If you take ADHD medication and you are pregnant, or hoping to be, one of the first questions is whether you can keep taking it. There is no single answer that suits everyone. It depends on which medicine you take, how much it helps you, and what life looks like without it.
This guide explains what UK sources say about the main ADHD medicines in pregnancy and breastfeeding, what the research shows, and how to plan the decision with your prescriber. It is general information, not a substitute for advice about your own treatment.
Do not stop or reduce your ADHD medication on your own. Speak to your prescriber, GP or midwife first.
The short answer
Some people stop ADHD medication during pregnancy, and some continue. Both can be reasonable. The UK's Best Use of Medicines in Pregnancy (bumps) leaflets say that if your ADHD is well controlled on a medicine, it may be better to stay on it than to stop and risk a relapse. They also advise against stopping without speaking to your GP or specialist, because symptoms can return and stopping suddenly can cause withdrawal effects.
The aim is a planned decision, made with your prescriber, that weighs the possible risks of the medicine against the effect of untreated ADHD on you, your work, your safety and your pregnancy.
If you are planning a pregnancy
The best time to talk about ADHD medication is before you conceive. Bumps advises anyone planning a pregnancy to ask their GP or specialist whether their current medicine is still the best option. The NHS also advises telling your doctor if you are trying to get pregnant, as they may want to review your treatment.
A planning conversation usually covers:
- how much the medicine helps you day to day, and what happened during any past breaks
- whether a different medicine has more pregnancy safety information
- whether you could manage some or all of the pregnancy without medication, and what extra support you would need
- what to do if you become pregnant before you have made a plan
If you are not yet diagnosed or treated, our guide to deciding whether to take ADHD medication covers the wider question.
If you find out you are pregnant
Many pregnancies are unplanned. If you discover you are pregnant while taking ADHD medication, bumps advises arranging to be seen as soon as possible by your GP or specialist. In the meantime, do not simply stop. Tell your midwife which medicine you take so it can be considered in your antenatal care.
What the evidence shows for each medicine
The UK Teratology Information Service publishes patient leaflets through bumps. This is what they say about the main ADHD medicines.
Methylphenidate (for example Concerta XL, Medikinet, Equasym)
- Most babies exposed to methylphenidate in the womb do not have a birth defect.
- Some studies have suggested a higher chance of miscarriage and some types of heart defect after use in early pregnancy. It is uncertain whether this is caused by the medicine or by other factors more common in people who take it.
- Use in later pregnancy has been linked to a smaller baby, so extra growth scans may be offered.
- Taken in the weeks before delivery, it can cause short-term withdrawal symptoms in the newborn, so your baby may be checked after birth.
The NHS says methylphenidate is not often taken in pregnancy because there is not much information about its safety, and that some people decide the benefits outweigh the possible risks.
Lisdexamfetamine and dexamfetamine (for example Elvanse or Amfexa)
- Use in pregnancy is not known to cause birth defects.
- Use in later pregnancy may affect blood flow through the placenta, which could increase the chance of a low birth weight.
- A slight increase in stillbirth has been seen in some studies but not others, possibly linked to pre-eclampsia. Stillbirth remains rare.
- Use around the time of delivery can cause short-term withdrawal symptoms in the newborn.
If you are weighing these two medicines more generally, our comparison of Elvanse and Concerta explains how they differ.
Atomoxetine
- It is not thought to cause birth defects, although more research is needed to confirm this.
- Taken in the weeks before delivery, it may cause short-term withdrawal symptoms in the newborn.
- Bumps notes it may occasionally be used in pregnancy when symptoms cannot be treated another way.
Whichever medicine you take, routine antenatal care includes a detailed anomaly scan at around 20 weeks. Bumps says extra monitoring for birth defects is not usually needed after these medicines.
What the large studies found
Two large studies are often quoted, and both are easy to overstate.
Birth defects. A study of more than 4 million pregnancies in the United States and the Nordic countries (Huybrechts and colleagues, 2018) suggested a small increase in the risk of heart defects with methylphenidate in early pregnancy, but not with amphetamines. In the US data, heart defects were recorded in about 19 per 1,000 babies exposed to methylphenidate, compared with about 13 per 1,000 unexposed babies. After adjusting for other factors, this was about a 28% relative increase, and the result was not statistically certain. The authors described it as a small increase.
Child development. A separate US study of around 4.3 million pregnancies (Suarez and colleagues, 2024) looked at autism, ADHD and other neurodevelopmental conditions in children exposed to stimulants in the womb. Once the researchers accounted for other factors, including the parent's own ADHD, they concluded that exposure is not likely to meaningfully increase the risk.
Neither study can tell you what is right for you. They are part of the picture your prescriber will weigh.
The risks of stopping
Stopping medication is not automatically the safe option. Pregnancy and a new baby bring more demands on memory, organisation and sleep, which ADHD can make harder. Untreated symptoms can make it harder to keep appointments, manage work and look after yourself.
If you do stop, plan it. Agree with your prescriber how to come off the medicine, what support you will use instead, and when to review the decision. Practical strategies, talking therapies and help from family can all fill some of the gap. Our article on CBT for adults with ADHD explains one non-medication option.
ADHD medication and breastfeeding
The NHS says that if your baby is healthy, you can take methylphenidate while breastfeeding, as only tiny amounts pass into breast milk. The Breastfeeding Network describes methylphenidate as the stimulant of choice while breastfeeding.
The Breastfeeding Network notes that there is less research on lisdexamfetamine, dexamfetamine and atomoxetine in breastfeeding. That does not always mean you have to choose between breastfeeding and treatment, but it does mean the decision should be made with your prescriber, taking your baby's age and health into account. Whatever you take, watch for changes in your baby's feeding, sleep or weight, and contact a healthcare professional or call 111 if you are worried.
After the birth
The weeks after birth can be hard with ADHD: broken sleep, a new routine and little time to plan. If you stopped medication, agree in advance when you will review restarting it. If you are restarting or changing medicine, your prescriber may want to titrate the dose again. Our guide to ADHD and sleep may also help.
Who to talk to
- Your prescriber. The specialist who manages your ADHD medicine is best placed to review it.
- Your GP. If you are on a shared care agreement, your GP may prescribe your medicine and should know about the pregnancy.
- Your midwife. Tell them which medicine you take at your booking appointment.
- Your pharmacist. They can answer questions about your specific medicine.
If you have suicidal thoughts or feel unable to keep yourself safe, call 999 or go to A&E. For urgent help that is not an emergency, call NHS 111.
Frequently asked questions
Can I take ADHD medication while pregnant?
Some people do, after discussing it with their prescriber. UK pregnancy medicine leaflets say that if ADHD is well controlled on a medicine, staying on it may be better than stopping and risking a relapse. The decision is individual.
Should I stop my ADHD medication as soon as I find out I am pregnant?
No, not on your own. Contact your GP or specialist as soon as possible. Stopping suddenly can bring symptoms back and some medicines can cause withdrawal effects.
Is methylphenidate safe while breastfeeding?
The NHS says you can take methylphenidate while breastfeeding if your baby is healthy, because only tiny amounts pass into breast milk. Keep an eye on your baby's feeding, sleep and weight.
Does ADHD medication affect fertility?
The NHS says there is no evidence to suggest that methylphenidate affects fertility in men or women. Ask your prescriber about other ADHD medicines, and tell your doctor if you are trying to conceive so they can review your treatment.
Conclusion
There is no one right answer about ADHD medication in pregnancy. What matters is that the decision is planned, based on good information and made with your prescriber, rather than made alone in a hurry. A clear plan, covering pregnancy, birth and the months after, can make the whole period easier to manage.
Read more about our ADHD medication service, or contact our team if you would like to talk through your treatment.
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