Wellbutrin + Abilify?

[Morbidmeli]

Hello,
My psychiatrist prescribed 300mg of Wellbutrin (in the form of two 150mg pills a day) and 5mg of Abilify for my bipolar disorder. I have been off of medication since my daughter was born just over 6mo ago, but it's becoming difficult to cope with the symptoms. I'm scared to fill my prescription based off of the info on Lactmed... I used to take my pills at night and my daughter sleeps through the night. Also, she just started solids, but mostly just plays with her food... So solids definitely aren't replacing any nursing sessions at this point.

Any advice?
Thanks!

[cpride]

Dear Morbidmeli,

Of the infants studied thus far, no bupropion (Wellbutrin) has been detected in the infants' blood systems. The author of one study has had at least 3 case reports in which bupropion may have suppressed the mothers milk supply. Observe closely for changes in your milk production. The time bupropion is highest in your milk is 2 hours after your dose so breastfeed first then take your dose. Only a small amount of the drug enters milk, 0.2 to 2 percent of your dose (less than ten percent is usually considered compatible with breastfeeding. For aripiprazole (Abilify), only one small case report has been found on one breastfeeding mother. The amount of aripiprazole entering her milk was about 1%. Your levels may be somewhat different since we only have one subject's data. Dr. Hale has received several cases of somnolent babies in mothers using this product. Some caution is recommended until we know more. Since your infant is older, the risk is probably less as older infants metabolize medications more efficiently than younger infants. The time Abilify is highest in your milk is 3 to 5 hours after your dose. Hope this information is helpful. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[Morbidmeli]

Thanks again!

Just one question. With the somnolence, what should I look out for? Would she be drowsy all day?

[cpride]

Dear Morbidmeli,

The drowsiness has the potential to be long lasting as the half-life (the length of time it takes for half of the drug to be metabolized out of your system) of Abilify is 75 hours. It takes 5 half-lives for 98 percent of the drug to be metabolized out of your system so the drug will be in your system as long as you take it daily. If you notice your infant being sedated, you should talk with your pediatrician.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center

[Morbidmeli]

Sorry, one last question:

Are there any "safer" mood stabilizers? I took Lamictal a while back with some success.

Thanks so much, again.

[cpride]

Dear Morbidmeli,

Other medications in the same class as Abilify are risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel). Lamictal is compatible with breastfeeding, but blood levels are recommended for the breastfeeding infant. Also some authors recommend blood levels for Seroquel also. You may want to talk with your physician about the best medication for your symptoms. Once you have your treatment plan in place, call the InfantRisk Center at 806-352-2519, and we can give you specific information on each medication you are on. We are open Monday through Friday, 8 to 5 CDT.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center