Nursing & Seroquel/Neurontin

[AineMorrigan]

I'm on high dose seroquel (800mg at night), and 1200mg of neurontin (600 in the morning, 600 in the afternoon).

When I had my son nearly 5 years ago, I was only on seroquel, but my psychiatrist recommended that I not nurse. I have since done research which seems to indicate that no real effects have been seen in the infants of mothers using seroquel, even in high doses. Is it safe for me to nurse the child I am currently carrying?

Also, I did see somewhere that there is a recommendation to monitor babies of mothers on seroquel for signs of tardive dyskinesia. I also take reglan (20mg 4x a day, which is a high dose, for severe gastroparesis), which for me is an added risk of tardive dyskinesia, can this amplify/increase the risk to the baby as well?

Any advice is appreciated.

[admin-james]

Hi, thanks for your post.

Seroquel (quetiapine) transfers minimally into the breastmilk, on the order of 0.1% of your daily dose. The risk of tardive dyskinesia is believed to be dose-dependent. It has never been reported in babies exposed to Seroquel exclusively through the breastmilk. It may cause some sedation in your baby, so keep an eye out for that. We give Seroquel an L2 safety rating (out of 5, "safer").

Reglan (metoclopromide) is used extensively in breastfeeding women and in neonates, although the exact risk of TD is difficult to pin down. It is a very rare side effect but severe enough to warrant an FDA warning on the drug. Risk is also dose-dependent with Reglan. Only 5-15% of what you take gets to the baby, and that ends up being 25-50% of the minimum dose prescribed directly to preemies. The TD risk from both drugs will probably add together, but I don't have any reason to think that they would amplify each other. We also give Reglan an L2 safety rating.

Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

-James Abbey, MD