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Adderall has been a common attention deficit hyperactivity disorder (ADHD) medication for decades, but many people rely on this or other stimulant medications to boost their academic and professional performance.
If you’ve been taking Adderall and are pregnant or trying to conceive, you may be wondering if it’s safe to continue. Although it can be an effective ADHD medication, Adderall is not recommended as a performance enhancer, due to increased risks of certain adverse outcomes.
The US Food and Drug Administration (FDA) places Adderall in the Pregnancy Category C, meaning it has unclear evidence of safety in pregnant women. Research with animal models on how Adderall works has not found a significant risk of deformities with Adderall use. However, doses equivalent to those taken by humans are linked to neurological issues such as learning and motor function defects [1].
Adderall acts as a stimulant drug that increases your brain’s levels of the neurotransmitters dopamine and noradrenaline. This improves focus, motivation, and energy, and corrects the deficiency of these neurotransmitters seen in attention deficit hyperactivity disorder [2].
Besides managing ADHD symptoms, Adderall abuse is also common as a method of improving academic and professional performance.
Noradrenaline stimulates more than cognitive performance. It also increases the contraction of the smooth muscles, which are found in the body’s organs and blood vessels. In the case of blood vessels, increased contractions can mean reduced blood flow—including to your baby. Pregnancy complications seen with stimulant abuse are thought to be primarily caused by this issue [3].
Common Adderall side effects when it is taken as an ADHD medicine include insomnia, headache, and loss of appetite [4]. However, Adderall dangers during pregnancy carry extra risks.
A review of five studies found a significant, dose-dependent link between ADHD medication use and pre-eclampsia. Here, an increased risk began to appear from at least 30 days of taking Adderall. Being prescribed Adderall during the first 20 weeks of pregnancy was linked to a 33% rise in pre-eclampsia, while the risk was 44% higher with Adderall use from eight to 18 weeks [5].
The review also found a 20% higher risk of preterm birth from taking Adderall up to 20 weeks gestation. However, this was only significant with at least 90 days of drug use. They also demonstrated a 54% greater risk of placental abruption.
When it came to more absolute measurements of risk, 63 pregnant women had to take amphetamines for one case of pre-eclampsia. Other potential dangers needed over 500 women on amphetamine to find one negative outcome, including premature births. This is a much lower risk, but may be affecting hundreds of expecting mothers as Adderall use is so common.
Babies born to mothers taking Adderall to manage ADHD symptoms may show behavioral health conditions, such as agitation [1]. More serious risks of Adderall abuse during pregnancy include low birth weight and a higher chance that the baby will need intensive care after birth.
A study of 237 expectant mothers taking d-amphetamine as a weight control aid found that it led to slightly lower birth weights. There was an average decrease by 100–400 grams, depending on how much weight the mother gained during pregnancy [6].
However, there was no difference in birth weight when mothers quit before they were 28 weeks pregnant. The research also excluded women who needed amphetamines to treat ADHD.
A smaller study of 33 women found that one-quarter of babies were born weighing less than 2500 grams. Seven needed care in the neonatal intensive care unit (NICU), and two exposed infants died. These results cannot be related to amphetamine use alone, however, as a number of mothers reported abusing other drugs [6].
Additionally, an analysis of eight studies found that ADHD medication may increase the risk of a baby needing care in the NICU after birth by 88%. Compared to babies whose mothers used the drugs before or after pregnancy, the risk was 38% higher [7].
The FDA has placed Adderall in Pregnancy Category C because there is a chance it may affect fetal development. While there is weak evidence of birth defects among animal models, one report of birth defects linked to using the medication during pregnancy has been published. Here, a pregnant woman taking dextro-amphetamine sulfate gave birth to a baby with severe bone and throat deformities [1].
Larger studies don’t show a clear link between Adderall and birth defects. Research on thousands of women from the United States and Scandinavian countries suggested that amphetamine could raise the risk of birth defects by 30%. This was an absolute increase from 35 to 45 babies per 1,000 births. When these results were adjusted for factors such as psychiatric disorders, the association disappeared [8].
However, the study’s criteria only required at least one prescription in the first three months of pregnancy, and only looked at live births. Miscarriages and Adderall abuse were therefore overlooked, so it may not be relevant if you use Adderall as a study pill.
As withdrawal symptoms have been seen in babies whose mothers were taking amphetamines, it is possible for Adderall to pass through the placenta [1].
There is inconsistent evidence of Adderall causing malformations in human studies, with the FDA only describing one report where a case was likely linked to amphetamine use [1].
In the study where unadjusted results pointed to a 30% increase in birth defects, there was only an absolute rise by an extra 10 per 1,000 births. This did not hold up when the results were adjusted, so the increased risk was unlikely to be valid [8].
You may be pleasantly surprised to learn that “baby brain” isn’t unequivocally evidence-based, especially if you’ve struggled to focus under normal circumstances. Therefore, using more stimulant medication during pregnancy is not necessary.
Self-reported studies suggest issues including poor attention span, memory impairment, trouble reading, confusion, and lack of coordination. However, memory and executive function tests still showed that average scores were within the normal range, even if there was some impairment.
There is also mixed evidence for pregnancy’s impact on the development of new brain cells. Some research suggests slowed growth of new brain cells in the hippocampus (the “memory center”), others report an increase, and some have found no change.
It is possible that “baby brain” is at least partially the result of stress and an unfamiliar, busier lifestyle, too [9].
If you have ADHD, there is limited evidence as to whether or not pregnancy causes cognitive impairment. Case studies suggest that ADHD symptoms may improve during pregnancy, thanks to the rise in estrogen and progesterone. Others show that symptoms worsen when these hormones fall, such as during PMS.
With or without pregnancy, higher estrogen is associated with improved executive function. Lower estrogen is more strongly associated with worsened ADHD symptoms if you score highly on impulsivity [10].
If you are concerned about the risks of Adderall during pregnancy, you may be looking for a natural Adderall alternative. As Adderall works by increasing your levels of dopamine and noradrenaline, nootropic supplements that support the production of these neurotransmitters are best.
However, pregnancy is a critical time in your child’s development, so it is best to only take supplements under the care of a physician.
Mind Lab Pro features N-acetyl-tyrosine and Bacopa monnieri, two ingredients that may boost dopamine, as well as citicoline, a safe form of choline.
The amino acid tyrosine, as N-acetyl-tyrosine, may be efficiently converted into dopamine [11]. In a way, it is like an OTC Adderall. Bacopa monnieri is a herbal remedy that may support the balance of dopamine, serotonin, and acetylcholine, all needed for focus, motivation, and cognition [12].
Choline is used to produce both acetylcholine and cell membranes, making it necessary for healthy brain development. In fact, higher choline intakes are associated with improved cognitive development in babies [13].
Read the full Mind Lab Pro review here for more information on how it may benefit you.
Performance Lab Mind also contains citicoline and tyrosine, alongside French maritime pine bark and phosphatidylserine.
French maritime pine bark is an antioxidant, anti-inflammatory ingredient that may protect your brain [14]. Oxidative stress and inflammation may contribute to ADHD too. Therefore, antioxidant support could give this nootropic an extra edge over Adderall by targeting an overlooked underlying cause [15].
Phosphatidylserine has been specifically tested in ADHD as a potential treatment for cognitive performance. A study on children with ADHD found that it significantly improved auditory memory, inattention, and impulsivity over two months. These benefits did not come with adverse effects [16].
For comprehensive product information, read the Performance Lab review here.
If you have recently learned that you are pregnant and have been taking Adderall, it’s important to avoid going cold turkey. Abruptly stopping the drug leads to a sharp fall in dopamine and noradrenaline, as your body has established Adderall tolerance.
Going cold turkey leads to the infamous Adderall crash, which features symptoms including depression, fatigue, and insomnia. In the worst cases, mental health can decline with the development of psychosis and suicidal thoughts, putting you and your baby at even greater risk of harm [17].
The sooner you quit Adderall, the better. As written above, associations between lower birth rate and stimulants were only seen if they were taken during the third trimester, or beyond 28 weeks. The research showing a heightened risk of pre-eclampsia revealed a stronger link when the study period began at eight weeks gestation [6] [18].
In order to prevent or minimize Adderall withdrawal symptoms, a health professional can help you with tapering off the drug. They can advise you on how to gradually reduce the dose, and recommend or prescribe other medication to relieve the side effects of withdrawal.
Here are the most important things to know about taking Adderall during pregnancy.
Adderall has not been demonstrated to reduce fertility or cause harm during embryonic development. The rat models showing this safety in fertility and early pregnancy used doses five times higher than recommended in humans [1].
A 5 mg dose of Adderall is the minimum recommended dose for adults with ADHD, and half of that advised for adults with narcolepsy [6]. In these cases, you are correcting a neurotransmitter deficiency, and the minimum dose is less likely to cause adverse effects. If you have either of these conditions, seek medical advice on whether you should continue taking Adderall during your pregnancy.
Adderall does not appear to cause miscarriage. In fact, a case study of two women who had suffered multiple miscarriages in the past used dextroamphetamine sulfate as a preventive treatment for miscarriage.
Both women completed their first trimester. One woman had a successful pregnancy and birth, while the second sadly lost her baby to premature birth. Progesterone therapy was unsuccessful in both women during previous pregnancies [19].
Adderall has its place in treating ADHD but can cause adverse maternal and neonatal outcomes. These include impaired fetal growth, withdrawal symptoms after birth, and pre-eclampsia.
Although there is little evidence that the drug causes physical deformities, Adderall should not be used in pregnancy unless your doctor determines the benefits outweigh the risks. If you want to improve your cognitive performance, there are other treatment options such as nootropic supplements.
