Methylphenidate
(Date: January 2023. Version: 4)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
Quick read
Methylphenidate is occasionally used in pregnancy if it is needed to manage attention deficit hyperactivity disorder (ADHD) or narcolepsy.
What is it?
Methylphenidate (Ritalin®, Affenid XL®, Concerta XL®, Delmosart®, Equasym XL®, Matoride XL®, Medikinet XL®, Metyrol XL®, Tranquilyn®, Xaggitin XL®, Xenidate XL®) is used treat attention deficit hyperactivity disorder (ADHD), and occasionally narcolepsy.
What are the benefits of using methylphenidate in pregnancy?
Methylphenidate can reduce some features of ADHD and improve concentration and function. This can help with work, activities of daily living, and overall quality of life.
Narcolepsy is a potentially dangerous condition as it causes a person to suddenly fall asleep. Effective treatment is therefore important for the wellbeing of a pregnant woman and her baby.
What are the risks of using methylphenidate in pregnancy?
Some studies have suggested that there is an increased chance of miscarriage and some types of heart defect in the baby following use of methylphenidate in early pregnancy. Overall, it is very clear that most babies exposed to methylphenidate in the womb do not have a birth defect. It is also uncertain if these problems are due to methylphenidate itself, or to underlying factors that are more common in women taking methylphenidate.
Methylphenidate and similar drugs have been linked to reduced growth of the baby in the womb. This is thought to be because they can affect blood flow through the placenta.
Methylphenidate can potentially cause short-term withdrawal symptoms in the newborn baby if taken in the weeks before delivery. For this reason, a baby may be monitored for some time after birth to check for symptoms such as jitteriness, difficulty sleeping and breathing problems.
Are there any alternatives to using methylphenidate in pregnancy?
Possibly. Some people are able to manage their ADHD without medicines but this is not right for everyone. Different medicines can be used to treat some specific features of ADHD, such as anxiety, so switching may be an option.
There are also other potential treatments for narcolepsy.
However, if a woman’s condition is well-controlled with methylphenidate, it may be best to stay on it rather than change and risk a relapse. Ideally, a woman planning a pregnancy should speak to her GP or specialist to determine whether methylphenidate is still the best option. Similarly, women who have an unplanned pregnancy while taking methylphenidate should be reviewed at the earliest opportunity by their GP or specialist.
What if I prefer not to take medicines during pregnancy?
For some women it might be possible to avoid use of ADHD medicines in pregnancy. Others may need to continue taking their drugs to ensure they remain well and can carry out activities of daily living.
Women with narcolepsy may need to continue methylphenidate treatment to ensure their safety and wellbeing.
Doctors will only prescribe medicines when absolutely necessary and will be happy to discuss any concerns.
Pregnant women should not stop or reduce the dose of methylphenidate unless this has been advised by their GP or specialist.
Will I or my baby need extra monitoring?
All pregnant women in the UK will be offered a very detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. No extra monitoring for major birth defects is required following methylphenidate use in pregnancy. Extra growth scans might be offered to women taking methylphenidate in later pregnancy as it has been linked to having a smaller baby.
Are there any risks to my baby if the father has taken methylphenidate?
We would not expect any increased risk to the baby if the father takes methylphenidate.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org
How can I help to improve drug safety information for pregnant women in the future?
Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org