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Buspirone, Anafranil, and Ativan

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  • Buspirone, Anafranil, and Ativan

    Hello,
    I am pregnancy with my second and was diagnosed with OCD 2 years ago. I was put on Zoloft which made everything worst. Second was Celexa and buspirone- they worked okay but the obsessions were still there. Then I got pg with my second and stopped all meds. At 32 weeks I have decided to go back on buspirone 10mg once a day to help relieve the anxiety. But I have been looking into options for pp and breastfeeding. My psychiatrist and I have decided anafranil at a low start does after 10 days pp and buspirone 10mg once a day. I was also using Ativan 5mg as needed usually during a panic attack- taking 3 times a week. I would like to be able to take it on a as needed basis while breastfeeding. Does this sound like a solid plan compatible with breastfeeding a newborn full term.

    Thanks,
    L

  • #2
    Hi,

    Dr. Hale rates the medications by risk. The L1 medications are the most compatible with breastfeeding. The scale goes to L5, which are the medications that should be avoided.

    Anafranil is rated an L2. The plasma levels of this medication in the breastfed infants were below the limit of detection, which suggests there is minimal transfer to the infant via breastmilk.

    Buspirone is rated an L3. We don’t have any data on the transfer of this medication into breastmilk. However, due to the relatively brief half-life of this medication, it would not likely lead to buildup in the infant’s plasma.

    Ativan is rated an L3. This medication is probably compatible with breastfeeding, provided its use is short term, intermittent, and at a low dose after the first week of life. The infant should be monitored for sedation.

    These medications are probably compatible with breastfeeding at the dosages you have mentioned.

    If you have any further questions, please call the InfantRisk Center at 806-352-2519. We are open Mon-Fri from 8:00am-5:00pm, CST.

    Colleen Peace, RN, MSN
    TTUHSC, InfantRisk Center

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