Intractible Migraines

[laurenl]

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?
Thanks
Lauren

[admin]

Laurenl:

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.