Abstract
- Methylphenidate is an amphetamine-like psychostimulant.
- In animals, at high doses, various amphetamines carry a risk of cardiac malformations. Methylphenidate is teratogenic at toxic doses for the pregnant female, and can lead to skeletal abnormalities and neural tube closure defects, depending on the species. Behavioural disorders have also been reported.
- Two studies, including a total of about 3500 pregnant women exposed to methylphenidate during the first trimester of pregnancy, have shown that the risk of cardiac malformations is probably greater in children of exposed mothers compared to those of non-exposed mothers: around 3 additional cases per 1000 pregnancies.
- When exposure to methylphenidate occurred during the second and third trimesters of pregnancy, the risk of preeclampsia and premature birth seemed to be greater than in the absence of exposure. At birth, cardiorespiratory and neurological disorders associated with this exposure were observed.
- The long-term neuropsychiatric consequences of in utero exposure to methylphenidate are largely unknown.
- In practice, use of methylphenidate during pregnancy should be avoided as far as possible.
©Prescrire 1 June 2019
"Methylphenidate during pregnancy: teratogenic and fetotoxic, with concerns about long-term effects" Prescrire Int 2019; 28 (205): 153-155. (Pdf, subscribers only).
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