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The Journal of Clinical Psychiatry

Original Research August 12, 2026

Time Trends in Maternal Attention-Deficit/Hyperactivity Disorder and Medication Use in Pregnancy

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J Clin Psychiatry 2026;87(3):26m16321

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized among women of reproductive age. Little is known about time trends in maternal ADHD, and treatment utilization in this group.

Methods: We conducted a cross-sectional time series analysis of all obstetrical deliveries in Ontario, Canada, from 2002–2023 (medication data available from 2014). Maternal ADHD was defined by inpatient or outpatient diagnosis within 10 years preconception. Stimulant medication use (amphetamine, dextroamphetamine, lisdexamfetamine, methylphenidate) was assessed via prescription fills in the year before pregnancy, during pregnancy, and stratified by trimester. We described the annual proportions of pregnancies with preconception maternal ADHD diagnoses and stimulant use patterns in this group.

Results: Of 2,327,110 included pregnancies, the proportion of pregnancies with maternal ADHD rose from 0.5% to 2.5% from 2002 to 2023. Between 2014 and 2023, stimulant use increased from 21.8% to 39.8% in the year prior to pregnancy and from 10.1% to 20.9% during pregnancy among those with ADHD. Methylphenidate predominated early in the study period, but increases over time were largely driven by lisdexamfetamine. Approximately 75% of those prescribed a stimulant in the year prior to conception discontinued it prior to, or in, the first trimester of pregnancy, with stable time trends.

Conclusions: The 4-fold increase in maternal ADHD in pregnancy over a 20-year period and 2-fold increase in the use of stimulant medication before and during pregnancy in this group underline the need for clinical guidance on managing ADHD in pregnancy.

J Clin Psychiatry 2026;87(3):26m16321

Author affiliations are listed at the end of this article.

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  1. Posner J, Polanczyk GV, Sonuga-Barke E. Attention-deficit hyperactivity disorder. Lancet. 2020;395(10222):450–462. PubMed CrossRef
  2. Sibley MH, Swanson JM, Arnold LE, et al. Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity. J Child Psychol Psychiatry Allied Discip. 2016;58(6):655–662. PubMed CrossRef
  3. Cortese S, Adamo N, Del Giovane C, et al. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2018;5(9):727–738. PubMed CrossRef
  4. Ostinelli EG, Schulze M, Zangani C, et al. Comparative efficacy and acceptability of pharmacological, psychological, and neurostimulatory interventions for ADHD in adults: a systematic review and component network meta-analysis. Lancet Psychiatry. 2025;12(1):32–43. PubMed CrossRef
  5. Danielson ML, Claussen AH, Bitsko RH, et al. ADHD prevalence among U.S. children and adolescents in 2022: diagnosis, severity, co-occurring disorders, and treatment. J Clin Child Adolesc Psychol. 2024;53(3):343–360. CrossRef
  6. Bachmann CJ, Philipsen A, Hoffmann F. ADHD in Germany: trends in diagnosis and pharmacotherapy. Dtsch Arztebl Int. 2017;114(9):141–148. PubMed CrossRef
  7. Auro K, Holopainen I, Perola M, et al. Attention-deficit/hyperactivity disorder diagnoses in Finland during the COVID-19 pandemic. JAMA Netw Open. 2024;7(6):e2418204. PubMed CrossRef
  8. Philipsen A. Attention deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000-2018: population-based cohort study. BJPsych Open. 2024;10(5):e152. PubMed CrossRef
  9. Young S, Adamo N, Ásgeirsdóttir BB, et al. Females with ADHD: an expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC Psychiatry. 2020;20(1):404. PubMed CrossRef
  10. Karlstad Ø, Zoëga H, Furu K, et al. Use of drugs for ADHD among adults—a multinational study among 15.8 million adults in the Nordic countries. Eur J Clin Pharmacol. 2016;72(12):1507–1514. PubMed CrossRef
  11. Scoten O, Tabi K, Paquette V, et al. Attention-deficit/hyperactivity disorder in pregnancy and the postpartum period. Am J Obstet Gynecol. 2024;231(1):19–35. PubMed CrossRef
  12. di Giacomo E, Confalonieri V, Tofani F, et al. Methylphenidate and atomoxetine in pregnancy and possible adverse fetal outcomes: a systematic review and meta-analysis. JAMA Netw Open. 2024;7(11):e2443648. PubMed CrossRef
  13. Cohen JM, Srinivas C, Furu K, et al. Prevalence trends and individual patterns of ADHD medication use in pregnancy in Norway and Sweden, 2010-2019. Eur J Clin Pharmacol. 2023;79(1):173–180. PubMed CrossRef
  14. Lemelin M, Boukhris T, Zhao JP, et al. Prevalence and determinants of attention deficit/hyperactivity disorder (ADHD) medication use during pregnancy: results from the Quebec Pregnancy/Children Cohort. Pharmacol Res Perspect. 2021;9(3):e00781. PubMed CrossRef
  15. Madsen MG, Zhu JL, Munk-Olsen T, et al. Prevalence and temporal trends of attention deficit hyperactivity disorder medication fills during pregnancy and breastfeeding in Denmark. Paediatr Drugs. 2025;27(2):233–246. PubMed CrossRef
  16. Nitchske A, Salmanpour A, Kaur P, et al. Prevalence trends and patterns of perinatal ADHD stimulant medication use in British Columbia, Canada. Pharmacoepidemiol Drug Saf. 2025;34(4):e70129. PubMed CrossRef
  17. Ray JG, Schull MJ, Urquia ML, et al. Major radiodiagnostic imaging in pregnancy and the risk of childhood malignancy: a population-based cohort study in Ontario. PLoS Med. 2010;7(9):e1000337. PubMed CrossRef
  18. Paul ML, Sheth P, Davis R, et al. Incidence of attention-deficit/hyperactivity disorder between 2016 and 2023: a retrospective cohort. Psychiatr Res Clin Pract. 2025;7(1):18–24. PubMed CrossRef
  19. Song J, Park SJ, Jeong S, et al. Increasing incidence of ADHD among children, adolescents and young adults: COVID-19 pandemic-driven trend in Korea (2012-2023). BMJ Ment Health. 2025;28(1):e301662. CrossRef
  20. Rogers MA, MacLean J. ADHD symptoms increased during the COVID-19 pandemic: a meta-analysis. J Atten Disord. 2023;27(8):800–811. PubMed CrossRef
  21. Fabiano F, Haslam N. Diagnostic inflation in the DSM: a meta-analysis of changes in the stringency of psychiatric diagnosis from DSM-III to DSM-5. Clin Psychol Rev. 2020;80:101889. PubMed CrossRef
  22. Kazda L, Bell K, Thomas R, et al. Overdiagnosis of attention-deficit/hyperactivity disorder in children and adolescents: a systematic scoping review. JAMA Netw Open. 2021;4(4):e215335. PubMed CrossRef
  23. Scharf T, Huber CA, Näpflin M, et al. Trends in prescription of stimulants and narcoleptic drugs in Switzerland: longitudinal health insurance claims analysis for the years 2014-2021. JMIR Public Health Surveill. 2025;11:e53957. PubMed CrossRef
  24. Grøntved S, Hald K, Mohr-Jensen C, et al. Prevalence and incidence of attention deficit/hyperactivity disorder in Denmark. A national register-based open cohort study. Acta Psychiatr Scand. 2025;152(1):27–38. CrossRef
  25. Chan AYL, Ma TT, Lau WCY, et al. Attention-deficit/hyperactivity disorder medication consumption in 64 countries and regions from 2015 to 2019: a longitudinal study. EClinicalMedicine. 2023;58:101780. PubMed CrossRef
  26. Bang Madsen K, Larsson H, Skoglund C, et al. In utero exposure to methylphenidate, amphetamines and atomoxetine and offspring neurodevelopmental disorders—a population-based cohort study and meta-analysis. Mol Psychiatry. 2025;30(9):3885–3894. doi:1038/s41380-025-02968-4. PubMedCrossRef
  27. Suarez EA, Bateman BT, Hernandez-Diaz S, et al. Prescription stimulant use during pregnancy and risk of neurodevelopmental disorders in children. JAMA Psychiatry. 2024;81(5):477–488. PubMed CrossRef
  28. Huybrechts KF, Bröms G, Christensen LB, et al. Association between methylphenidate and amphetamine use in pregnancy and risk of congenital malformations: a cohort study from the International Pregnancy Safety Study Consortium. JAMA Psychiatry. 2018;75(2):167–175. PubMed CrossRef
  29. Srinivas C, Karlstad Ø, Stigum H, et al. Attention-Deficit/Hyperactivity disorder medication use in pregnancy and risk of preterm birth: a population-based cohort study. Paediatr Perinat Epidemiol. 2025;40(2):281–290. doi: 10.1111/ppe.70031. PubMed CrossRef
  30. Li L, Sujan AC, Butwicka A, et al. Associations of prescribed ADHD medication in pregnancy with pregnancy-related and offspring outcomes: a systematic review. CNS Drugs. 2020;34(7):731–747. PubMed CrossRef
  31. Health Canada – Drug Product Database. Vyvanse (lisdexamfetamine dimesylate). Product Monograph. Accessed july 30, 2026. https://pdf.hres.ca/dpd_pm/00075011.PDF
  32. Frampton JE. Lisdexamfetamine: a review in ADHD in adults. CNS Drugs. 2016;30(4):343–354. PubMed CrossRef
  33. Carton L, Icick R, Weibel S, et al. What is the potential for abuse of lisdexamfetamine in adults? A preclinical and clinical literature review and expert opinion. Expert Rev Clin Pharmacol. 2022;15(8):921–925. CrossRef
  34. McGrath JJ, Lim CCW, Plana-Ripoll O, et al. Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries. Epidemiol Psychiatr Sci. 2020;29:e153. PubMed CrossRef

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