Atomoxetine in Pregnancy and Breastfeeding Handy Fact Sheet

Thinking about starting a family?

• Plan ahead – talk to your prescriber before trying for a baby.

• Atomoxetine is not known to affect fertility.

• Possible options to discuss:

  • Carrying on with atomoxetine

  • Using a lower dose (only with medical advice)

  • Switching to another medicine, if safer and effective

  • Stopping medicines that are no longer needed

👉 If atomoxetine helps you manage ADHD, staying on treatment is often safer than letting symptoms come back.

Just found out you’re pregnant?

• Don’t stop suddenly – your baby has already been exposed.

• Contact your prescriber within the next day or two.

• Together you can agree on the best plan for you and your baby.

• Stopping suddenly may trigger: tiredness, rebound hyperactivity, increased appetite, or low mood.

• If you decide to stop, taper slowly over weeks to give your body time to adjust.

• You may choose to restart atomoxetine again after birth if needed.

⚠️ Untreated ADHD in pregnancy is linked to higher risks of complications (e.g. pre-eclampsia, caesarean birth) and unhealthy coping behaviours (e.g. smoking, alcohol). Staying well is important for both you and baby.

Early pregnancy (first 3 months)

• This is when your baby’s organs are developing.

• A 2024 review of over 16 million pregnancies found no evidence that atomoxetine increases the risk of birth defects.

• No clear link with low birth weight or prematurity, but research is still limited.

• We don’t know if atomoxetine affects risk of miscarriage or stillbirth.

Later pregnancy (months 4–9)

• Normal body changes (fluid retention, kidney and liver changes) can alter how medicines work.

• If atomoxetine feels less effective, speak to your prescriber – a dose review may help.

• Research so far shows no consistent problems at birth, but data is still limited.

Around delivery

• You’ll usually be offered a hospital birth, depending on your pregnancy health overall.

• Withdrawal-type symptoms in the baby are possible (restlessness, poor feeding, irritability), though not proven.

• Theoretical risk of persistent pulmonary hypertension in the newborn (PPHN) – a rare breathing condition (about 1 in 500 babies). If your team know about your medicine, they can be prepared to treat this quickly.

Breastfeeding

• Atomoxetine is thought to be “likely compatible” with breastfeeding, but data is limited.

• Only small amounts are expected to pass into breast milk.

• Monitor your baby for:

  • Restlessness

  • Excessive sleepiness

  • Poor feeding or weight gain

• If problems arise, stop breastfeeding and seek advice quickly.

• If your baby is preterm or unwell, get specialist advice before breastfeeding.

Long-term child development

• A large follow-up study of children exposed to ADHD medicines in pregnancy (including atomoxetine) found no increased risk of:

  • Developmental delays

  • Autism or ADHD

  • Hearing or vision problems

  • Epilepsy or seizures

  • Growth impairment

Looking after yourself in pregnancy

• Avoid unnecessary medicines – check with your pharmacist before buying over the counter.

• Eat a balanced diet with fruit and vegetables.

• Keep hydrated, especially if you have pregnancy sickness.

• Take supplements if advised (folic acid, vitamin D, iron).

• Stay active with gentle exercise.

• Use non-drug ways to manage stress (relaxation, mindfulness, support networks).

• Arrange a support system so others can spot if you’re struggling.

Remember

✨ Babies do better with well mums. Keeping your ADHD well-managed is an important part of giving your baby the best start.