Using Adderall while pregnant and breastfeeding? I’ve talked with my OB, and she says it’s okay if that’s my decision. But the stigma around it… makes me feel like I’m doing something wrong? But I’m seriously impacted, and that displays as anxiety and depression. I feel like I’ll be a safer mom taking it. What does the data say?—Mary
I’m glad you asked this, because I think your feeling is a common one (around this and other medications, largely for mental health). On one hand, there are such clear reasons to take the medications for your own well-being. On the other hand, there’s a stigma — a feeling that somehow doing this is a sign of weakness.
We’re not always able to speak to these questions with data, but here we can do so, at least to some extent. The big concern about the use of these medications in pregnancy, in particular, is a worry about birth defects, especially with early-trimester exposure. In 2017, researchers published an enormous study looking at possible links between this type of medication and birth defects. The study exploits data on almost 2 million pregnancies in the U.S. and 2.5 million in Norway.
The researchers look at the relationship between taking ADHD medications in early pregnancy and birth defects, both overall and for cardiac defects in particular.
What they find is that for the amphetamine drug class, which includes Adderall, there is no relationship between medication usage and either of these outcomes. (Their data does point to a small, marginally statistically significant relationship between cardiac malformations and use of the related class of drugs called methylphenidates; an example is Ritalin. For this reason, Adderall would usually be the first drug prescribed in pregnancy.)
These medications are generally thought to be quite safe in breastfeeding, passing through at only low concentrations.
Overall, ultimately it is your choice, but the data is very reassuring.