The safety of stimulant medications on the developing baby during pregnancy is unknown because pregnant women are often excluded from clinical trials that study the effects of medication on them. The effects of medications used in pregnancy depend on many factors, such as:

• How much medication is taken (sometimes called the dose)
• When during the pregnancy the medication is taken
• Other health conditions a woman might have.
• Other medications a woman takes

Stimulant medications, such as amphetamines like Adderall or methylphenidates like Concerta, Ritalin LA and Metadate CD, are all considered “Category C” medications.  This means that studies of animals exposed to these medications have shown a negative effect on their developing pups, but there are no adequate and well-controlled studies in humans to allow healthcare providers to make conclusions about the effects of these medications on human pregnancies. A Category C label also means that the benefits of using these medications during pregnancy may be acceptable despite its potential risks.

This is why it’s important for all women to talk with their doctor if they are pregnant or are planning a pregnancy and are using any medications. Together you can weigh the risks and benefits of managing your ADHD with the potential risks of using the medication during pregnancy.

If you are thinking about getting pregnant, or are already pregnant and taking medication to treat your ADHD, here are some important questions to consider that you may wish to discuss further with your doctor:

• What are the risks associated with taking stimulant medications during pregnancy?
• Should I discontinue stimulants before becoming pregnant?
• Should I discontinue stimulant medication during the first 3 months of pregnancy?
• Should I discontinue stimulant medication during my entire pregnancy?
• What are the risks both to me and my developing baby if my ADHD goes untreated?
• Are there risks to my baby if I stop using my stimulant medication?
• If I decide to stop using medication, how can I stop safely?
• Are there other medications used to treat ADHD that are safer in pregnancy?
• Are there treatments for ADHD that do not include medication that might be helpful?

Lists of safe medications during pregnancy

Many Internet websites post lists of medications that are safe to take during pregnancy. But for many of the medications listed, there is not enough known to determine their safety or risk for use during pregnancy. Don’t make decisions about medication use during pregnancy based on lists you find online. Instead use the lists as a starting point to talk with your doctor. Don’t stop or start taking any type of medication that you need without first talking with a healthcare provider. A conversation with a healthcare provider can help ensure that you are taking only what is necessary.

Accidental exposure

Sometimes women take medication before they realize that they are pregnant. When this happens, they may worry about the effects of the medication on their unborn baby. The first thing a woman who is pregnant or who is planning on becoming pregnant should do is talk with her healthcare provider. Some medications are harmful when taken during pregnancy, but others are unlikely to cause harm.

Non-medication treatments for ADHD

When discussing your ADHD treatment plan with your doctor you may wish to inquire about non-medication treatments for ADHD that might be suitable before or during pregnancy in addition to medication, or in lieu of medication. You may wish to discuss non-medication treatments with your doctor such as:

• Cognitive Behavioral Therapy
  Effective cognitive-behavioral treatments have been developed specifically for ADHD that aim to help people develop their executive skills, including time-management, organization, and planning, and can be provided in a group setting or individually.  Read more about cognitive-behavioral therapy for adults with ADHD.
• Coaching
  Coaching helps adults to manage their behavior in all areas of their lives, while having accountability and support from their coaches to help them follow through with their plans. Coaches use question and answer to help you set realistic, specific goals, develop action plans and decided on what helps and what gets in the way of you reaching your goals. Read more about coaching for adults with ADHD.

Further Information on pregnancy and medication:

Treating For Two is CDC’s initiative to improve the health of women and babies by working to identify the safest treatment options for the management of common conditions before and during pregnancy.

MotherToBaby provides information, in English and Spanish, for women and healthcare providers on the risks and safety of taking medication during pregnancy and breastfeeding. To speak with an OTIS counselor, you can call 1-866-626-6847.

LactMed is a database of medications that women might be exposed to while breastfeeding. The database is hosted by the National Library of Medicine. It contains information about the medication, ways it might affect the mother or baby, and potential alternatives to consider.