Risperdal with breastfeeding
We have a mother of a NICU baby who was on Risperidal in her first trimester. Her psychiatrist has taken her off of it due to breastfeeding. The baby is term and is here for CHD. The baby's nurse tells me that this mother needs to be back on her medication. She's not taking anything else other than pain meds at the moment. Risperdal is an L3 but I see that the RID is 2.8% - 9.1%, the MW is 410, and PB is 90%. Am I safe to believe that little gets into the breastmilk? Is there anything that would prohibit this mom from going back on the Risperdal?
Thank you so much!
Risperidone is probably okay to use in breastfeeding in most cases. No adverse effects have been reported in breastfeeding infants. The amount of mother's dose that enters breastmilk (RID) is between 2.8 to 9.1 percent. The usual adult dose is 3 mg twice daily. One of the side effects though is cardiac arrhythmia and since the infant has CHD, this drug may not be the best choice. An alternative would be quetiapine (Seroquel) or olanzapine (Zyprexa). Quetiapine RID is 0.07 to 0.1 percent of mother's dose and olanzapine RID is 0.3 to 2.2 percent of mother's dose. Observe infant for sedation. This mother may want to talk with her physician about the possibility of using one of these alternatives. Also, discussing the potential risk for arrhythmia with the neonatal team would be appropriate if this mother does have to be on risperidone. Let me know if you have further questions.
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center