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? However, 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.
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I’m grateful that both my Psychiatrist and OBGYN agreed that taking Vyvanse and dextroamphetamine during pregnancy was safe. I did stop postpartum for a bit while breastfeeding, but it was such a difficult time, I was grateful to go back on it. And while I’m well aware this is extremely anecdotal – my 16 month old is the most focused person I’ve ever seen and I am so looking forward to watching him progress – adhd or not!!
Is one kind of adhd medication safer than others for breastfeeding? What is the risk?
In your book, Expecting Better, you explained how alcohol metabolizes throughout your system and why one drink a day could be okay during pregnancy. Can you explain how adderall goes through your system? And is extended release adderall safer than regular adderall? Thank you.
What about adderall while trying to conceive? Is there evidence of increased of miscarriage or other issues?
This isn’t well studied, unfortunately. You could periodically check if anything new is mentioned in literature round-ups one the MGH Center for Women’s Mental Health website. They don’t have their own research projects around trying to conceive as far as I know, but they look at ADHD as well as ADHD medications and studies related to pregnancy more than most other resources I am aware of. Here is a link: https://womensmentalhealth.org/posts/category/adhd/