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Abilify and Celexa

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  • Abilify and Celexa

    Dear Dr. Hale,
    I'm an LC working with a Mom who has just been started on Abilify 2 mg daily (increasing to 5) for postpartum depression, she also takes Celexa. She has been told by her providers to stop breastfeeding and is very sad and teary about this. What are your thoughts. Many thanks in advance, paw100

  • #2
    Dear paw100,

    Abilify (aripiprazole) is classified as a L 3 medication. The relative infant dose is one percent of the mother's dose. The time the drug would be most concentrated is three to five hours after taking her dose so she should avoid breastfeeding during this time. The half-life is long at 75 hours. Dr. Hale has received several cases of somnolent babies with Abilify. The infant should be observed closely for sedation. Being on a low dose of Abilify (usual dose 10 to 15 mg per day), decreases the risk to the infant. If her infant is premature or is younger than two months of age, these risk factors increase the risk of sedation. There are breastfeeding compatible alternatives such as olanzapine, quetiapine, and risperidone that mother may talk with her physician about if the baby has problems with sedation. Celexa (citalopram) is a L 2 medication. The relative infant dose is 3.6 percent of mother's dose, and the time the drug is most concentrated is two to four hours after taking her dose. She should avoid breastfeeding at this time. The typical adult dose of Celexa is 20 to 40 mg daily. The breastfeeding infant should be observed for sedation and colic symptoms. Both of these medications are compatible with breastfeeding, but the infant should be monitored closely for sedation. Let me know if you have further questions.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center
    Last edited by cpride; 03-28-2012, 10:30 AM.

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    • #3
      Dear Dr hale.
      I'm in a situation with finding the right medication for my mood swings and my bi polar and depression.
      I have taken ability most of my life.
      I recently started taking Zoloft because it was safe to take while I breast feed my son who is 6 months now. But it just mad my moods worse.
      I'm wanting to go back and try ability again but with the doseges that I was taking which were 15 mg in the morning and 25 at night. How will be that effect my son, or will it at all.
      I really would like to continue to breastfeed him as long as possible til he's over a year or more.
      Thanks.

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      • #4
        Alicia:

        Zoloft or any SSRI, is well known to activate manic episodes, and they are rarely used in such conditions.

        As for Ability (aripiprazole), we have a few papers and the Relative infant dose ranges from 0.7% - 6.44% of the maternal dose. These were done with doses of 10 mg and 15 mg daily.

        I think it would probably be safe for you to breastfeed your infant. Perhaps you could start with a lower dose (10 mg) and see how it works.

        Monitor the infant for sedation.

        Tom Hale Ph.D.

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