ADHD Medication and Pregnancy
Psychiatrists are often approached by women who are trying for an infant or are expecting and are concerned about the consequences of their ADHD medication. There's good news: Research suggests that, on balance, it is safe to continue taking stimulant drugs during pregnancy.
The results are based on naturalistic studies with a large number of exposures to the first trimester.
Pregnancy
Women are thrilled about the having a baby and expecting babies however, they are concerned about how their ADHD medication affects their child's future. These medications are known to have teratogenic effects and some physicians recommend patients to stop taking their medication when trying to conceive or during the first trimester of pregnancy. However, many people suffering from ADHD require the benefits of their medication to be able to function in their daily lives and may be unable to function without it during this time.
A recent Danish study found that exposure to methylphenidate within the first trimester (in the form a redeemable medication) did not seem to increase the risk of major malformations when compared with the control group who didn't receive redeemed medications in the first trimester. The study used registry-based information from various Danish databases to determine the number of pregnant women and their medication history prior to and during pregnancy, including information on whether the woman was treated for ADHD.
The researchers monitored a total of 898 babies born to mothers who were exposed to methylphenidate and other stimulants in the initial trimester of pregnancy. They were compared to 1,270 babies who were part of the group that did not receive methylphenidate or any other stimulant medication in the first three months of pregnancy.
Both groups of infants were assessed for neurodevelopmental disorders of the psychiatric kind as well as other neurodevelopmental impairments, growth impairments, and fetal heart issues (such as gastroschisis, omphalocele, or transverse limb deficiency). The results revealed that babies of women exposed to methylphenidate while in utero did not have increased rates of any of these conditions contrasted with the control group. This was true for the first and second pregnancy trimesters.
This is a promising study that could provide comfort to pregnant women who use ADHD medication and may need or want to continue their treatment throughout pregnancy. This study did not assess the impact of lifestyle changes or other medications on the pregnant fetus. Other studies have shown a link between stimulant medication and adverse pregnancy outcomes such as a caesarean birth or the baby needing assistance to breathe during birth.
Breastfeeding
Even when women who suffer from ADD or ADHD require medication to control their symptoms, they realize that breastfeeding is beneficial for their child. It is essential that the mother and child are well-nourished. Therefore, the decision to breastfeed or use ADHD medication should be taken in consultation with a medical professional. The most recent guidelines and evidence1 suggest that women do not need to stop breastfeeding to take her prescribed medications. Multiple studies have shown that the neurodevelopmental effects on the infant's health in the long run are not significant when a mother is taking her ADHD medication according to the prescription.
Stimulants such as methylphenidate and dexamfetamine are commonly used to treat ADHD. They are available in immediate-release form that lasts up to four hours and extended-release versions that are taken once a day in the morning and may last up to 16 hours. Many people with ADD or ADHD find that the best way to manage their symptoms is to take an extended-release medication with an immediate-release pill in the evening or afternoon.
Some medications, such as Clonidine, reduce prolactin production and are incompatible with breastfeeding. Some people suffering from ADD or ADHD aren't ready to stop breastfeeding due to this reason. They decide to switch their medication to another stimulant or non-stimulant like atomoxetine or guanfacine. These drugs have lower RIDs and are more likely to be covered by the Pharmaceutical Benefits Scheme. If you're thinking of changing your medication during pregnancy or nursing it is essential to consult an GP or specialist. They can give you advice on the safest medications and ways to monitor your infant's growth and weight. The doctor or specialist can also help with the referral to a psychologist or psychiatrist to receive additional assistance. They may also refer you a dietitian to assist with managing diet and nutrition.
Postpartum
During pregnancy, the female body undergoes massive emotional, physical, and hormonal changes. For some women, the transition to parenthood can be a time of great happiness, joy and love, but also anger or sadness. This is normal, and it's essential to seek support from relatives or her doctor and/or mental health experts if the new mom is experiencing difficulties.
It can be exciting to have a baby and it can also be overwhelming but a new mother should not feel like she has to do everything alone. Finding the right balance is challenging, but it is possible to help by allowing yourself to relax, sleeping enough and eating properly. You should also go to your postpartum check-ups, as they can spot any potential issues early.
The "baby blues" is an expression used to describe a brief time in which some women feel depression or anxiety following the birth of their baby. It is a common occurrence that tends to go away on its own within a week or so. Certain people experience symptoms that are more intense and last for longer. This is referred to as postpartum depression, and is a condition that can be treated. If a woman has experienced anxiety or depression before the birth of her child, she is at a greater chance of developing it again following the birth of her child.
In rare instances, women may develop postpartum psychiasis. This can be extremely hazardous for both mother as well as child. This is a psychiatric crisis which should be treated as soon as possible. The treatment can include combination of therapy and medication. A therapist with experiences with this condition can be extremely helpful. If the symptoms are severe, electroconvulsive therapy (ECT) may be recommended.
In the case of postpartum psychiasis that affects a mother, her doctor is likely to prescribe an antipsychotic like lithium or Valproate along with a mood stabilizer like citalopram. They may also suggest the use of cognitive-behavioral therapy to help with the root causes. Tricyclic antidepressants like nortriptyline or imipramine are often utilized, but they can also have adverse side effects that are difficult to manage and are typically only prescribed when other medications have not been effective.
Adolescence
Adolescence is a crucial period of physical, cognitive and psychosocial growth. Adolescence is a period of rapid growth in terms of physical, cognitive and psychosocial development. Adolescents begin to take an interest in expanding their social circle from just their family, to include friends, peers and acquaintances with whom they spend a lot of time at school or in other activities. Their social circle could also include members of student organizations as well as team sports or jobs.
In adolescence, the biological changes in brain structure and connectivity can be correlated with increased experience, knowledge and changing social demands to trigger rapid cognitive growth. This includes improvements in selective and divided focus (the ability to concentrate on several stimuli at the same time), working memory, and long-term memory. Furthermore, the ability of adolescents to think abstractly and morally also improves.
These cognitive changes are accompanied with hormonal changes, which makes adolescents more drawn to novel and intense experiences. Their hormones also force them to seek out experiences which will elevate their status to other individuals. managing adhd without medication toward new experiences can be utilized in positive ways for example, by trying out for an upcoming school play or getting involved in a volunteer activity for the community. It is also a good way to take healthy risks for example, like exploring sexual activity or other risky behavior when they are in a safe and supportive environment.
The various levels of physical growth could result in awkward stages of adolescence and feelings of self-consciousness or anxiety about their body changes. In certain cultures, like those of Aboriginal or Torres Strait Islander, adolescence can be a period when young people find their place within their families, clans and their communities, their ancestors, and their country.
Teens' relationships with friends can be a source of comfort or conflict during this time. The quality of these relationships is important to the health of adolescents and is an important factor in their happiness and well-being. The relationships between adolescents and their parents can be a wonderful source of support for them, especially when they are able to resolve issues in a non-confrontational way.