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Intractible Migraines

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  • Intractible Migraines

    Hi I am taking care of a 2 month old, his mother is taking the following medications for migraines, anxiety and ADHD:
    Imitrex 100 mg twice a week, Percocet 20 per month, Firocet 20 per month, Wellbutrin 300 mg daily, Ritalin 10 mg daily, Lorazepam 0.5 mg twice a week, and Ibuprofen as needed.

    Her prescribing neurologist is very concerned about the additive effect of all these medications on the baby through her breast milk.

    Is there any guidance I can give her neurologist or the mother?

    There is some discussion about Topomax as a preventative, I was wondering your thoughts on this?

  • #2

    The only two that would be additive are Percocet (oxycodone+acetaminophen) and Lorazepam, and maybe Fioricet (butalbital + acetaminophen). This dosing sounds like them mom takes them randomly, and only occasionally, and maybe not all together at the same time. If so, I suggest the mom not take the three above all at the same time and breastfeed.

    If she can space these out so that she's not taking them simultaneously, I think the infant will do just fine. This is ASSUMING that the infant is full term, health, and does not have apnea?

    Tom Hale Ph.D.