The use of dexamphetamine for narcolepsy during pregnancy: A case series and literature review

Dexamphetamine, a central nervous system stimulant, is increasingly prescribed to women of childbearing age, yet data on its safety in pregnancy, particularly for narcolepsy, remains limited. This case series examined pregnancy outcomes in 10 women with narcolepsy or idiopathic hypersomnolence at the Royal Brisbane and Women's Hospital who were prescribed dexamphetamine during pregnancy. Six women continued therapy throughout pregnancy. Apart from one case complicated by congenital CMV infection, all pregnancies progressed to the late third trimester with favourable neonatal outcomes. No cases of pre-eclampsia were observed; one woman developed gestational hypertension. All neonates had normal Apgar scores, with the exception of two where the Apgars were not recorded. However, no neonates required additional ventilatory support. Our findings suggest that therapeutic dexamphetamine use for narcolepsy may not be associated with adverse obstetric or neonatal outcomes. Individualised counselling is essential to balance maternal functional needs against potential pregnancy risks.