ADHD Does Not Take Maternity Leave

What we know about ADHD medicine in pregnancy, breastfeeding, and the first year after birth.

You are at the pharmacy counter with a refill in one hand and a positive pregnancy test in the other. You may have heard that stimulants are never allowed in pregnancy, yet stopping has made daily tasks much harder.

The answer is not a slogan. The decision depends on the exact drug, the timing, what happens without it, your health, and your goals.

Do not stop in panic. A planned pause is different from suddenly running out or stopping without support. Contact the prescriber and the clinician caring for the pregnancy so they can compare realistic choices with you.

What has changed

Use of ADHD medicine during pregnancy has grown. In one older U.S. study, reported ADHD medicine use rose from 0.2% among pregnancies with last-menstrual-period dates in 1997 and 1998 to 1.3% in 2013.[1] In Denmark, prescription fills during pregnancy rose from 0.08 per 1,000 pregnancies in 2005 to 7.71 per 1,000 in 2022.[2] These studies used different methods and populations, so the numbers should not be compared as if they came from one survey.

Stopping or reducing treatment around pregnancy is still common. In a Canadian population study of 899,679 pregnancies, 77% of people using an ADHD stimulant before pregnancy discontinued it before or during pregnancy.[3] A dispensing record does not prove someone took a drug, and a missing record does not tell us why treatment stopped.

Evidence has improved most for major birth defects and child neurodevelopment. It is thinner for miscarriage, placental outcomes, newborn effects, and breastfeeding. There is still no U.S. national, graded guideline giving a drug-by-drug ADHD plan for pregnancy and breastfeeding.[6,33] A 2024 review offers expert clinical guidance, not a formal guideline with graded recommendations.[6]

The FDA removed the A, B, C, D, and X pregnancy letters and now requires narrative pregnancy and lactation sections.[4] Current labels describe human data, animal data, clinical considerations, and gaps instead of hiding a complex decision behind one letter.

Start with the background risk

About 1 in 33 babies is born with a birth defect in the U.S. each year, before any one medicine is considered.[5] This broad surveillance measure is not identical to a study-defined major malformation in a liveborn infant.

Timing also matters. Research usually dates pregnancy from the first day of the last menstrual period, not from fertilization. The large malformation studies focus on first-trimester exposure. Studies of preterm birth or newborn effects often examine medicine continued later in pregnancy.[7-11]

Methylphenidate in pregnancy

Methylphenidate includes Ritalin, Concerta, and generics. The pivotal malformation study combined U.S. Medicaid and Nordic registry data covering more than four million pregnancies.

For methylphenidate, the adjusted study estimate did not show a clear increase in all major malformations: relative risk 1.11, 95% confidence interval 0.91 to 1.35.[7] The interval includes both a small decrease and a possible increase, so this is not proof of zero risk.

The cardiac result deserves a careful explanation. For cardiac malformations, the pooled methylphenidate relative risk was 1.28, with a confidence interval from 1.00 to 1.64. Using the authors’ illustrative baseline of about 10 cardiac malformations per 1,000 births, that models about 13 per 1,000, or roughly 3 additional cases per 1,000, with a compatible range of about 10 to 16 per 1,000.[7] That is a calculation from an adjusted relative estimate. It is not the crude difference between the exposed and unexposed groups.

Amphetamine products in pregnancy

Amphetamine products include mixed amphetamine salts such as Adderall, dextroamphetamine, and lisdexamfetamine, which the body converts to dextroamphetamine. They should not be treated as methylphenidate data.

For amphetamine products, the adjusted estimates were relative risk 1.05, confidence interval 0.93 to 1.19, for any malformation, and 0.96, interval 0.78 to 1.19, for cardiac malformations.[7] These results did not show the methylphenidate cardiac pattern, but they cannot rule out every uncommon outcome or every formulation.

A smaller 2024 Western Australian study of 547 continuers, 297 ceasers, and 844 unexposed pregnancies found no increase in severe outcomes when dexamphetamine was continued rather than ceased, but it was small and could not capture spontaneous abortions.[12] That study should not be used to claim that continuing is always better.

Blood pressure, the placenta, and preterm birth

Birth defects are only one part of the question. Blood pressure, appetite, growth, and birth timing also matter.

In a U.S. Medicaid study, early stimulant exposure as a class was associated with preeclampsia: adjusted relative risk 1.29, confidence interval 1.11 to 1.49, against a 3.7% unexposed risk.[8] Applying that relative estimate to the same baseline gives a calculated risk of about 4.8%, but that is a calculation, not an adjusted risk the study reported directly.

Continuation after 20 weeks was associated with preterm birth: 16.8% in continuers versus 11.7% in discontinuers, adjusted relative risk 1.30, confidence interval 1.10 to 1.55.[8] Those percentages are observed values. The adjusted relative risk is the better estimate once measured differences are considered.

A newer Norway and Sweden study also found a preterm-birth signal with two or more early fills, adjusted relative risk 1.29, confidence interval 1.08 to 1.53, while one or more fills gave 1.08, interval 0.93 to 1.25.[9] Signals were strongest for atomoxetine early in pregnancy and methylphenidate later. The study did not find the same clear pattern for amphetamines. This is one reason to keep drugs and timing separate.

Placental abruption and small-for-gestational-age results were less certain in the earlier study because their confidence intervals included no difference.[8] Your clinician may decide to follow blood pressure, weight and appetite, fetal growth, or other pregnancy measures. That is a monitoring plan, not a reason to change a dose on your own.

What about miscarriage?

A newer finding adds uncertainty. A 2025 Norwegian case-control study of 2,993 miscarriage cases and 10,305 matched live births found associations with methylphenidate fills, adjusted odds ratio 1.55, confidence interval 1.35 to 1.79; lisdexamfetamine, 1.81, interval 1.06 to 3.10; and atomoxetine, 2.34, interval 1.41 to 3.89.[10]

These are odds ratios, not risk ratios. The case-control design cannot tell us an absolute chance of miscarriage. Prescription fills may also mark ADHD severity, other conditions, or other medicines that were not fully measured. The finding needs replication and should be discussed, not treated as proof that the medicines caused the losses.

Newborn effects

A Swedish study of 964,734 births, mostly involving methylphenidate and combining ADHD medicines, found higher NICU admission after pregnancy exposure, adjusted odds ratio 1.5, confidence interval 1.3 to 1.7, compared with never use.[11] The estimate became smaller when the comparison group was people who used ADHD medicine before or after pregnancy rather than never.

For the prescribed stimulant evidence reviewed here, drug-specific newborn withdrawal, jitteriness, and feeding problems have not been established well enough to quote a rate. The MotherToBaby fact sheet for mixed amphetamine salts states that withdrawal has not been reported in the newborns of people who take the medicine as prescribed.[11,34,35] Tell the birth and pediatric teams what was taken and when. They can decide what observation is useful for that baby.

Zoom

What do we know about the child years later?

In a large U.S. child follow-up study of more than 4.2 million pregnancies, late amphetamine and dextroamphetamine exposure was not associated after adjustment with autism, hazard ratio 0.80, confidence interval 0.56 to 1.14, or childhood ADHD, 1.07, interval 0.89 to 1.28.[13]

For methylphenidate, the main adjusted model found childhood ADHD hazard ratio 1.43, confidence interval 1.12 to 1.82, but that association did not persist with stricter control for maternal ADHD.[13] That change matters because ADHD runs in families and is hard to separate from medication exposure.

A 2025 Swedish study of 861,650 children, using an active comparison of people who discontinued before pregnancy, found no increase in any neurodevelopmental disorder: adjusted hazard ratio 0.95, confidence interval 0.82 to 1.11. Its pooled Nordic estimate was 1.00, interval 0.83 to 1.20.[14] That pooled estimate includes an earlier Danish cohort, so it is not wholly independent replication. Separate amphetamine and atomoxetine estimates were much less precise than the methylphenidate result, and the studies did not give a clear drug-specific answer about seizures or learning disorders.[13,14]

These are observational data. They can reduce uncertainty, but they cannot prove that a medicine did or did not cause an outcome.

The other side of the decision

One study followed only 25 women through pregnancy. It found significant differences between those who discontinued medication and those who adjusted it on measures of mood and family functioning, and between discontinuers and those who maintained treatment, while ADHD symptom scores did not clearly differ. The report gives the size of those differences and their p-values but does not state which group scored better.[38] With 25 participants, it cannot prove cause or answer questions about appointments, driving, work, substance use, or parenting safety.

Tell clinicians what untreated symptoms have cost you, from crashes or job problems to mood symptoms or trouble with daily care, and what support you have. The comparison is between realistic options, not between medicine and a symptom-free pregnancy.

Postpartum mood deserves its own plan. In Swedish records covering 773,047 births, postpartum depression was diagnosed in 16.76% of women with ADHD versus 3.29% of women without ADHD during the first year after birth, a prevalence ratio of 5.09.[15] Anxiety diagnoses were also more common. This association may partly reflect other mental-health conditions and more contact with care. It does not prove that ADHD caused the depression.

A 2026 U.S. claims study of 3,676 pregnancies did not show that continuing stimulants during pregnancy prevented postpartum mental-health admissions or new mood and anxiety diagnoses after adjustment.[16] It also did not measure everyday function or ADHD symptom control. Research has not yet shown that postpartum hormone shifts directly cause ADHD symptoms to worsen.[6,15,16]

Nonstimulants need their own evidence

A nonstimulant is not automatically the lower-risk choice. Its own pregnancy and breastfeeding evidence matters.

Continue, pause with a plan, or change treatment

The realistic options are to continue, to pause with a plan, or to change treatment with the prescriber. Which options belong on the table depends on symptom severity, prior response, pregnancy timing, blood pressure, other conditions, and feeding goals.[6]

Continue: This may be discussed when benefit is clear and stopping would create important risk. The plan can name the product, the timing, other medicines, and clinician-selected monitoring.

Pause with a plan: A planned pause includes support for affected tasks, warning signs that trigger a call, and follow-up. It is not a panic stop.

Change treatment: Another formulation, a nonstimulant, or non-medication care is not automatically safer or equally effective. The reason should fit your history and that option’s evidence.

No article can choose among these paths for you. Ask the prescriber and obstetric clinician to document the shared goal, what will be monitored, and when the plan will be reviewed. Timing and dose changes require individual clinical review.

Breastfeeding is a separate decision

Pregnancy exposure and milk exposure are not the same. Milk studies often report a relative infant dose, or RID, comparing the baby’s estimated dose through milk with the parent’s weight-adjusted dose. RID describes dose transfer, not the whole safety picture. Infant age, prematurity, feeding pattern, blood levels, symptoms, milk supply, and follow-up all matter. LactMed and InfantRisk are specialist summaries, not primary studies.[21,36]

Methylphenidate: In a three-person milk series, the mean RID was 0.7%, and methylphenidate was undetectable in the infant plasma that was measured.[21,22] Other reports also found very low milk levels. The number of studied infants is small, and long-term development has not been well tested.

Amphetamine: One case at 35 mg daily produced RIDs of 1.9% to 2.1%, with measurable infant serum that fell from about 15% of maternal levels at two weeks to 5% at nine weeks.[23] This was one person treated for narcolepsy, so it is not a precise estimate for every dose or product.

Dextroamphetamine: Four dexamphetamine-treated mothers had a median RID of 5.7%, with an interquartile range of 4.0% to 10.6%. Two of three tested infants had detectable blood levels.[24] No overt short-term effects were reported, but four pairs cannot rule out uncommon or long-term effects.

Lisdexamfetamine: Lisdexamfetamine becomes dextroamphetamine in the body. A small follow-up included 6 lisdexamfetamine and 7 mixed-salt pairs, so it cannot supply a precise lisdexamfetamine-only estimate. In a reported series of 13 infants, 5 had possible adverse reactions: 1 with somnolence, 3 with crying or restlessness, and 4 with colic or constipation. All eventually had normal growth and normal developmental and quality-of-life scores. A separate 17-infant report is available only as a conference abstract.[25]

Atomoxetine: Ten atomoxetine-treated participants nursing 11 infants, including one pair of twins, had a dose-normalized mean RID of 0.19% and a modeled worst-case RID of 0.65%. Infant serum was not measured and long-term outcomes remain unknown.[26,27]

Other nonstimulants: No published human milk level or infant-effect data were found for guanfacine.[28] Clonidine reaches milk at about double the simultaneous maternal serum concentration, infant serum averages about half the maternal level, and one case described drowsiness, low muscle tone, and suspected seizures.[29] Viloxazine has short milk-transfer data but no infant outcomes.[19,30] Bupropion usually produces low milk exposure at doses up to 300 mg daily, but two possible seizure cases have been reported in partially breastfed infants around six months of age.[31]

There are no studies of the mixed amphetamine-dextroamphetamine combination product in breastfeeding.[34] Large stimulant doses might reduce milk production in some people, especially before supply is established, but the clinical evidence is limited.[21,23-25] A pediatric clinician can help plan what to watch, such as feeding, weight gain, sleep, or unusual irritability, without assuming that every exposed baby will have a problem.

Support beyond medicine

Psychoeducation, external structure, coaching, and psychotherapy are reasonable supports, but the evidence comes mostly from adults who were not pregnant.[6] Practical examples include a shared calendar, written reminders, protected sleep, simpler meals, and help with driving or night care. These can support medicine or a planned pause.

Build the postpartum plan before delivery

ACOG recommends standardized depression and anxiety screening at the initial prenatal visit, later in pregnancy, and at postpartum visits.[32] With ADHD, ask who will screen, who will manage the ADHD medicine, and whom to call if sleep, mood, anxiety, or daily function changes.

No pregnancy-specific study found in this review measured whether treatment prevents driving crashes after birth. Still, do not drive if you feel too sleepy or unfocused to drive safely. Arrange another driver and contact your clinician if this is new or worsening.

Before delivery, write down:

• who prescribes the ADHD medicine and who covers after hours;
• whether the obstetric team wants blood-pressure, growth, or other follow-up;
• what the birth team should know about later-pregnancy exposure;
• who will protect at least one reliable block of sleep;
• when mood and anxiety screening will happen;
• when feeding and infant weight will be checked if breastfeeding; and
• when the whole plan will be reviewed after birth.

Questions for the prescriber and obstetric clinician

• What exact benefit are we trying to preserve, and what happened during past pauses?
• Which findings apply to my exact medicine and pregnancy timing?
• Do my blood pressure, appetite, other medicines, or pregnancy history change the plan?
• If we plan a pause or change, what support and follow-up make it a real plan?
• What symptoms deserve a same-day call, and where should I go after hours?

Questions for the baby’s pediatric clinician

• What do we know about this exact medicine in milk?
• Does prematurity or the baby’s health change the discussion?
• When will feeding, sleep, behavior, and weight be checked?
• Whom should I call if the baby is not feeding, gaining weight, or sleeping as expected?

If symptoms become urgent

If you have thoughts of suicide or of harming yourself or someone else, this needs assessment the same day, not at the next routine visit. ACOG advises clinicians to assess suicide risk immediately when someone answers yes to a self-harm screening question, and then to arrange care matched to that risk.[32] Call or text 988, the Suicide and Crisis Lifeline, any time. If anyone is in immediate danger of harm, call 911.[39]

Frequently asked questions

I took Adderall before I knew I was pregnant. Did I cause a birth defect?

The large first-trimester study did not find an adjusted increase in overall or cardiac malformations with amphetamine exposure.[7] That cannot promise an outcome for one pregnancy, but it is different from saying that any exposure is known to cause a defect. Tell the pregnancy clinician the product, dose, dates, and other exposures. Evidence about nonmedical methamphetamine use is not a substitute for evidence about prescribed amphetamine medicines, and taking amphetamine medicines at higher doses or more often than prescribed carries its own risks to fetal growth and birth timing.[34]

Does the methylphenidate cardiac finding mean my baby has a 28% chance of a heart problem?

No. The 1.28 result is a relative risk, not a 28% absolute chance. Using the study authors’ illustrative baseline, it models about 10 cardiac malformations per 1,000 births without exposure and about 13 per 1,000 with exposure, with substantial uncertainty.[7]

Is a nonstimulant always safer in pregnancy?

No. A nonstimulant is not automatically the lower-risk choice. Atomoxetine has growing but mixed evidence, while guanfacine and viloxazine have major gaps.[9,10,17-20]

Should I stop my stimulant now?

This article cannot answer that for you. The realistic options are to continue, to pause with a plan, or to change treatment with the prescriber. Contact the prescriber and pregnancy clinician promptly, and do not change the medicine or dose on your own.[6]

Can I breastfeed while taking an ADHD stimulant?

The answer depends on the exact stimulant and the baby. Methylphenidate transfer is very low in the small reports available. Amphetamine and dextroamphetamine show measurable transfer and sometimes measurable infant blood levels. RID describes dose transfer, not the whole safety picture.[21-25]

Does ADHD always get worse after birth because hormones fall?

Research has not yet shown that postpartum hormone shifts directly cause ADHD symptoms to worsen. The first year can still be harder because sleep, routines, demands, depression, and anxiety all change. Plan screening and practical help rather than assuming every change is ADHD.[15,16,32]

Where to get help

• 988 Suicide and Crisis Lifeline: call, text, or chat 988, 24/7, free and confidential. For Spanish, press 2 or text AYUDA to 988.
• 911: if anyone is in immediate danger of harm.
• National Maternal Mental Health Hotline: call or text 1-833-852-6262 (1-833-TLC-MAMA), free and confidential, 24/7, in English and Spanish, with interpreters for 60 more languages. For TTY, use your preferred relay service or dial 711, then the number. This is not a crisis line.
• MotherToBaby, for medication exposure questions: 1-866-626-6847 or text 1-855-999-3525, Monday to Friday, 8am to 7pm Eastern. Available to residents of the United States and its territories.
• InfantRisk Center, for breastfeeding medication questions: 1-806-352-2519, 8am to 3pm Central.
• CHADD National Resource Center on ADHD: 1-866-200-8098, Monday to Friday, 1pm to 5pm Eastern. The center does not provide counseling, medical or legal advice, or direct referrals to specific professionals.

Related reading on NP FADY

• Was It Anxiety—or Was ADHD Missed? ADHD in Women
• The Cost of Untreated ADHD: What It Can Take From a Child, an Adult, and a Family
• Skills, Not Willpower: How CBT Helps Teens and Adults With ADHD
• Postpartum Depression Doesn’t Always Look Like Sadness
• Pregnant, Anxious, and Taking Medication: A Two-Patient Decision
• Staying Well Through Pregnancy and the Postpartum Weeks

References

1. Louik C, Kerr S, Kelley KE, Mitchell AA. Increasing use of ADHD medications in pregnancy. Pharmacoepidemiology and Drug Safety. 2015;24(2):218-220. PMID 25630904. PMCID PMC4313616. doi:10.1002/pds.3742.

2. Madsen MG, Zhu JL, Munk-Olsen T, et al. Prevalence and temporal trends of attention deficit hyperactivity disorder medication fills during pregnancy and breastfeeding in Denmark. Paediatric Drugs. 2025;27(2):233-246. PMID 39806199. PMCID PMC11829916. doi:10.1007/s40272-024-00671-5.

3. Nitschke A, Salmanpour A, Kaur P, et al. Prevalence trends and patterns of perinatal ADHD stimulant medication use in British Columbia, Canada. Pharmacoepidemiology and Drug Safety. 2025;34(4):e70129. PMID 40123051. PMCID PMC11931092. doi:10.1002/pds.70129.

4. U.S. Food and Drug Administration. Pregnancy and Lactation Labeling Final Rule. Published December 3, 2014; effective June 30, 2015. FDA page.

5. Centers for Disease Control and Prevention. Data and Statistics on Birth Defects. Updated April 21, 2026. CDC page.

6. Scoten O, Tabi K, Paquette V, et al. Attention-deficit/hyperactivity disorder in pregnancy and the postpartum period. American Journal of Obstetrics and Gynecology. 2024;231(1):19-35. PMID 38432409. doi:10.1016/j.ajog.2024.02.297.

7. Huybrechts KF, Bröms G, Christensen LB, et al. Association between methylphenidate and amphetamine use in pregnancy and risk of congenital malformations: a cohort study from the International Pregnancy Safety Study Consortium. JAMA Psychiatry. 2018;75(2):167-175. PMID 29238795. PMCID PMC5838573. doi:10.1001/jamapsychiatry.2017.3644.

8. Cohen JM, Hernández-Díaz S, Bateman BT, et al. Placental complications associated with psychostimulant use in pregnancy. Obstetrics & Gynecology. 2017;130(6):1192-1201. PMID 29112657. PMCID PMC5709205. doi:10.1097/AOG.0000000000002362.

9. Srinivas C, Karlstad Ø, Stigum H, et al. Attention-deficit/hyperactivity disorder medication use in pregnancy and risk of preterm birth. Paediatric and Perinatal Epidemiology. 2026;40(2):281-290. PMID 40364699. doi:10.1111/ppe.70031.

10. Srinivas C, Karlstad Ø, Stigum H, et al. Attention-deficit hyperactivity disorder medication use in pregnancy and risk of miscarriage. British Journal of Psychiatry. Published online November 7, 2025:1-7. PMID 41199455. doi:10.1192/bjp.2025.10467.

11. Nörby U, Winbladh B, Källén K. Perinatal outcomes after treatment with ADHD medication during pregnancy. Pediatrics. 2017;140(6):e20170747. PMID 29127207. doi:10.1542/peds.2017-0747.

12. Russell DJ, Wyrwoll CS, Preen DB, Kelty E. Investigating maternal and neonatal health outcomes associated with continuing or ceasing dexamphetamine treatment for women with attention-deficit hyperactivity disorder during pregnancy. Archives of Women’s Mental Health. 2024;27(5):785-794. PMID 38424254. PMCID PMC11405422. doi:10.1007/s00737-024-01450-4.

13. Suarez EA, Bateman BT, Hernandez-Diaz S, et al. Prescription stimulant use during pregnancy and risk of neurodevelopmental disorders in children. JAMA Psychiatry. 2024;81(5):477-488. PMID 38265792. PMCID PMC10809143. doi:10.1001/jamapsychiatry.2023.5073.

14. Bang Madsen K, Larsson H, Skoglund C, et al. In utero exposure to methylphenidate, amphetamines and atomoxetine and offspring neurodevelopmental disorders: a population-based cohort study and meta-analysis. Molecular Psychiatry. 2025;30(9):3885-3894. PMID 40148550. PMCID PMC12339372. doi:10.1038/s41380-025-02968-4.

15. Andersson A, Garcia-Argibay M, Viktorin A, et al. Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder. Journal of Affective Disorders. 2023;325:817-823. PMID 36681302. doi:10.1016/j.jad.2023.01.069.

16. Xu KY, Pappas LM, Brown TR, et al. Psychostimulant continuation and postpartum mental health in pregnant people with attention-deficit/hyperactivity disorder. Obstetrics & Gynecology. 2026;148(3):160-168. PMID 41511017. PMCID PMC12795318. doi:10.1097/AOG.0000000000006169.

17. Bröms G, Hernandez-Diaz S, Huybrechts KF, et al. Atomoxetine in early pregnancy and the prevalence of major congenital malformations: a multinational study. Journal of Clinical Psychiatry. 2023;84(1):22m14430. PMID 36652686. doi:10.4088/JCP.22m14430.

18. MotherToBaby. Guanfacine (Intuniv®, Tenex®). Updated July 1, 2025. Fact sheet.

19. DailyMed. Qelbree (viloxazine extended-release capsules), U.S. prescribing information, sections 8.1 and 8.2. Label revised January 2025; DailyMed record updated September 15, 2026. Current label.

20. MotherToBaby. Bupropion (Wellbutrin®). Updated January 1, 2026. Fact sheet.

21. National Library of Medicine. Methylphenidate. Drugs and Lactation Database (LactMed), NBK501310. Last revised August 15, 2025. LactMed record.

22. Hackett LP, Kristensen JH, Hale TW, Paterson R, Ilett KF. Methylphenidate and breast-feeding. Annals of Pharmacotherapy. 2006;40(10):1890-1891. PMID 16940409. doi:10.1345/aph.1H159. Published as a letter.

23. National Library of Medicine. Amphetamine. LactMed, NBK501307. Last revised June 15, 2025. LactMed record.

24. Ilett KF, Hackett LP, Kristensen JH, Kohan R. Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder. British Journal of Clinical Pharmacology. 2007;63(3):371-375. PMID 17380592. PMCID PMC2000726. doi:10.1111/j.1365-2125.2006.02767.x.

25. National Library of Medicine. Lisdexamfetamine. LactMed, NBK501741. Last revised April 15, 2026. LactMed record.

26. Yamada E, Trehan S, Stark A, Krutsch K, Datta P. Atomoxetine as a viable ADHD treatment in breastfeeding mothers: evidence from human milk pharmacokinetic analysis. Journal of Clinical Psychopharmacology. 2026;46(1):16-22. PMID 41427840. doi:10.1097/JCP.0000000000002109.

27. National Library of Medicine. Atomoxetine. LactMed, NBK501732. Last revised June 15, 2026. LactMed record.

28. National Library of Medicine. Guanfacine. LactMed, NBK501522. Last revised November 15, 2024. LactMed record.

29. National Library of Medicine. Clonidine. LactMed, NBK501628. Last revised November 15, 2024. LactMed record.

30. National Library of Medicine. Viloxazine. LactMed, NBK588747. Last revised February 15, 2025. LactMed record.

31. National Library of Medicine. Bupropion. LactMed, NBK501184. Last revised January 15, 2026. LactMed record.

32. American College of Obstetricians and Gynecologists. Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG Clinical Practice Guideline No. 4. Obstetrics & Gynecology. 2023;141(6):1232-1261. PMID 37486660. doi:10.1097/AOG.0000000000005200.

33. Dreier JW, Bang Madsen K. Pregnancy and ADHD medications: is it time for clinical guidelines? Paediatric and Perinatal Epidemiology. 2026;40(2):291-293. PMID 40616334. PMCID PMC13010236. doi:10.1111/ppe.70048.

34. MotherToBaby. Dextroamphetamine-Amphetamine (Adderall®). Updated March 1, 2026. Fact sheet.

35. MotherToBaby. Methylphenidate. NBK582838. PMID 35952111. Updated February 1, 2026. Fact sheet.

36. InfantRisk Center. Frequently Asked Questions. Accessed September 12, 2026. InfantRisk page.

37. MotherToBaby. Clonidine. Updated April 1, 2026. Fact sheet.

38. Baker AS, Wales R, Noe O, Gaccione P, Freeman MP, Cohen LS. The course of ADHD during pregnancy. Journal of Attention Disorders. 2022;26(2):143-148. PMID 33307923. doi:10.1177/1087054720975864.

39. 988 Suicide & Crisis Lifeline, About and Contact pages; U.S. Health Resources and Services Administration, National Maternal Mental Health Hotline FAQ; CHADD National Resource Center on ADHD. All accessed September 12, 2026. 988 Lifeline.

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, or chat at 988lifeline.org, available 24/7, free and confidential. En español: marque 988 y oprima 2, o envíe AYUDA al 988. Deaf or hard of hearing: 988 videophone (ASL) or TTY 711 then 988. Veterans: 988 and press 1, or text 838255.
• Crisis Text Line — text HOME to 741741.
• The Trevor Project (crisis support for LGBTQ+ young people) — call 1-866-488-7386, or text START to 678-678.
• National Sexual Assault Hotline (RAINN) — call 1-800-656-HOPE (4673) or text HOPE to 64673; free, confidential, 24/7. Online chat at RAINN.org/hotline.
• National Domestic Violence Hotline — call 1-800-799-SAFE (7233) or text START to 88788; 24/7, help in 200+ languages. Online chat at TheHotline.org. If your phone or computer may be monitored, calling from a safer device is an option.
• Riverside County — Inland SoCal Crisis Helpline 951-686-HELP (4357), 24/7 (Inland SoCal United Way / 211+, in partnership with RUHS-BH); Community Access, Referral, Evaluation and Support (CARES) Line 800-499-3008, 24/7.
• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
• California Peer-Run Warm Line (non-crisis — someone to talk to) — call or text 1-855-600-WARM (9276); daytime and evening hours, not a 24/7 line.
• NP Fady (non-emergency) — for routine scheduling or questions, call (909) 707-6261. This line is not monitored for emergencies.