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Risperdal/Trileptal/Cymbalta

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  • bioerunner
    started a topic Risperdal/Trileptal/Cymbalta

    Risperdal/Trileptal/Cymbalta

    Prior to birth of my son, I consulted a perinatalogist who confirmed my personal research that the risk of not managing my bipolar disorder was greater than the risk that 450 mg trileptal and 1 mp risperdal I take 1x daily posed to my developing baby. This was confirmed by a second perinatalogist who also agreed that the data for breastfeeding was too little to make an adverse determination against using the medication throughout pregnancy and breastfeeding. I am diligent about following both doctors' recommendations about taking 4 mg of folic acid daily in addition to prenatal/postnatal vitamins with DHA from NatureMade. I had an ultrasound done every month because I was classified as high risk due to medication exposure and each month it was confirmed that I had a perfectly healthy baby developing My son is now 7 weeks old and I couldn't have prayed for a healthier baby!

    At week 5.5 I was prescribed 30 mg Cymbalta 1x in a.m. for postpartum depression/anxiety and an increase in my p.m. dose of trileptal to 600 mg. I was referred to this website by my lactation consultant to determine risk. After reading the information on this website and forums, I determined for myself that the risk was low at that dose but have been on the lookout for a change in behavior. I am sure to take my Cymbalta in the am and the Risperdal/Trileptal in the p.m. after feedings. I have seen no changes thankfully!

    However, every morning when I nurse him, naturally as a worrisome Mother who is already prone to overthinking everything and being anxious, I get a little worried and finally thought perhaps I should just post to this site and ask the experts in this arena.

    I am a Ph.D. candidate in Biomedical Engineering so I really appreciate the informative review of the literature that is provided because I could get lost in the literature myself since this is not my area of expertise.

    My questions are twofold:
    (1) I have been watching for symptoms of exposure and have seen none. Are my current levels of daily 600 mg trileptal/1mg risperdal/30 mg cymbalta safe for my 7 week old baby? Or should I cease breastfeeding or dilute my breastmilk 50/50 with supplemental formula?

    (2) I have frozen breastmilk since 3 weeks postpartum as well as monthly ultrasound measurement data and paper pictures, would this "data" be useful for a case study? If the breast milk could be tested for medication levels and/or the ultrasounds/medical records would be useful, I would be happy to contribute in any way I can to expanding the literature in this area.

    Thank you in advance for your time in responding and your wonderful research!

  • CharmaineCalhoon
    replied
    Hello. Thanks for your post.

    Leave a comment:


  • admin-james
    replied
    Hi, thanks for your post.

    (1) It is my assessment that your medication regimen is safe for your baby. We don't know exactly how much Trileptal (oxcabazepine) transfers into the milk but we expect it to be very little. The existing literature has no reports of adverse effects on infants exposed to this drug via breastmilk. Only 2-10% of your daily Risperdal (risperidone) dose gets to the baby and this is too little to have any real effect. The Cymbalta (duloxetine) is even safer with a daily infant dose around 1% of yours. Cymbalta has to be taken in a delayed-release or enteric-coated tablet because it is not stable in stomach acid. What little drug gets into your breastmilk will be largely destroyed in the baby's stomach. You should be able to continue breastfeeding without restriction while on these meds.

    (2) Dr. Hale is out of town this week, but I'll let him know about your offer.

    For anyone reading this, please post again or call us at the InfantRisk Center, (806)352-2519, if this has not completely answered your question. I would also appreciate you filling out a 2 minute survey about your time on the forum:

    https://tthsclubbock.co1.qualtrics.com/SE/?SID=SV_bJzhyKVSivVkQZL&Counselor=Web

    -James Abbey, MD

    Leave a comment:

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