Adderall and Pregnancy

Adderall (amphetamine and dextroamphetamine) and Adderall XR (amphetamine-dextroamphetamine extended release) are medications that stimulate the central nervous system, affecting brain chemicals and nerves that contribute to hyperactivity and impulse control. These meds are primarily prescribed to treat narcolepsy and attention deficit hyperactivity disorder (ADHD), in order to decrease impulsiveness and improve attention span.

If you know you are pregnant or worried that you may be pregnant and are currently taking Adderall, consult your doctor right away -- Adderall is generally contraindicated with pregnancy. Early signs of pregnancy often mimic signs of an impending period and include lower abdominal cramping, spotting, breast tenderness, moodiness and a missed menstrual cycle.

The Risks

"Adderall has been shown to cause birth defects in mice, so pregnant women are advised not to use it," explains psychiatrist Eva Ritvo, M.D. "Other safer alternatives are available. Make sure you speak with a qualified physician to discuss your options."

The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify potential risks to the fetus from specific medications. "Adderall in pregnancy is a class C drug because there have been no studies directly in humans, but it has adverse effects in lab animals," says board-certified obstetrician and gynecologist Marra Francis, M.D. Category C is often assigned to medications that have not been studied in pregnant women but appear to cause detriment to the fetus in animal studies.

Adderall was shown to cause birth defects and increased miscarriage in lab mice, as well as disordered brain chemical function resulting in long-term memory problems. Additionally, it has been retrospectively found to cause premature birth, low birth weight and a chemical withdrawal syndrome in newborns whose mothers used the drug long-term while pregnant, according to Dr. Francis. Animal studies have also found that prenatal exposure to amphetamines can have long-term behavioral effects, including learning difficulties and memory deficits.

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How to Proceed

"For drugs like Adderall, I see if the patient can function without the medication and if the answer is yes then we stop use in pregnancy," says Dr. Francis. "If they can't, then we discuss potential effects to the baby and how to best monitor for negative effects in the pregnancy. For example, growth scans to assess fetal weight, non-stress tests to assess fetal well-being, etc. As with any Class C drug, it should be used if the benefit to the mom outweighs the risk or potential risk to the fetus."

If you have decided to stop taking Adderall in pregnancy but are worried about how to cope with your ADHD, there are other alternatives to try throughout pregnancy that you should discuss with your doctor.

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Other Options

"Antidepressants can be used during pregnancy to treat ADHD if the benefits outweigh the risks," suggests Dr. Ritvo. There are also ways to care for ADHD that do not involve prescription drugs. "Non-pharmacologic ways of treating ADHD include exercise and psychotherapy and can be effective in treating the disease if medication needs to be avoided," Dr. Ritvo says. Other non-pharmacologic activities to help with relaxation and concentration include massage and meditation, which may relieve some ADHD symptoms as well as help you through your pregnancy and labor.

Adderall is not recommended to breastfeeding mothers, since the drug can be passed to your newborn via breast milk.