Citalopram and Haloperidol

[PippiL]

Dear doctors,

First of all, thank you for having this forum. I have a question about the safety of a combination of medicines and breastfeeding and my doctor says it's possible but she is not very enthousiastic about it.
I use 10 mg of Citalopram and 1 mg of Haloperidol each day. Right now, I'm six months pregnant and I would like to know what is best for our baby, breastfeeding with these medicines or feed him with artificial babymilk?
Also I suffer from chronical fatigue syndrome (ME), is it wise to start breastfeeding then?

Thank you very much for answering!

[admin]

PippiL,

Citalopram is an L2-limited data-probably compatible. The amount transferred into breast milk is 3.56-5.37% of your dose. Eleven mothers taking citalopram and their babies were monitored during pregnancy and lactation. Plasma and milk samples were taken that suggested citalopram and its metabolite concentrations in milk were 2-3 times higher than in maternal plasma, but infant plasma levels were very low or undetectable. We think it is probably safe to use as long as your infant is not symptomatic, monitor your infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

Haloperidol is rated an L3-limited data-probably compatible. The amount transferred into breast milk is 0.2-12% of your dose. Haloperidol is a potent antipsychotic agent that as a side effect may increase prolactin levels in some patients. Levels in milk range from low to significant. Some caution is recommended in breastfeeding mothers. Your dose is low, your infant will probably be exposed to more in utero than it will be through breast milk. Dr Hale says that the infants do become accustomed to metabolizing the medications in utero. This medication may be ok if your infant is not symptomatic. Monitor your infant for sedation or irritability, apnea, not waking to feed/poor feeding, constipation, weight gain and extrapyramidal symptoms.

If your infant is symptomatic you may want to try half breast milk and half formula to reduce exposure to these medications.

Sandra Lovato R.N.
InfantRisk Center
806-352-2519