ADHD Medication and Pregnancy
Psychiatrists are often approached by women who are trying for an infant or are expecting, 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 drugs during pregnancy.
The findings are based on naturalistic studies using a vast sample of first-trimester exposures.
Pregnancy
The birth of a baby and pregnancy are exciting for women, but many are concerned about the effects of their ADHD medication on their unborn child. These medications are known to have adverse teratogenic consequences and some doctors recommend patients to stop taking their medication when trying to conceive or in the first trimester of pregnancy. However, many people suffering from ADHD require the benefits of their medication to function in daily life and may be unable to function without it during this period.
A recent study from Denmark discovered that the exposure to methylphenidate during the first trimester (in the form of a redeemed prescription) does not appear to increase the risk of major malformations compared to a group that did not have redeemed prescriptions in the first trimester of pregnancy. The study used registry information from Danish databases to identify pregnant women and their medical history as well as whether they were treated for ADHD.
Researchers observed 898 babies whose mothers were exposed to methylphenidate as well as other stimulants during the first trimester. They were compared to 1,270 babies who were part of the group of control and did not receive methylphenidate, or any other stimulant medication in the first three months of pregnancy.
adhd sleep medication of babies underwent a comprehensive assessment for birth defects in the heart like gastroschisis and omphalocele. The results showed that infants born to women who were exposed to methylphenidate in pregnancy did not exhibit any higher rates as compared to those who were not. This was the case for both the first and second trimesters of pregnancy.
This is a promising finding that can be comforting for women who are pregnant and take ADHD medication and may need or want to continue their treatment during pregnancy. It is important to note that the study did not evaluate the impact of other medications or lifestyle changes on the fetus and that other studies have demonstrated an correlation between the use of stimulant medications and adverse outcomes during pregnancy, for example having a caesarean birth or the baby needing support to breathe upon the time of birth.
Breastfeeding
Even when women with ADD or ADHD need to take medication to control their symptoms, they realize that breastfeeding benefits their baby. The mother and child must be well-nourished. Therefore the decision to breastfeed or take ADHD medications should be formulated with the help from a health professional. The most current guidelines and evidence1 suggest a woman does not need to stop breastfeeding to take her prescribed medication. Numerous studies have shown that the long-term neurodevelopmental effects of the baby are minimal in the event that the mother takes her ADHD medications as prescribed.
Stimulants are the most commonly used treatment for ADHD such as methylphenidate (with brand names Ritalin and Concerta) and dexamfetamine (brand name Vyvanse). They are available in immediate-release forms, which lasts for up to four hours and extended-release versions that are taken once a day in the morning, and could last as long as 16 hours. Many people suffering from ADD or ADHD discover that the best way to manage their symptoms is to take an extended-release medication in the afternoon or evening and then follow it up with a tablet that is immediate-release.
Certain medications, such as Clonidine, reduce prolactin production and are incompatible with breastfeeding. Certain people suffering from ADD and ADHD don't want to stop nursing for this reason, so they switch to a different stimulant. These drugs are less likely to contain high RIDs and could be covered under the Pharmaceutical Benefits Scheme. It is crucial to speak with an GP or specialist if you are considering switching your medication during pregnancy, breastfeeding, or early postpartum. They can provide advice about the safest medication and how to monitor the baby's growth and weight. The doctor or specialist can assist in referring to a psychologist or psychiatrist for additional support. They can also refer to dietitians for assistance in managing nutrition and diet.
Postpartum
During pregnancy, the female body undergoes enormous hormonal, physical and emotional changes. The transition to motherhood can be a time of tremendous joy, excitement and affection, but also anger or anxiety for some women. This is normal and it is important to ensure that the new mom receives help from family members as well as her health care provider and/or a mental health professional in case she is experiencing difficulties.
Being a mother can be exciting and overwhelming, however there's no reason the new mom should feel like she must do it all alone. Finding the right balance can be challenging, but it is possible to help by allowing yourself time to rest, getting enough sleep and eating well. You should also go to your postpartum check-ups as they can spot any issues that could be present early.
Some women experience a brief period of depression or anxiety after the birth of their child. This is called the "baby blues." It is a common condition and will usually disappear by itself within a week or two. Some people experience feelings that are more intense and last for longer. This is known as postpartum depression and is a condition that can be treated. If a woman has had depression or anxiety before, she is at an increased risk of developing it following the birth of her baby.
In rare instances, women may develop postpartum psychiasis. This can be extremely risky for both mother and child. This is a mental health issue which should be treated as soon as possible. The treatment may include a combination therapy and medication. A therapist who has had experiences with this condition can be particularly helpful. If the symptoms are severe electroconvulsive (ECT) therapy is advised.
In the case of an episode of postpartum psychiasis that affects a mother who is pregnant, the doctor will likely prescribe an antipsychotic such as lithium or Valproate as well as an antidepressant such as citalopram. They may also recommend cognitive behavioral therapy to treat the root cause of the problem. Tricyclic antidepressants like imipramine and nortriptyline, are sometimes prescribed, but have serious adverse effects. They are usually only prescribed after other medications have failed.
Adolescence
Adolescence is a crucial time for physical, cognitive and psychosocial development. Adolescence is an age of rapid growth in terms of physical, cognitive and psychosocial development. Adolescents begin to take an interest in expanding their social circle from only their family members to include peers, friends and acquaintances with whom they may spend significant time at school or in other activities. Their social networks also may include people from team sports, student groups or jobs.
During adolescence the biological changes in brain structure and connectivity interact with increasing experience, knowledge, and changing social demands and results in rapid cognitive development. This includes improvements in selective and divided focus (the ability to concentrate on multiple things at the same time) as well as working memory and long-term memory. Furthermore, the ability of adolescents to think abstractly and morally also improves.
These cognitive changes are often accompanied by hormonal changes, which make adolescents more attracted by novel and intense experiences. Their hormones also force them to seek out experiences which will elevate their status to others. This drive toward new experiences can be used to gain positive results for example, by trying out for the school play or getting involved in a community service activity. It is also possible to take risks that are healthy, such as exploring sexual activities or other risk-taking behaviors, provided that they are in a safe and secure environment.
Varying rates of physical development can result in awkward phases of appearance during adolescence, as well as feelings of self-consciousness and anxiety about the changes in their bodies. In certain cultures, like those of Aboriginal or Torres Strait Islander, adolescence is a time when young people are able to establish their identity in relation with their clans, families and their communities, their ancestors, and their country.
Relationships between teens and friends could be a source of support or conflict. These relationships are important for the health of adolescents and can significantly impact their happiness and wellbeing. The relationship of adolescents with their parents can be a significant source of comfort, particularly if they can work out family issues in a non-threatening manner.