ADHD Medication and Pregnancy
Psychiatrists are often approached by women who are trying to have the birth of a child or are pregnant and are concerned about the negative effects of their ADHD medication. The good news is that Research suggests that, in the end, it is safe to continue taking stimulant medication during pregnancy.
The findings are based upon naturalistic studies with a large sample of first-trimester exposures.
Pregnancy
Pregnancy and a new baby are exciting times for women, but some women are concerned about the impact of their ADHD medication on their child who is yet to be born. Stimulant medications are known to have teratogenic effects and some physicians recommend patients to stop taking their medication while trying to conceive or in the first trimester of pregnancy. Many people with ADHD need their medication in order to function and may struggle with it without it.
A recent study in Denmark discovered that the first trimester exposure to methylphenidate (in the form of a prescription redeemed) does not seem to increase the risk of major malformations when compared to a group that did not have redeemed prescriptions in the first trimester of pregnancy. The study utilized registry-based data from various Danish databases to determine the number of pregnant women and their medications prior to and during pregnancy, including information about whether the woman was treated for ADHD.
The researchers followed a total of 898 babies born to mothers who were exposed to methylphenidate or other stimulants during the first trimester of pregnancy. They were compared with 1,270 babies in the control group who did not receive any stimulant medication or methylphenidate during the first trimester of pregnancy.
Both infant groups were examined for neurodevelopmental disorders of the psychiatric kind and other neurodevelopmental disorders growth impairments, as well as fetal heart problems (such as gastroschisis, omphalocele or transverse limb deficiency). The results showed that babies born to mothers who were exposed to methylphenidate during pregnancy didn't exhibit any higher rates as compared to controls. This was the case for both the first and second trimesters of pregnancy.
This is a promising outcome that could be a source of comfort for pregnant women who take ADHD medication and may want or need to continue their treatment throughout the pregnancy. The study did not examine the impact of lifestyle changes or other medications on a fetus. Other studies have demonstrated that there is a link between stimulant medications and adverse pregnancy outcomes such as a caesarean birth, or a baby needing assistance to breathe during birth.
Breastfeeding
Even when women with ADD or ADHD require medication to control their symptoms, they find that breastfeeding benefits their baby. The mother and baby must be healthy and well-nourished. Therefore the decision to breastfeed or use ADHD medications should be formulated with the help of a healthcare provider. The most recent guidelines and evidence1 suggest that women do not need to discontinue breastfeeding to take her prescribed medication. Numerous studies have demonstrated that the long-term neurodevelopmental effects for the baby are not significant when the mother is taking her ADHD medications according to the prescription.
Stimulants are the most common medication used to treat ADHD, including methylphenidate (with brand names Ritalin and Concerta) and dexamfetamine (brand name Vyvanse). They are available in immediate-release versions, which lasts for up to 4 hours, and extended-release formulations that are taken every day in the morning. They could last as long as 16 hours. Many people with ADD or ADHD find that the best way to manage their symptoms is to take an extended-release medication by taking an immediate-release pill in the afternoon or evening.
Some medications are not suitable for breastfeeding, such as clonidine, which reduces prolactin levels and lowers production of milk. Some people suffering from ADD or ADHD are not able to stop breastfeeding due to this reason, and instead opt to change their medication to an alternative stimulant or non-stimulant, such as atomoxetine or guanfacine. These drugs are less likely to have high RIDs and may be covered under the Pharmaceutical Benefits Scheme. If you are thinking about changing your medication during pregnancy or nursing it is crucial to speak with a GP or a specialist. They can offer information on the most secure medication and how to track your infant's growth and weight. They can also refer you a psychiatrist or psychologist to provide additional assistance. They may also refer you to a dietitian to assist with managing nutrition and diet.
Postpartum
During pregnancy, women go through massive physical, hormonal, and emotional changes. For some women who are expecting, the transition can bring feelings of joy, excitement and love, but also anger and sadness, or even anxiety. This is normal and it's essential to seek help from family members, her doctor and/or mental health professionals if the new mother is experiencing difficulties.
The birth of a child can be thrilling and a little overwhelming but there is no reason why mothers should feel as if she must do it on her own. Finding the right balance can be difficult, but you can help yourself by taking the time to rest and get a good night's sleep. You should also go to your postpartum checks, since they can detect any issues that could be present early.
Some women experience a brief period of anxiety or depression following the birth of their child. This is often referred to as the "baby blues." It is a common occurrence that usually goes away on its own within around a week. However for some, these symptoms become more severe and last longer than that. This is known as postpartum depression, and is a treatable illness. If a woman has experienced anxiety or depression in the past, she is at a greater risk of developing it again after the birth of her child.
In rare instances, a woman may develop postpartum psychiasis. This can be very dangerous for both mother and child. This is a psychiatric crisis that should be treated as soon as is possible. The treatment could include a combination therapy and medication. A therapist who has experience with this condition can be extremely helpful. If the symptoms are severe, electroconvulsive (ECT) therapy could be advised.
In the case of an episode of postpartum psychiasis in a mother, her doctor is likely to prescribe an antipsychotic like Valproate or lithium and a mood stabilizer such as citalopram. They may also recommend cognitive behavioral therapy to treat the root causes. Tricyclic antidepressants, such as nortriptyline and imipramine are occasionally used but they can have challenging side effects and so are typically only prescribed when other medications have not worked.
Adolescence
Adolescence is a critical time of cognitive, physical and psychosocial growth. It involves a shift from dependency on parents to independence in making decisions and taking action in the world around them. Adolescents begin to take an interest in expanding their social circles from only their family members to include friends, peers and acquaintances with whom they may spend a significant amount of time at school or other activities. Their social networks may also include members of teams in activities, student organizations, or even jobs.
As we grow older, changes in brain structure and connectivity are interacted with increased experience, knowledge and social demands that change to create rapid cognitive growth. This includes improvements in selective and divided focus (the ability to concentrate on multiple stimuli simultaneously) and working memory and long-term memory. In addition adolescents' ability to think abstractly and morally improves.
These cognitive changes are often accompanied with hormonal changes, which makes adolescents more drawn to exciting and new experiences. best medication for adhd in their bodies also cause them to seek out experiences that raise their status above other people. The desire to explore new things can be used positively for instance, by taking part in a school performance. It is possible to take risks that are healthy in exploring sexuality or other risk-taking behaviours as long as they are in a safe and secure environment.
The different rates of physical growth can create awkward adolescent stages and anxiety or self-consciousness about the changes in their bodies. In some cultures, such as those of Aboriginal and Torres Strait Islander people, adolescents could be a time when young people begin to establish their place with their clans, families nations, ancestors, and country.
Relationships between teens and friends could be a source of support or conflict. The quality of these relationships is crucial for the wellbeing of adolescents and is an important factor in their happiness and well-being. Relationships between adolescents and their parents can be a wonderful source of assistance for them, especially when they are able to solve problems in a non-confrontational fashion.