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ADHD Medication and Pregnancy GPs can prescribe stimulants (methylphenidate dexamfetamine Lisdexamfetamine) as well as nonstimulants such as atomoxetine or modafinil to treat ADHD. These medications can assist patients in managing their ADHD symptoms, and attend regular appointments with an GP or a specialist. The majority of studies on pregnancy safety of ADHD medication restrict outcomes to live births, thus underestimating severe teratogenic effects that can cause terminations and abortions. This is the first study to include such information. Risk/Benefit Discussion The use of ADHD stimulants during pregnancy is a typical treatment dilemma for many women with the disorder. On the other hand, they function well with the aid of their medication but stopping it can cause marital conflict as well as difficulties at school or at work, and other significant consequences. On the other hand they do not want to expose their child to drugs whose long-term consequences are unknown. While some doctors counsel their patients to stop taking ADHD medications before they become pregnant, others have come to a balance between the assumed safety and the needs of the individual patient. The latter usually arrive at an option after consulting with their physician and/or spouse and strike an appropriate balance between the mother's desire for her medication and the possibility of developing severe symptoms, such as agitation, depression, and trouble staying awake when stopping the medication. Most studies of ADHD medication and pregnancy concentrate on the impact of the first trimester's exposure to stimulant medication on the formation of abnormalities in the fetus (eg, cardiac malformations). The literature is inconsistent. The literature is inconclusive, in part because most studies don't provide data on outcomes other that live births (eg. terminations or stillbirths, miscarriages, and terminations) neither do they consider factors that can cause confusion, such as the calendar year, pregnancy characteristics and maternal sociodemographics. However, a fantastic read of some of the available studies suggest that there is no significant increase in risk for the fetus from the use of the most frequently used stimulant drugs prior to and during the first trimester. The signals for certain cardiac abnormalities are strong. This is especially true for VSD (ventricular defect). However, these findings must be confirmed by larger studies that provide more specific information. Insufficient evidence exists to support the link between methylphenidate and the use of atomoxetine by mothers, and a higher incidence of gastroschisis, omphaloceles, and transverse limb deficiency. These birth defects may also be caused by other medications, but the risks are not clear due to the limited information available. Treatments to avoid Women with ADHD who are pregnant confront a dilemma whether to continue their ADHD medication or stop it? This is a major change that will affect both the mother and the foetus. Many doctors believe that the best time to bring up this topic is when a woman informs her doctor she is planning to start a family. This will provide her with the information she needs to make a decision prior to when she is pregnant. This is not always possible, and women may discover they are pregnant later in the course of pregnancy, which is too late to stop taking medication. Unfortunately, there isn't much research into the dangers of stimulants during pregnancy and breastfeeding. Most studies have been based on retrospective analyses of data, and don't properly control for factors like the age of the mother at the time of first exposure to drug and chronic conditions, the stimulants' indications, cotreatment with psychiatric or pain medications as well as other factors that affect risk. Although certain studies have shown minor increases in preeclampsia risk and premature birth with the use of psychostimulants during pregnancy, these findings should be taken with a pinch of salt. Certain behavioral issues in infants have been related to the use of stimulants during pregnancy. The most frequent tics (abnormal movements of the muscles) are observed in children. Other behavior issues that have been observed include increased impulsivity and irritability. The good news is these symptoms tend to improve after the medication is stopped. Certain ADHD medications can interact with other drugs and cause dangerous side effects, particularly when used in conjunction with alcohol or CNS stimulants such as methylphenidate and amphetamines salts. These medications should not be combined with antidepressants or narcotics, including pain relievers, and should be avoided by those who use illegal drugs or nicotine products. Some patients discover that a reduction or even the discontinuation of ADHD medication during pregnancy is feasible without significant impairment in function. In these instances it is important to inform the mother and child about the decision. Request their help in minimizing symptoms recurrence. This might include identifying local support sources, seeking assistance from family members or friends, or seeking accommodations at work that can help with the underlying impairments that cause symptoms. It is also beneficial to know more about effective cognitive-behavioral treatment and coaching for ADHD which can be provided by professionals who are trained. Considerations for Medications Both doctors and patients find it difficult to decide whether or not to continue taking ADHD medication during pregnancy. It is a particularly difficult choice for those with co-occurring substance use disorders due to the fact that many of the medications used to treat addictions can have similar effects as common ADHD medications, including the possibility of creating high blood pressure and a recurrence of chest pain. Unfortunately, these individuals and their doctors don't have many alternatives. Lack of research into how to treat a person 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. It is best to discuss the question of whether or not you should continue taking ADHD medications well before planning a family. However, a lot of women with ADHD discover that they are pregnant in a sudden manner. This typically happens in the first trimester, when fetal growth is most susceptible to exposure to drugs. If the doctor and patient decide to proceed with medication during the first trimester of pregnancy, it is recommended that they select the dose that is most effective and monitor closely for symptoms. The doctor may suggest that the patient supplement her dose with an immediate-release medication that is taken at the midpoint of the day. This will help to reduce the fluctuations and downs that are caused by fluctuating levels of medication in the bloodstream. In the future it is expected that more research to be done on how best to manage ADHD and other addiction disorders in nursing or pregnant women. In the meantime, those who are pregnant or trying to get pregnant should be encouraged to speak with their GP and psychiatrist about what options may be available for psychotherapy that targets ADHD symptoms and how they could differ from a treatment-only approach. It is important to inform them that if they don't opt to take medication, they may be more difficult in school and at work, and could even struggle to maintain the relationship. This could have a significant impact on their children too. Medications to Incorporate Women with ADHD may take medication to manage symptoms like inattention, hyperactivity and impulsivity. Recent research has shown that these medications do not harm the fetus and can be used during pregnancy. This is fantastic news for the increasing number of women who rely on their ADHD medication and want to become mothers. However many women are worried about the safety of sustaining their medication during pregnancy, particularly those who take stimulant medications such as methylphenidate or amphetamines. These women should discuss with their healthcare providers the potential risks and benefits associated with medication use according to current research and recommendations. Methylphenidate is one of the most frequently prescribed ADHD medications and has been proven to be safe for women who are pregnant when used under the care of a health professional. Amphetamine, atomoxetine, and other stimulant medications are also safe for women who are pregnant. It is crucial to keep in mind that both stimulants and other medications should be monitored closely during pregnancy. A recent study of data from Danish national registers showed that children born to mothers who were taking ADHD medication during pregnancy had no adverse effects on their neurodevelopment or growth. These findings are significant as they encompass a significantly larger patient population than previous research and take into account several possible confounding factors. Additionally, the results show that the use of ADHD medication during pregnancy is not associated with an increased risk of complications for mothers like anemia, iron deficiency, hyperemesis gravidarum or TORCH infections. These findings are a significant advance in our understanding of how obstetricians can safely manage the use of ADHD medication during pregnancy. It is crucial that women with ADHD continue to follow their treatment plans and work closely with their healthcare professionals throughout their pregnancy. This will help to ensure that symptoms are treated effectively, allowing women to make the most of their pregnancy. If you are unable or choose not to discontinue medications, there is a variety of non-pharmacological interventions which can help ease symptoms and support overall well-being during pregnancy. These include: