Saphris while breastfeeding?

[thebassomatic76]

I have reviewed the old forums and this, and have not found much information on this drug. I was on it prior to pregnancy and it worked well but had to discontinue for pregnancy. Is there any more current information on this drug's safety during breastfeeding? I'm due in a few weeks. Also, over the last five years since diagnosis, I have been on Zyprexa, Seroquel, Depakote, Abilify, and Topamax, all with either no response or poor response. Are there any other relatively safe mood stabilizers if Saphris is not considered safe? Thanks.

[cpride]

Dear thebassomatic76,

Asenapine (Saphris) is a new atypical antipsychotic medication used in the treatment of bipolar disorder and schizophrenia. There is no data on the transfer of asenapine into human milk. It is present in animal milk. Other medications in the same family as asenapine transfer into breast milk in small amounts. Until studies are done on the transfer of asenapine into breast milk, Dr. Hale recommends alternative medications such as risperidone, quetiapine or aripiprazole. It appears from your list above that you haven't tried risperidone, so you may talk with your physician about the medication. The amount of the medication that the baby will be exposed to through your milk is 2.8 to 9.1 % of your dose (typically less than 10 % is considered compatible with breastfeeding for most medications). The time asenapine is most concentrated in your milk is 0.5 to 1.5 hours after you take your dose so avoid breastfeeding during that time if possible. Side effects to observe for in the baby are sleepiness, and muscle twitches. You may experience increased milk supply also. If risperidone doesn't work for you or your physician doesn't want to prescribe it, lamotrigine, or carbamazepine are options along with a combination of medications such as valproate + quetiapine or valproate + olanzapine. Once your physician decides on your treatment plan, you may either call us at the InfantRisk Center, 806-352-2519 or use the forum to ask about specific side effects and the amount of medication the baby will be exposed to through your breast milk. The baby's blood levels for some of the options should be monitored by the pediatrician. Let me know if you have further questions.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center