ADHD Medication and Pregnancy
Psychiatrists often encounter women who are trying to conceive or who are pregnant and concerned about the effects of their ADHD medication on their child. The good news is that Research suggests that, on balance it is safe to continue taking stimulant drugs during pregnancy.
The results are based on naturalistic studies using a vast sample of first-trimester exposures.
Pregnancy
Women are ecstatic about their pregnancy and the birth of babies, but they may worry about the way their ADHD medication will affect their unborn child. These medications are known to have teratogenic effects and some physicians recommend that patients stop taking their medication while trying to conceive or during the first trimester of pregnancy. However, many people suffering from ADHD require the benefits of their medication in order to perform in everyday life and may have difficulty without it during this time.
A recent study from Denmark discovered that exposure to methylphenidate in the first trimester (in the form of a redemption medication) did not seem to increase the risk of major malformations in comparison to the control group who did not receive redeemed medication during the first trimester. The study utilized registry data from Danish databases to determine the gender of the pregnant women and their medical history as well as whether they were treated for ADHD.
The researchers monitored 898 babies born to mothers exposed to methylphenidate and other stimulants in the initial trimester of pregnancy. They were compared to 1,270 babies who were part of the control group and were not exposed to methylphenidate or any other stimulant medication in the first three months of pregnancy.
Both groups of babies were assessed for neurodevelopmental disorders of the psychiatric kind, other neurodevelopmental impairments growth impairments, as well as fetal heart defects (such as gastroschisis, omphalocele, or transverse limb deficiency). The results showed that infants born to mothers who were exposed to methylphenidate during pregnancy did not show any increased rates when contrasted with those who were not. This was the case for both the first and second trimesters of pregnancy.
This is a positive result that could be a source of comfort for pregnant women who take ADHD medication and who may wish or need to continue their treatment throughout the pregnancy. It is important to remember that this study did not assess the effects of other medications or lifestyle changes on a fetus and that other studies have demonstrated an association between stimulant medication use and adverse pregnancy outcomes, like having a caesarean delivery or the baby needing assistance to start breathing at birth.
Breastfeeding
Even when women with ADD or ADHD need to take medication to manage their symptoms, they discover that breastfeeding benefits their baby. The mother and child should be well-nourished. Therefore the decision to breastfeed or use ADHD medications should be taken with the assistance from a health professional. The most recent guidelines and evidence1 suggest that women do not have to stop breastfeeding in order to take her prescribed medications. In fact, multiple studies have shown that the long-term neurodevelopmental effects of the infant are minimal if the mother takes her ADHD medications according to the prescription.
Stimulants such as methylphenidate and dexamfetamine are commonly used to treat ADHD. They come in two forms: immediate release, which lasts for four hours; and extended-release that is taken every day in the morning and can last up to 16 hours. Many people who have ADD or ADHD find that the best method to manage their symptoms is to take an extended-release medication with immediate-release pills in the evening or in the afternoon.
Certain medications are not compatible with breastfeeding, for example, clonidine, which reduces prolactin secretion and decreases the production of milk. Certain people with ADD or ADHD do not want to stop breastfeeding for this reason and choose to switch their medication to a different stimulant or a non-stimulant, like guanfacine or atomoxetine. These drugs are less likely to contain high RIDs and may be covered under the Pharmaceutical Benefits Scheme. It is important to speak with an GP and/or specialist if you are considering switching your medication during your pregnancy, breastfeeding, or early postpartum. They can offer information on the most secure medication and how to track the growth of your infant and its weight. They can also refer you to a psychiatrist or psychologist for further assistance. They may also refer you a dietitian to assist with managing diet and nutrition.
Postpartum
During pregnancy, the female body undergoes immense hormonal, physical and emotional changes. For some women who are expecting, the transition can bring feelings of happiness, joy and love, but also anger, sadness or anxiety. This is normal and it's important to get help from family members or her doctor and/or mental health professionals if the new mother is struggling.
It's exciting to have a baby and it can also be overwhelming but a new mom should not feel like she must do it all alone. Finding the right balance is challenging, but it can be made easier by allowing yourself the time to rest, taking enough sleep and eating healthy. It is also essential to go to your postpartum checkups as they will be able to detect any issues that could be developing early on.
The "baby blues" is a term used to describe a brief period in which some women experience depression or anxiety following the birth of their child. This is a normal occurrence that usually goes away on its own within about a week. Certain people experience symptoms that are more intense and last for longer. This is known as postpartum depression, and is a medical condition that can be treated. If a woman had anxiety or depression in the past, she is more likely to develop it again after having children.
In some cases women can develop postpartum psychiasis. This can be extremely risky for both mother and child. This is a mental health issue that needs to be addressed promptly. The treatment could include a combination of therapy and medication. types of adhd medication with experience in this illness can be very helpful. If the symptoms are severe, electroconvulsive therapy (ECT) may be recommended.
If a mother experiencing postpartum psychosis, the doctor will probably prescribe an antipsychotic medication like lithium or valproate as well as a mood stabilizer like citalopram. They may also recommend cognitive behavioral therapy to treat the root causes. Tricyclic antidepressants, such as nortriptyline and imipramine are often prescribed, but they can have serious adverse effects. They are usually only prescribed after other treatments have failed.
Adolescence
Adolescence is a crucial time for physical, cognitive and psychosocial growth. It is a time of transition from dependency on parents to independence in making decisions and acting in the world around them. Adolescents become interested in expanding their social circle beyond their immediate family members to include their peers, friends, and acquaintances. Their social networks could also include people from team activities, student organizations, or jobs.
In adolescence, the biological changes in brain connectivity and structure interact with increasing knowledge, experience and the changing demands of society, resulting in rapid cognitive growth. This includes improvement in divided and selective attention (the ability to concentrate on a variety of stimuli simultaneously), working memory and long-term memory. Furthermore, the ability of adolescents to think abstractly and morally also improves.
These cognitive changes are associated by hormonal changes, which makes adolescents more drawn to exciting and new experiences. Their hormones also make them seek out experiences that make them more attractive to other individuals. This desire to experience new things can be used to gain positive results like taking part in an upcoming school play or getting involved in a volunteer activity for the community. It can be used to take a healthy risk in investigating sexuality or other risk-taking behaviours, provided they are in a supportive and secure environment.
The various rates of physical growth can cause awkward stages in adolescence and anxiety or self-consciousness about their body changes. In certain cultures, such as those of Aboriginal or Torres Strait Islander, adolescence can be a time where young people are able to establish their identity in relation with their clans, their families and their countries as well as their ancestors and their country.
Relationships between teens and their friends can be a source for support or conflict. These relationships are essential for the health of adolescents and can significantly impact their happiness and wellbeing. The relationships between adolescents and parents can be a great source of assistance for them, especially when they can solve problems in a non-confrontational fashion.