Atomoxetine

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Date: December 2022, Version 3.0

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Atomoxetine may occasionally be used in pregnancy if attention-deficit hyperactivity disorder (ADHD) symptoms cannot be treated any other way.

What is it?

Atomoxetine (Atomaid®,Strattera®) is used to treat ADHD.

Benefits

What are the benefits of taking atomoxetine in pregnancy?

Atomoxetine can help with some symptoms of ADHD. Controlling these symptoms can help a woman remain well during pregnancy and while looking after her baby.

Risks

Are there any risks of taking atomoxetine during pregnancy?

Atomoxetine use in pregnancy is not thought to cause birth defects in the baby but ongoing research is ideally required to confirm this.

Atomoxetine works through effects on the brain. It might, therefore, cause short-term withdrawal symptoms in the newborn baby if taken in the weeks before delivery. The baby may need to be monitored after birth to check for jitteriness, difficulty sleeping, and breathing and feeding problems.

Alternatives

Are there any alternatives to taking atomoxetine?

Possibly. Other medicines can be used to treat ADHD, so switching to one with more pregnancy safety information may be an option. People with ADHD can sometimes manage without medicines but this is not the case for everyone. If ADHD is well-controlled with atomoxetine, it may be better to stay on it rather than stop or try something new and risk a relapse.

Ideally, a woman planning a pregnancy should speak to her GP or specialist to determine whether atomoxetine is still the best option. Similarly, women who have an unplanned pregnancy while taking atomoxetine should be reviewed at the earliest opportunity by their GP or specialist.

No treatment

What if I prefer not to take medicines during pregnancy?

If a woman’s ADHD causes problems with health and wellbeing, it is important that symptoms are well-controlled during pregnancy. Discontinuing ADHD medication can cause symptoms to return and stopping suddenly can cause withdrawal effects.

A medicine will only be prescribed during pregnancy if absolutely necessary and a doctor or specialist will be happy to discuss the benefits and any risks.

Please do not stop atomoxetine without speaking to your midwife, GP or specialist.

Will my baby need extra monitoring?

All pregnant women in the UK should be offered a detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. Because this scan is so thorough, extra monitoring for birth defects is not usually required following atomoxetine use in pregnancy.

Are there any risks to my baby if the father has taken atomoxetine?

We would not expect any increased risk to the baby if the father took atomoxetine before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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