Vyvanse and breastfeeding 12 month old

[amhancok]

I am breastfeeding my 8.5 month old daughter. Prior to becoming pregnant I took 70 mg of Vyvanse for ADHD. I am hoping to resume medications for ADHD at the 12 month mark but would like to continue nursing when we are together at night and on weekends (I plan to stop pumping at 12 months). Would it be safe to take 70 mg of Vyvanse while nursing a 12 month old at night and on weekends, or should I look at trying another medication? I've taken Strattera in the past and didn't find it helpful. I also tend to be prone to anxiety and have heard that the methylphenidate meds can exacerbate this. I'm willing to try anything for my daughter's well-being, though. Thanks for your help!

AF

[admin]

amhancok:

Levels of dextroamphetamine (the active metabolite of Lisdexamphetamone) readily transfers into milk as a function of dose. In a study of 4 mothers who received 15-45 mg/day dextroamphetamine, the average absolute infant dose was 21 (11-39) ?g/kg/day.[3] The authors suggest the relative infant dose was 5.7% (4-10.6). Plasma levels in the infants ranged from undetectable to 18 ?g/L. No untoward effects were noted in any of the 4 infants.

Again this was at a dose of 15-45 mg, you can probably increase this dramatically at a dose of 70 mg.

While all this is concerning, the volume of milk your infant takes starts to taper normally at 6 months and is probably less than half of normal by about 12 months. HENCE, the dose the infant receives from milk is less due to less milk. But feeding the infant only at night is problematic due to the insomnia properties of this drug. In essence, you infant may not sleep at well following exposure at bedtime.

I'd suggest you discuss this with your physician. You can always try it out and if your infant is insomnic, or anorexic, then you know what is going on.

Tom Hale Ph.D.




3.##Ilett KF, Hackett LP, Kristensen JH, Kohan R. Transfer of dexamphetamine into breast milk during treatment for attention deficit hyperactivity disorder. Br J Clin Pharmacol 2006; 63(3): 371-375.