Is Adderall safe during pregnancy?

What does the evidence say about Adderall during pregnancy?

1. Studies of people who take dextroamphetamine-amphetamine as prescribed have not shown an increased chance of birth defects, and studies of prescribed amphetamines have not shown a consistent increase in miscarriage. 1
2. Prescribed dextroamphetamine-amphetamine may increase the chance of pregnancy-related problems such as poor fetal growth, low birth weight, or preterm delivery, while newborn withdrawal has not been reported at prescribed doses. 1
3. No increased malformation risk appeared with first-trimester amphetamine exposure across 1,813,894 US pregnancies, at a relative risk of 1.05 for any malformation and 0.96 for cardiac malformations, while methylphenidate carried a small cardiac signal with a pooled relative risk of 1.28. 2
4. ADHD is a neurodevelopmental condition whose symptoms begin in childhood and usually continue into the teen years and adulthood, which is why so many people reach pregnancy already taking a stimulant. 3
5. Weighing the safety and effectiveness of psychiatric medications during pregnancy and lactation is the explicit purpose of ACOG's clinical practice guideline on mental health conditions in pregnancy and postpartum. 4

Is Adderall safe in each trimester?

• First trimester. First-trimester amphetamine exposure showed no increased malformation risk in a cohort of 1.8 million US pregnancies, with a relative risk of 1.05 for any malformation and 0.96 for cardiac malformations. Methylphenidate, a different stimulant, did show a small cardiac signal in the same analysis.
• Second trimester. Growth is the less settled question. Prescribed amphetamine use may raise the chance of poor fetal growth, low birth weight, or preterm delivery, so many clinicians add growth scans if the medication continues. Appetite suppression is worth tracking alongside your own weight gain this trimester.
• Third trimester. Withdrawal has not been reported in newborns of people who take dextroamphetamine-amphetamine as prescribed, which is a different picture from misuse. Stopping suddenly can cause withdrawal symptoms in you, so any late-pregnancy change should be a planned, gradual reduction with your prescriber.