Understanding ADHD Medications and Pregnancy: What You Need to Know

Last update: August 23, 2024 | 3 min read

For women with Attention-Deficit/Hyperactivity Disorder (ADHD), managing symptoms during pregnancy can be challenging. Many women choose to stop their ADHD medications, especially psychostimulants, when they become pregnant. This decision often stems from a desire to avoid exposing the developing baby to unnecessary medications, especially if the woman's ADHD symptoms are mild. However, some women find that stopping their medication during pregnancy leads to a significant decline in their mental health and functioning. This concern is supported by research, which shows that discontinuing stimulant medications can lead to increased family stress and higher levels of depression during pregnancy (MGH Center for Women's Mental Health, 2021).

What Does the Latest Research Say?

A large study from Denmark provides new insights into the safety of ADHD medications during pregnancy. This research analyzed over 364,000 pregnancies that occurred between 2007 and 2014, focusing on the effects of ADHD medications like methylphenidate. The study found that 5.1% of pregnancies exposed to ADHD medications during the first trimester were associated with major birth defects, compared to 4.6% in pregnancies not exposed to these medications. Specifically, 2.1% of pregnancies exposed to ADHD medications had babies with heart defects, compared to 1.0% in those not exposed (Kolding et al., 2021).

When looking at the use of methylphenidate, the study found a slightly increased risk of heart defects, particularly a type called ventricular septal defect (a hole in the heart). However, it is important to note that the overall risk of major birth defects was not significantly higher in pregnancies exposed to methylphenidate (Kolding et al., 2021).

How Do These Findings Compare with Other Studies?

These findings align with previous research. A 2017 study in the United States looked at pregnancies exposed to ADHD medications and found a slight increase in heart defects when the data was not adjusted for other factors. However, once researchers accounted for these factors, the increased risk disappeared. The adjusted findings suggested that methylphenidate exposure did not significantly raise the risk of birth defects overall or heart defects specifically (Huybrechts et al., 2018).

What Should You Take Away from This?

The takeaway from this research is that while there may be a small increase in the risk of certain heart defects associated with methylphenidate use during pregnancy, the overall risk remains low. The most important consideration is to maintain your mental health and functioning during pregnancy, as untreated ADHD symptoms can have significant negative impacts on your well-being and your family's health.

If you are pregnant or planning to become pregnant and are concerned about your ADHD medication, it is crucial to have a conversation with your healthcare provider. Together, you can weigh the risks and benefits of continuing or adjusting your medication to ensure the best possible outcomes for both you and your baby.

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Finding Focus Care Team

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References

Huybrechts, K. F., Bröms, G., Christensen, L. B., Einarsdóttir, K., et al. (2018). Association between methylphenidate and amphetamine use in pregnancy and risk of congenital malformations: A cohort study from the International Pregnancy Safety Study Consortium. JAMA Psychiatry, 75(2), 167-175.

Kolding, L., Ehrenstein, V., Pedersen, L., Sandager, P., Petersen, O. B., Uldbjerg, N., & Pedersen, L. H. (2021). Associations between ADHD medication use in pregnancy and severe malformations based on prenatal and postnatal diagnoses: A Danish registry-based study. Journal of Clinical Psychiatry, 82(1), 20m13458.