Although research exists on the impact of CNS stimulants used in pregnancy, only a few small studies have looked at atomoxetine and pregnancy outcomes. This large cohort study of 4.2 million pregnancies ending in live births in northern Europe and the US reviewed nearly 1,000 pregnancies exposed to atomoxetine in the first trimester. Compared with non-exposed pregnancies, there was no observed increase in major congenital abnormalities with atomoxetine use in the first trimester.