can affect risk. Although certain studies have shown small increased risks of preeclampsia and premature birth with psychostimulants used during pregnancy, these findings should be interpreted with caution.
Certain behavioral issues in infants are caused by the use of stimulants during pregnant women. The most frequent tics (abnormal movements of muscles) are reported in children. Other behavior issues that have been observed include an increase in irritability and impulsivity. The good news is that these symptoms generally improve after the medication is removed.
Some ADHD medications can interact with other drugs which can cause dangerous side effects, especially when used in conjunction with alcohol or CNS stimulants like methylphenidate or amphetamines salts. These medications should not be taken in conjunction with narcotics or antidepressants including pain relievers, and should be avoided by people who are using illicit drugs or nicotine products.
Some patients find that a reduction or even the discontinuation of ADHD medication during pregnancy is feasible without significant impairment to function. In these instances it is essential to inform the patient and her spouse or partner about the decision and ask them for help in reducing recurrence of symptoms. This might include locating local resources, asking for assistance from family members or friends or seeking accommodations in the workplace which address impairments resulting from symptoms. It is also beneficial to learn about effective cognitive-behavioral therapies and coaching for ADHD which can be provided by professionals who are trained.
Medicines to Take into
Both doctors and patients are unable to decide whether or not to continue taking ADHD medication during pregnancy. It's a tough decision for patients suffering from co-occurring disorders because many of the drugs they take to treat their addictions share similar effects to standard ADHD medications. This can include the possibility of high blood pressure or chest pain attacks.
There aren't a lot of options for these people and their doctors. The lack of research on how to properly manage those who suffer from both ADHD and a substance use disorder can lead certain doctors to erron on the side of caution and advise their patients to discontinue their medication during pregnancy.
It is recommended to discuss whether or not to continue taking ADHD medications prior to making plans for a family. However, a lot of women who have ADHD discover that they are pregnant in a sudden manner. This usually happens during the first trimester, which is when the development of the fetus is the most vulnerable to exposure to drugs.
If the doctor and patient decide to continue with medication during the first trimester, it is recommended that they choose the most effective dose and monitor closely for signs. The doctor may suggest that the woman take immediate-release medication in the middle of the day in order to reduce the fluctuations in the levels of medication in the bloodstream.
In the near future, it is hoped that more research will be conducted on the best ways to manage both ADHD and substance use disorders in people who are breastfeeding or pregnant. In the meantime women who are pregnant or are planning to become pregnant, should speak to their GP about the options they have, such as psychotherapy that targets ADHD symptoms and how this might differ from a medication only approach. They should be informed that if they don't choose to take medication, they will likely have more difficulty at work and school, and could even struggle to maintain a relationship. This will likely be a major influence on their children as well.
Medicines to Incorporate
Women with ADHD frequently rely on medications as part of their treatment plan to combat symptoms such as hyperactivity, inattention, and an impulsiveness. Recent research has shown that these medications do not negatively impact the fetus, and can be used throughout pregnancy.
This is good news for women who wish to become mothers and rely on their ADHD medication. However many women are worried about the safety of continuing their medication during pregnancy, especially those taking stimulant medications like amphetamines or methylphenidate. Women should discuss with their healthcare providers the potential risks and benefits associated with the use of medications, based on current research and guidelines.
Methylphenidate is one of the most frequently prescribed ADHD medications. It has been proven to be safe for women who are pregnant when under the supervision of a health professional. Other stimulant medications that are commonly prescribed like atomoxetine or amphetamine are also considered safe for pregnant women. It is important to remember that stimulants and other medications must be closely monitored in pregnancy.
A recent study of data collected from the Danish national registers revealed that children born to mothers who took ADHD medication during pregnancy did not experience adverse impacts on their child's neurodevelopment or long-term growth. These findings are significant because they include a much larger number of patients than prior research and consider several possible confounding factors.
Additionally, the results show that the use of ADHD medication during pregnancy is not associated with an increased risk for maternal complications like anemia, hyperemesis gravidarum, iron deficiency or TORCH infections. These findings represent a major improvement in our understanding of how obstetricians safely manage the use of ADHD medication during pregnancy.
Women with ADHD must continue to follow their treatment plan and work closely with their healthcare provider throughout their pregnancy. This will help to ensure that symptoms are managed correctly, allowing women make the most of their pregnancy. If you cannot or choose not to discontinue medications, there is various non-pharmacological treatments which can help ease symptoms and promote overall well-being during pregnancy. These include: