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ADHD Medication and Pregnancy Psychiatrists are often approached by women who are trying to have a baby or are pregnant, and are concerned about the negative effects of their ADHD medication. There's good news: Research suggests that, overall it is safe to continue taking stimulant medications during pregnancy. The results are based on naturalistic studies with a large sample of first-trimester exposures. Pregnancy The birth of a baby and pregnancy are exciting times for women, however many are concerned about the effects of their ADHD medication on their unborn child. Some doctors advise their patients to quit taking stimulant drugs during pregnancy or when trying to conceive. Many people with ADHD require their medication in order to function and may struggle in this time without it. A recent study from Denmark found that exposure to methylphenidate in the first trimester (in the form of a redeemed prescription) does not appear to increase the risk of major malformations compared to a control group without prescriptions redeemed during the first trimester of pregnancy. The study utilized registry data from Danish databases to identify pregnant women and their medication history, including whether they were treated for ADHD. The researchers followed a total of 898 babies born to mothers exposed to methylphenidate or other stimulants in the initial trimester of pregnancy. They were compared to 1,270 babies who were in the control group and did not receive methylphenidate, or any other stimulant medication during the first three months of pregnancy. Both infant groups were assessed for neurodevelopmental disorders of the psychiatric kind as well as other neurodevelopmental impairments, growth impairments, and fetal heart problems (such as gastroschisis, omphalocele, and transverse limb deficiency). The results showed that infants of women exposed to methylphenidate in utero did not have higher rates of any of these conditions compared to the controls. This was true both for the first and second pregnancy trimesters. This is a good news finding that can be comforting for women who are pregnant and take ADHD medication and may need or desire to continue their treatment during pregnancy. It is important to remember that the study did not evaluate the impact of other medications or lifestyle changes on a fetus and other studies have revealed an correlation between the use of stimulant medications and adverse outcomes during pregnancy, for example having a caesarean delivery or the baby needing support to breathe at the time of birth. Breastfeeding Many women with ADD or ADHD find that breastfeeding can be beneficial for their baby, even when they need to take medication to alleviate their symptoms. The mother and child must be well-nourished. Therefore the decision about whether to breastfeed or take ADHD medications should be formulated with the help of a healthcare provider. The most current recommendations and evidence1 suggest that women do not have to stop breastfeeding to take her prescribed medications. Numerous studies have proven that long-term neurodevelopmental effects for the baby are minimal in the event that the mother takes her ADHD medication 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 come in two forms: immediate-release, which lasts up to four hours; and extended release, which is taken daily in the morning and can last up to 16 hours. Many people suffering from ADD or ADHD find the best way to treat their symptoms is to take an extended-release medication in the afternoon or evening, and then supplement it with a tablet that is immediate-release. Certain medications are not compatible with breastfeeding, such as Clonidine, which decreases prolactin secretion and decreases milk production. Some people with ADD or ADHD are not able to stop breastfeeding due to this reason and choose to change their medication to another stimulant or a non-stimulant, such as atomoxetine or guanfacine. These medications are less likely to have high RIDs and may be covered under the Pharmaceutical Benefits Scheme. It is important to speak with a GP or specialist if you are considering switching your medication during pregnancy, breastfeeding or postpartum. They can provide advice about the most secure medication and the best way to monitor your baby's weight and growth. The doctor or specialist can also help with the referral to a psychologist or psychiatrist for further assistance. They may also refer you to a dietitian for assistance with diet and nutrition. Postpartum During pregnancy, women undergo immense physical, hormonal and emotional changes. For some women, the transition to parenthood can bring big feelings of happiness, joy and love but also frustration, sadness or anxiety. This is normal and it's essential to seek assistance from relatives or her doctor, as well as mental health experts if the new mom is struggling. It's exciting to have a child, but it can also be overwhelming but a new mom shouldn't feel like she must do it all on her own. Finding the right balance can be difficult but it can be made easier by allowing yourself the time to relax, sleeping enough and eating healthy. It is also crucial to schedule your postpartum checkups since they can detect any issues that could be developing early on. The "baby blues" is the term used to describe a brief period in which some women experience depressed or anxious after the birth of their baby. This is a common condition that tends to go away by itself within a week or so. Some people experience feelings that are more intense and last longer. This is known as postpartum depression and is a condition that can be treated. If a woman has suffered from anxiety or depression in the past, she is more likely to develop it again after giving birth. In rare instances, women may develop postpartum psychiasis. This can be very risky for both mother and child. This is a mental health issue which should be treated as soon as possible. Treatment could consist of an amalgamation of medication and therapy. A therapist who has experience with this type of illness could be beneficial. If the symptoms are severe, electroconvulsive (ECT) therapy may be recommended. In the case of postpartum psychiasis that affects a mother her doctor is likely to prescribe an antipsychotic such as lithium or Valproate and a mood stabilizer such as citalopram. They may also suggest a course of cognitive behavioural therapy to address the root causes. Tricyclic antidepressants, such as nortriptyline and imipramine are occasionally used but they can have difficult side effects and are typically only prescribed when other medications haven't worked. Adolescence Adolescence is an important time for physical, cognitive, and psychosocial growth. It is a time of transition from dependence on parents to a sense of independence when 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 members of teams in sports, student organizations or jobs. During adolescence the biological changes in brain connectivity and structure occur in conjunction with the increase in experience, knowledge, and changing social demands which result in rapid cognitive growth. This includes improvements in selective and divided focus (the ability of focusing on different stimuli simultaneously) and working memory and long-term memories. Additionally, adolescents' ability to think abstractly and morally improves. These cognitive changes are coupled with hormonal changes that make teenagers more attracted to novel and intense experiences. Their hormones also prompt them to seek out experiences that increase their status in the public's eyes. This drive toward new experiences can be utilized in positive ways for example, by participating in an upcoming school play or getting involved in a volunteer activity for the community. It is also a good way to take healthy risks, such as exploring sexual activity or other risky behaviors when they are in a secure and secure environment. adhd anxiety medication differing levels of physical growth could create awkward adolescent stages and anxiety or self-consciousness about the changes in their bodies. In certain cultures, such as those of Aboriginal or Torres Strait Islander, adolescence is a time when young people are able to establish their identity in relation to their clans, their families and their communities as well as their ancestors and their country. Teens' relationships with friends can be a source of strength or conflict during this time. The quality of these relationships is important for the wellbeing of adolescents and can be a major factor in their happiness and wellbeing. Relationships between adolescents and their parents can be a wonderful source of support for them, especially if they are able to resolve issues in a non-confrontational way.
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