We often focus on the rising rates of ADHD diagnoses in children, but it’s become more commonly recognized among adults, as well. As a result, more and more expectant mothers have to decide whether they should continue to take Adderall to manage their ADHD symptoms. 

In fact, according to the Centers for Disease Control the number of pregnant women taking Adderall more than doubled between 1998 and 2011. The risks they face remain largely unclear, though hopefully low. We take a look at it in more detail below.

Key Takeaways: Adderall and Pregnancy

• There aren’t many long-term or high-quality studies regarding Adderall’s effects on pregnant women.
• The information we have suggests the risk to mother and fetus when taking Adderall is quite small.
• Adderall is an amphetamine, meaning it can be dangerous and habit forming.
• Amphetamines have been found in the breast milk of nursing mothers.
• Physical dependence on amphetamines has been associated with premature delivery and low birth weight.
• ADHD can lead to risky behaviors, which can also pose a risk to a developing fetus.
• The decision to continue to take Adderall while pregnant involves weighing the risk of complications from Adderall versus the risk of complications from ADHD.

What Is Adderall?

Adderall is the brand name of a medication used primarily for treating attention deficit hyperactivity disorder (ADHD). It is made up of two different stimulant medications, amphetamine, and the slightly stronger dextroamphetamine, together technically known as mixed amphetamine salts.

Both substances are central nervous system stimulants, similar in some ways to caffeine. While it may seem counterintuitive, ADHD symptoms can be addressed by stimulants by boosting focus. 

Adderall has become one of the most common methods of treating ADHD [1]. To make it more effective, Adderall XR or extended-release was developed to allow a single capsule to last all day.

Adderall, among other sorts of ADHD medications, is also used for other reasons. The chief reason for Adderall abuse is its reputation as a smart drug. It can help focus, it’s reasoned, so it can help with other types of cognition, as well. However, it’s not quite that simple.

Approximately 30% of kids with ADHD get treated with ADHD medication alone. Although 32% receive both behavioral treatment and ADHD medication

How Does Adderall Work?

Adderall use aids focus and certain other aspects of mental health by increasing the amount of dopamine in the brain. It prompts the additional production of dopamine and prevents existing dopamine from being broken down [2]. Amphetamines can also take the place of dopamine in some reactions so that the overall level is effectively even higher. 

The way brain chemistry relates to behavior remains somewhat of a mystery. However, the ability to focus is usually related to motivation, our ability to start and continue to work on a task. In turn, that’s related to the reward pathway, which uses dopamine to give us a feeling of well-being as a method of encouragement. 

If you’ve ever wondered, “how does Adderall work,” the answer is it’s sort of like chemical encouragement, a rush of positive energy. The potential risks are generally associated with getting too much energy or having that positive boost removed after coming to rely on it.

Side Effects of Adderall

While Adderall medications stimulate your reward pathway and feelings of motivation, it also stimulates many other aspects of your body’s functioning. As a result, you may feel some undesirable symptoms, often not very serious. However, they can become more serious, even life-threatening, in some cases. 

Common side effects can include [3]:

• Increased heart rate.
• Increased blood pressure.
• Headache.
• Trouble sleeping.
• Weight loss.
• Upset stomach.
• Anxiety
• Mood swings

More serious side effects are usually associated with using higher doses, particularly when used illicitly as a cognitive aid. Serious side effects can include:

• Heart attack.
• Sudden death.
• Stroke.
• Seizure.
• Hypersensitive immune reaction.
• Behavioral changes.
• Manic or psychotic symptoms.

While an ADHD medicine, Adderall is also a powerful drug. When you stop taking it, you may experience some withdrawal symptoms. This is a particular risk with larger doses. In some cases, specifically when used outside a doctor’s care, managing Adderall withdrawal may require getting help from a qualified healthcare provider.

Symptoms of withdrawal can include:

• Fatigue.
• Sleeping too much or trouble sleeping.
• Tremors.
• Difficult moving.
• Increased appetite.
• Unpleasant dreams [4].

Finally, the Federal Drug Administration classes Adderall as a Pregnancy Category C drug [3]. Such a rating indicates that there is the possibility of adverse outcomes, but it may be worth it for expecting mothers to continue to take it in some cases.

Adderall Safety During Pregnancy

As far as we can say at the moment, ADHD medicine use may not pose a risk for adverse maternal or fetal outcomes. However, there are several factors that make judging the actual risk difficult.

Concerns were initially raised when amphetamine use led to birth defects in several animal studies. However, those effects weren’t seen when human studies were performed. 

There is a caveat there, as well. First, the studies tended to be limited in time and scope [5]. As a result, we don’t have a good idea of what the long-term effects may be. Additionally, we don’t know what effects might appear later in life, such as an increased risk of mental illness.

It’s also complex to separate Adderall use from other factors. Many women who deal with attention deficit hyperactivity disorder also struggle with anxiety and depression. An ADHD diagnosis can also mean a greater risk of postpartum depression and similar conditions [6]. The risks are similar or even greater when Adderall is abused as a study drug or otherwise.

The odds of risky decision-making are all greater, as well. All those factors can negatively impact a developing child, whether Adderall is being used or not.

Adderall and Early Pregnancy

In some ways, early in a pregnancy is the most vulnerable time for a developing fetus. However, there is no evidence that using Adderall during the first trimester is more dangerous than at any other time.

As mentioned, there hasn’t been a lot of high-quality science done on this topic. However, there have been a few rare reports of birth defects [5]. The actual risk is difficult to judge. On the other hand, taking stimulant medication such as Adderall can help manage ADHD symptoms and behaviors that increase risk in other ways. 

A health professional is the best person to help you weigh those risks and make an informed decision.

Adderall While Breastfeeding

It is well established that amphetamines will show up in breast milk [7]. Even small amounts can pose a risk to a newborn, so breastfeeding women may wish to forgo taking Adderall. It’s a difficult decision that is probably best made with the help of professional medical advice.

Do You Have To Stop Taking Adderall While Pregnant?

Each person will have to make their own decision when it comes to taking Adderall as an ADHD medication during pregnancy. On the one hand, while the risk appears to be small, there’s no way to accurately judge. On the other, ADHD is a mental health disorder, and stopping medication can pose its own risks.

One thing to keep in mind is that there are multiple treatment options to help you manage ADHD, some of which don’t involve medication. Pregnant patients may wish to investigate some of those methods of treating ADHD. Ultimately, it will come down to conversation with a healthcare professional who can help you decide if the benefits outweigh the risks.

Note that it’s only really a question for ADHD sufferers. If you’re taking Adderall as a study aid, it’s most likely best you stop taking the drug.

The use of Adderall or Adderall XR during pregnancy increased significantly between 2006 and 2013

What Happens If I Take Adderall While Pregnant?

As far as we understand it presently, the odds are that Adderall won’t cause any negative maternal and neonatal outcomes. There can be a risk when taking any medications during pregnancy. Pregnant women taking stimulants may seem like a bad idea. However, at least in the short term, the risks that come with ADHD medication use during pregnancy seem small.

If you’d like to reduce that risk to zero, you can investigate other treatment strategies. Additionally, if you’re not taking Adderall to treat ADHD, some supplements can help improve cognition without the same risks.

Common Side Effects

Dependency on a stimulant medication like Adderall has been associated with a higher risk of premature delivery and low birth weight [3]. A drug dependence like that is more likely when abusing Adderall, rather than taking it as ADHD medication.

The dangers of Adderall during pregnancy aren’t well assessed, so it’s difficult to say what a common side effect could be. There remains a risk for side effects already discussed, however.

In some animal studies, Adderall was linked to certain birth defects. The risk to humans doesn’t seem to be as great [8].

Birth Defects

Selected birth defects were observed in animal studies, including spina bifida and transverse limb deficiency, which is the technical term for being born without a limb. The doses that led to birth defects were quite high, however, verging on being toxic to the mother. In other words, far more than would ever be prescribed therapeutically. 

Additionally, similar effects weren’t observed in human trials [8]. In all likelihood, the risk is probably quite low.

Adderall and Fertility

Adderall doesn’t seem to have any direct effect on fertility. It doesn’t lower sperm count or affect menstruation, as far as we know. However, both ADHD and Adderall affect behavior, which can affect your likelihood of getting pregnant or bring a baby to term.

Using Adderall outside the care of a doctor is a form of drug abuse, which as we’ve already mentioned, is associated with some poor choices. Both people with ADHD and drug abusers are more likely to make risky decisions, which can lead to a higher chance of pregnancy. It can also lead to a higher incidence of STDs and other health problems [9].

ADHD Management During Pregnancy

Managing ADHD symptoms can be difficult. Despite the possibility for increased risk in some areas, continuing to take Adderall may be the best bet. Remember that, while a pregnant woman taking stimulants may sound like a bad idea, most evidence indicates taking Adderall may not significantly affect neonatal outcomes. 

Some pregnant women with moderate symptoms of ADHD may wish to stop taking Adderall, as any risk may be too much.

Treatments that don’t involve ADHD medications during pregnancy include psychological treatments like mindfulness, meditation, therapy, and others. Their effectiveness hasn’t been well established, but they could be helpful [10].

What Can I Take Instead of Adderall While Pregnant?

Depending on your goal, there may be other options to consider. If you’ve been prescribed Adderall, there’s no real substitute and there’s no OTC Adderall equivalent. For women who use Adderall as a smart drug, however, some options worth investigating don’t pose as great a risk for premature birth or other problems.

Nootropic supplements like Mind Lab Pro or Performance Lab Mind contain citicoline, sometimes called a natural Adderall [11]. Other ingredients can also help you maintain focus or energy when you need it. 

In some cases, pregnant women may consider starting to take a smart drug, rather than continuing to use one. Women are often warned of pregnancy brain, the idea that pregnant women may have trouble with focus or memory. 

However, there’s no real evidence that pregnancy inherently leads to problems with cognition [12]. Studies have shown that, if anything, motherhood may improve some aspects of cognition. However, getting enough rest and nutrition when pregnant can sometimes be difficult [13]. Shortchanging either can negatively impact memory, reasoning, or attention.

While the risk might be lower with supplements, expectant mothers should check with licensed medical professionals before taking any supplement or medication.

FAQ

If you just want to cut to the chase, here are some answers to the most common questions.

Is It Safe To Take Adderall During Pregnancy?

The risk of taking Adderall as an ADHD medication during pregnancy seems to be pretty low. It’s impossible to say that any drug is 100% safe, however. 

Pregnant mothers with ADHD have to weigh the risks of stopping medication against the possible effect of ADHD on their child. It’s a tough choice that should be made with help from someone who can provide medical advice.

Can You Take ADHD Medication During Pregnancy?

In some cases, continuing to take Adderall during pregnancy is the best decision. Behavioral health conditions can also pose a risk to a developing child, so it can be a question of choosing the lesser of two risks.

Can Adderall Cause Birth Defects In Early Pregnancy?

As far as we know, there is little risk of birth defects due to the use of the ADHD medications like Adderall. You may actually continue to take Adderall through early pregnancy, only to discontinue its use later. Adderall can find its way into breast milk, so nursing mothers may decide to forgo their medication.

Can Adderall Cause Miscarriages?

There doesn’t seem to be a strong link between stimulant medications such as Adderall and miscarriages. Some evidence indicates there is a risk of premature delivery or low birth weight. However, that’s usually associated with mothers that are physically dependent on the drug, and therefore, probably taking larger doses.

Conclusion

Weighing risks when it comes to your child is not an easy thing to do. The fact that your own health is also at stake simply makes things more complicated. However, guidance is available from your doctor or other health care professionals. 

One decision is pretty straightforward, however. If you’re taking Adderall as a smart drug, there’s no reason to continue. While the risk may be low, there’s no real reason to take a chance.

References:

1. Louik, Carol, et al. “Increasing Use of Adhd Medications in Pregnancy.” Pharmacoepidemiology and Drug Safety, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4313616/.
2. Shoar, Nazila Sharbaf. “Dextroamphetamine-Amphetamine.” StatPearls [Internet]., U.S. National Library of Medicine, 5 June 2021, www.ncbi.nlm.nih.gov/books/NBK507808/
3. “Adderall CII.” Accessdata.gov, Federal Drug Administration, www.accessdata.fda.gov/drugsatfda_docs/label/2017/011522s043lbl.pdf.
4. “The Amphetamine Withdrawal Syndrome.” Department of Health | The Amphetamine Withdrawal Syndrome, www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-modpsy-toc~drugtreat-pubs-modpsy-3~drugtreat-pubs-modpsy-3-7~drugtreat-pubs-modpsy-3-7-aws.
5. “Use of Adhd Medicine Is Increasing among Pregnant Women.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 July 2020, www.cdc.gov/pregnancy/meds/treatingfortwo/features/keyfinding-ADHD-med-increase.html.
6. Kittel-Schneider, Sarah, et al. “Parental Adhd in Pregnancy and the Postpartum Period – a Systematic Review.” Neuroscience & Biobehavioral Reviews, Pergamon, 28 Jan. 2021, www.sciencedirect.com/science/article/abs/pii/S0149763421000166.
7. Ornoy, Asher. “Pharmacological Treatment of Attention Deficit Hyperactivity Disorder during Pregnancy and Lactation.” Pharmaceutical Research, Springer US, 6 Feb. 2018, link.springer.com/article/10.1007/s11095-017-2323-z.
8. Krista F. Huybrechts, MS. “Congenital Malformations and Methylphenidate and Amphetamine Use in Pregnancy.” JAMA Psychiatry, JAMA Network, 1 Feb. 2018, jamanetwork.com/journals/jamapsychiatry/article-abstract/2664964.
9. Soldati, Lorenzo, et al. “Sexual Function, Sexual Dysfunctions, and Adhd: A Systematic Literature Review.” The Journal of Sexual Medicine, Elsevier, 10 May 2020, www.sciencedirect.com/science/article/abs/pii/S1743609520301867.
10. Nimmo-Smith, Victoria, et al. “Non-Pharmacological Interventions for Adult Adhd: A Systematic Review: Psychological Medicine.” Cambridge Core, Cambridge University Press, 10 Feb. 2020, www.cambridge.org/core/journals/psychological-medicine/article/abs/nonpharmacological-interventions-for-adult-adhd-a-systematic-review/538F70FB89C5B687F4A75E7431E63B38.
11. Abad-Santos F, Novalbos-Reina J, Gallego-Sandín S, García AG. Tratamiento del deterioro cognitivo leve: utilidad de la citicolina [Treatment of mild cognitive impairment: value of citicoline]. Rev Neurol. 2002 Oct 1-15;35(7):675-82. Spanish. PMID: 12389156.
12. Christensen, Helen, et al. “Cognition in Pregnancy and MOTHERHOOD: Prospective COHORT Study: The British Journal of Psychiatry.” Cambridge Core, Cambridge University Press, 2 Jan. 2018, www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/cognition-in-pregnancy-and-motherhood-prospective-cohort-study/812FCA4BC00BCCC65E27715C6FB4E89E.

Prado, Elizabeth L., et al. “Associations of Maternal Nutrition during Pregnancy and Post‐Partum with Maternal Cognition and Caregiving.” Wiley Online Library, John Wiley & Sons, Ltd, 2 Nov. 2017, onlinelibrary.wiley.com/doi/full/10.1111/mcn.12546.