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ADHD Medication and Pregnancy Physicians are unable to provide accurate information regarding the security of ADHD medications during pregnancy. In the absence of further research, doctors must weigh the advantages and risks of using medication during pregnancy. A recent study on a population-based cohort tracked 898 infants born to women who were taking ADHD medications throughout their pregnancy (stimulants amphetamine, methylphenidate, dexamphetamine; non-stimulants: modafinil, atomoxetine, and clonidine) until they were diagnosed with a developmental disorder, or passed away or left the country. Risk/Benefit Discussion CAP Smart Take: Physicians are concerned about the long-term consequences of exposure to drugs during utero, particularly to centrally stimulating medications such as those used for ADHD. It is important that women receive proper guidance from their physicians about the dangers and benefits of taking medications during pregnancy and prior to conception. In adhd medication ritalin take we look at the most current research in this area and how they could influence clinical practices. Animal studies as well as illicit drug use research indicate that stimulant medication passes to the fetus through the placenta and may negatively impact fetal development and growth. There are few data on the effects of prescription stimulant drugs during pregnancy. The majority of the evidence comes from case-control studies using a single arm which isn't powerful enough to detect any significant associations. The study conducted by Cohen and colleagues4 is distinctive because it is the most thorough and meticulously controlled. The study included a sample of 364,012 pregnancies from the Danish Medical Registry, and information about the use of medications was gathered by analyzing prescriptions that were redeemed. Researchers excluded women who had taken SSRIs or clonidine as these drugs can interact with the fetal NMDA and increase the risk of developing neurodevelopmental disorders such as autism and ADHD. The authors also adjusted their analyses to control for possible confounding factors and to account for the timing of in utero exposure. The results of this study and other studies show that the majority of women who continue to take their stimulant medication prescribed for ADHD during pregnancy do not experience adverse effects on their fetuses. Therefore, it is likely that many pregnant women will continue to use their ADHD medication. However, it is important that physicians carefully weigh the risks and benefits of these medications for their pregnant patients, as well as be aware of the unique circumstances of each patient prior to suggesting that they stop taking their medication. No matter what decision they make, it is essential that pregnant women with ADHD educate their spouses or their partners, extended family members as well as their employers about the decision they have made. It is because the symptoms of hyperactivity, inattention, and impulsivity are likely to be re-present when the mother stops taking medication. Pregnancy Tests Preconception counseling for women suffering from ADHD who wish to become pregnant should concentrate on a comprehensive plan of management that includes both pharmacologic and behavioral treatment and ongoing monitoring throughout the perinatal period. The plan should include a discussion about the current treatment regimens, specifically in the first trimester where the risk of harming the baby due to untreated ADHD are the highest. This should be a joint effort with obstetrics, psychiatry and primary care. The discussion of the risks and benefits should also cover the way a woman plans to manage her ADHD symptoms during pregnancy, the impact of this on the family's functioning, and how she feels about discontinuing psychostimulant treatment in the early stages. This should be informed by a thorough review of evidence available, including consideration of the specific patient's needs and concerns. The authors of a huge study that examined children exposed to ADHD medications while in utero concluded that “continuation psychostimulant usage during early pregnancy did not cause adverse birth outcomes and, if anything, it was associated with lower stress levels among mothers.” However, their conclusion is not without a few limitations. The study did take into consideration other aspects, including the duration for which stimulant medication was taken as well as the dose and sociodemographics. Furthermore, there is no controlled research that evaluates the safety of continuing psychostimulant use among nursing mothers. While there is a lack of evidence-based research on the safety of ADHD medications in pregnancy, the majority of doctors are aware of what the existing research suggests and employ the best practices, in consultation with the specific needs of each patient. It is known, for example that infants born to mothers who take methylphenidate during the first trimester are more likely to have cardiac malformations (Cooper and co. 2018). However this conclusion is based on a small study that didn't consider the differences in the demographics of patients and the underlying psychiatric conditions. In an earlier survey of ADDitude readers, they found that they are more likely than ever to quit taking their ADHD medication during early pregnancy. Women who stopped psychostimulants during the first trimester showed an increase in depression symptoms. They also reported feeling less capable of enjoying their pregnancy and rated their family functioning as more difficult than those who continued or increased dosages of ADHD medication. Work Functioning Test The work functioning test is a vital component of the exam since it will determine if the patient is able to perform their duties. The test is designed to assess functional limitations and include graded material handling (lifting to different levels, pushing and pulling) and positional tolerance exercises (sitting, standing and walking, balancing or stooping, kneeling, crawling) and other relevant specialized tests (hand manipulation). The evaluator will analyze the results and come up with an appropriate return to a conclusion of the work. ROC curves are used to determine the point of minimal misclassification (MIC) for both physical and general working ability as well as the functional problem score. The MIC is calculated using the COnsensus Standards for the Selection of Health Measurement Instruments Checklist (COSMIN). This method is able to separate the scores of physical and general work abilities and work-functioning difficulties based on the answering an anchor question to prevent any change in the measurement from affecting the overall average. Driving Test The gold standard for treating ADHD is a psychostimulant drug. It eases symptoms and enhances performance in other domains, notably driving safety. Untreated severe ADHD can have severe financial and psychosocial consequences. Psychotherapeutic treatments, like cognitive behavior therapy (CBT) or “coaching” techniques have been shown by research to reduce symptoms and improve performance. These strategies can help women tailor their routines, and use their coping skills to minimize the effects of ADHD on work and other aspects. All of these factors can be crucial considerations when making the decision of whether to continue or stop psychostimulant therapy. The most reliable data suggest, even though there is some concern about pregnancy outcomes with in utero exposure to stimulant medication, the relative risks are small and the results are affected by other medication, health care utilization and physical and mental health and comorbidities. Bang Madsen K, Bliddal M, Skoglund CB, Larsson H, Munk-Olsen T, Hove Thomsen P, Bergink V. In utero exposure to attention deficit hyperactivity disorder medication and long-term offspring outcomes.