Issues and Considerations for ADHD Treatment in Pregnancy and Beyond

There is a lot of “very reassuring reproductive safety data and pharmacotherapy data” for treating ADHD during pregnancy, Allison S. Baker, MD, told Psychiatric Times. Baker, a double board-certified child, adolescent and perinatal psychiatrist and instructor in psychiatry at Massachusetts General Hospital in Boston, joined Katherine Bang-Madsen, MSc, PhD, as a speaker for the plenary session on ADHD and pregnancy at the American Professional Society of ADHD and Related Disorders (APSARD) 2026 Annual Conference. The session highlighted emerging data and practical guidance on managing ADHD during pregnancy and the postpartum period.^1-3

Baker underscored that adult ADHD in women is common and frequently encountered in clinical practice. “ADHD is a childhood onset neurodevelopmental condition that persists into adulthood for about, we think, 3% of women, or about roughly one in 30 women,” she said, adding that “many women are being diagnosed and certainly treated in their perinatal years.”

Central to Baker’s message was a shift in clinical decision-making. “We really need to move the clinical conversation away from a notion of there are risks versus no risks in terms of treatment decision-making, and more toward risk-risk analysis,” she said. That analysis should balance “risks of medication exposure, which are largely reassuring, versus known risks of under-treating or not treating ADHD in this population.”

Comorbidity emerged as a major clinical concern. “Women rarely have just one silo of ADHD symptoms and nothing else,” Baker explained, noting that “comorbidity with mood vulnerability and anxiety disorders is, I would say, the rule, not the exception.” She cautioned that the postpartum period carries “significant risk for roughening of those comorbid mood and anxiety vulnerabilities,” driven by “a pretty significant hormonal transition” alongside sleep disruption and increased executive functioning demands.

As such, clinicians should rethink how they frame treatment decisions for reproductive-age women. Baker emphasized the importance of planning ahead.

“This is a clinical population of great importance in terms of the future well-being of patients and families, and also one that is quite high risk,” Baker said. “And so to plan thoughtfully and intentionally for pregnancy and the postpartum, really leveraging non-pharmacologic therapies alongside of the pharmacotherapies—if there’s moderate to severe ADHD—is really a winning approach to excellent care of our patients,” she said.

On medication use, Baker offered a foundational guidance. “If ADHD pharmacotherapy is required for daily functioning of an individual, it is appropriate to consider and continue in pregnancy,” she said, stressing that these discussions are best held “well in advance of pregnancy.” In addition, Baker advocated for a collaborative communication process, and suggested involving pediatrics, obstetrics and gynecology, and psychotherapists.

She encouraged clinicians to establish baselines and take a holistic view, highlighting psychotherapies, good coaching, mindfulness-based interventions.

Comorbidity emerged as a major clinical concern, not just in pregnancy but also postpartum. “Women rarely have just one silo of ADHD symptoms and nothing else,” Baker said, with comorbidity mood and anxiety being more of the rule as opposed to the exception. The hormone transitions coupled with sleep disruption and increased demands result in a “significant risk for roughening of those comorbid mood and anxiety vulnerabilities,” she added.

“These are important conversations to be having, as I said, ideally well in advance of pregnancy, both for ADHD, but also more broadly from a psychiatric perspective for women and their clinicians to work alongside one another in a collaborative sort of shared decision analysis,” Baker said.

References

1. Plenary: ADHD and Pregnancy. Presented at the APSARD 2026 Annual Conference; January 15-18, 2026; San Diego, CA.

2. Bang Madsen K, Bliddal M, Skoglund CB, et al. Attention-Deficit Hyperactivity Disorder (ADHD) Medication Use Trajectories Among Women in the Perinatal Period. CNS Drugs. 2024;38(4):303-314.

3. Bang Madsen K, Robakis TK, Liu X, et al. In utero exposure to ADHD medication and long-term offspring outcomes. Mol Psychiatry. 2023;28(4):1739-1746.