Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Jan;77(1):96-101.
doi: 10.1111/bcp.12138.

Methylphenidate use in pregnancy and lactation: a systematic review of evidence

Blanca M Bolea-Alamanac  1 , Amy Green, Gauri Verma, Penelope Maxwell, Simon J C Davies
Affiliations
Case Reports

Methylphenidate use in pregnancy and lactation: a systematic review of evidence

Blanca M Bolea-Alamanac et al. Br J Clin Pharmacol. 2014 Jan.

Abstract

Aims: The aims of this review were to summarize the scientific evidence about the risks of using methylphenidate for ADHD in pregnancy and lactation, to present a case in which interruption of treatment after delivery and during breastfeeding was harmful and to discuss the implications of treating or not treating ADHD in pregnancy and lactation.

Methods: For the systematic review, databases searched included Pubmed, Psychinfo, Web of Science, Embase, Biosis and Medline.

Results: Three articles were found with a total sample of 41 children exposed to methylphenidate in pregnancy. Malformations reported included congenital heart defects (n = 2), finger abnormalities (syndactyly, adactyly and polydactyly n = 2) and limb malformations (n = 1). Other problems included premature birth, asphyxia and growth retardation. One case report (n = 1) and one case series (n = 3) were identified regarding exposure to methylphenidate through breast feeding. In all cases, children developed normally and no adverse effects were reported. In our case report we describe an infant exposed to methylphenidate during pregnancy and breast feeding, who developed normally having no detectable congenital abnormalities.

Conclusions: The number and size of the studies found were small. Identified cases were not representative of the general adult ADHD population having methylphenidate as monotherapy during pregnancy as all the articles reported combinations of methylphenidate with either known teratogenic drugs or drugs of abuse. There is a paucity of data regarding the use of methylphenidate in pregnancy and further studies are required. Although the default medical position is to interrupt any non-essential pharmacological treatment during pregnancy and lactation, in ADHD this may present a significant risk. Doctors need to evaluate each case carefully before interrupting treatment.

Keywords: ADD; ADHD; hyperactivity; lactation; methylphenidate; pregnancy.

PubMed Disclaimer

Comment in

  • Response to Damkier.
    Bolea-Alamanac B, Davies SJ. Bolea-Alamanac B, et al. Br J Clin Pharmacol. 2014 Jun;77(6):1084-5. doi: 10.1111/bcp.12237. Br J Clin Pharmacol. 2014. PMID: 24003952 Free PMC article. No abstract available.
  • Methylphenidate and pregnancy.
    Damkier P. Damkier P. Br J Clin Pharmacol. 2014 Jun;77(6):1083. doi: 10.1111/bcp.12238. Br J Clin Pharmacol. 2014. PMID: 24003978 Free PMC article. No abstract available.

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edn. Washington DC: American Psychiatric; 2000.
    1. National Institute for Health and Clinical Excellence. Attention deficit hyperactivity disorder: diagnosis and management of ADHD in children, young people and adults. 2008. Available at http://www.nice.org.uk/CG72 (last accessed 7 May 2013)
    1. Fayyad J, De Graaf R, Kessler RC, Alonso J, Angermeyer M, Demyttenaere K, De Girolamo G, Haro JM, Karam EG, Lara C, Lépine JP, Ormel J, Posada-Villa J, Zaslavsky AM, Jin R. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry. 2007;190:402–409. - PubMed
    1. Biederman J, Mick E, Surman C Doyle R, Hammerness P, Harpold T, Dunkel S, Dougherty M, Aleardi M, Spencer T. A randomized, placebo-controlled trial of OROS methylphenidate in adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2006;59:829–835. - PubMed
    1. Spencer T, Biederman J, Wilens T, Doyle R, Surman C, Prince J, Mick E, Aleardi M, Herzig K, Faraone S. A large, double-blind, randomized clinical trial of methylphenidate in the treatment of adults with attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005;57:456–463. - PubMed

Substances