Took Adderall Before You Knew You Were Pregnant?

What does the evidence say about took Adderall before you knew you were pregnant during pregnancy?

1. Most studies suggest that taking dextroamphetamine or amphetamine during the first trimester does not increase the chance of birth defects, against a background rate of about 3 out of 100 pregnancies having a birth defect regardless of exposure. 1
2. In a cohort of 5,571 pregnancies with first-trimester amphetamine exposure, the adjusted relative risk for any congenital malformation was 1.05, and for cardiac malformations specifically was 0.96, neither meaningfully different from an unexposed pregnancy. 2
3. A study of more than 7,000 pregnancies where the mother was prescribed dextroamphetamine-amphetamine in the second half of pregnancy found no increased chance of neurodevelopmental conditions, including autism and ADHD, in the child. 1
4. Stopping this medication suddenly can cause withdrawal, and it isn't known if or how that withdrawal might affect a pregnancy, which is why guidance favors talking with a healthcare provider before making any change rather than stopping abruptly. 3
5. Untreated ADHD during pregnancy has its own risks, including higher rates of prenatal stress, inadequate prenatal care, and postpartum depression, part of why guidance favors weighing those risks against medication risks rather than defaulting to stopping medication. 4

Is took Adderall before you knew you were pregnant safe in each trimester?

• First trimester. This is the window most people mean when they say they took Adderall before knowing they were pregnant, often because a positive test doesn't show up until 4 to 6 weeks along. In a cohort of over 5,500 pregnancies with first-trimester amphetamine exposure, the adjusted risk of any birth defect wasn't meaningfully different from an unexposed pregnancy.
• Second trimester. If you're still taking Adderall now that you know you're pregnant, don't stop on your own: sudden discontinuation can cause withdrawal, and it isn't known how that might affect a pregnancy. This is a conversation for your prescriber, who can weigh the benefits of managing ADHD against any risks.
• Third trimester. A study following over 7,000 pregnancies where Adderall was prescribed in the second half of pregnancy found no increased chance of neurodevelopmental conditions like autism or ADHD in the child, one more data point for an ongoing conversation with your provider about continuing into delivery.