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Methylphenidate (Ritalin° and other brands) during pregnancy: teratogenic and fetotoxic, with concerns about long-term effects

FEATURED REVIEW Methylphenidate is an amphetamine-like psychostimulant used in attention deficit hyperactivity disorder (ADHD). Recent studies have revealed important data about the consequences of in utero exposure to methylphenidate for the unborn child, in the short and long term.
Full review (3 pages) available for download by subscribers.

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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Download the full review.
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See also:

Methylphenidate (Ritalin°)
as a means of controlling
classroom behaviour
(May 2019)
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Methylphenidate: adverse
cardiovascular effects
(June 2015)
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Methylphenidate and
hyperactive children:
stunted growth
(October 2011)
Free

Methylphenidate: abuse
and addiction
(October 2012)
Free

Methylphenidate: trismus
Prescrire Int 2013 ;
22 (140) : 18.
Pdf, subscribers only

Hyperactivity in children:
risk of hallucinations
with methylphenidate
(September 2006)
Free

Hyperactivity in children
with attention deficit disorder:
methylphenidate only
as a last resort
(June 2006)
Free