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Mood stablizers and breastfeeding

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  • #1

    Mood stablizers and breastfeeding

    I'm currently breastfeeding my 16 month old and intend to until she self weans or around 24 months i'll start weaning. I'm currently on lamictal and seroquel for bipolar 2 depression and trying to wean off the seroquel and maybe lower the lamictal.

    My psychiatrist mentioned a couple medications, one being abilify (?) and another one i've never heard of geodon?

    I want to continue breastfeeding my daughter until she's ready to quit or until 2 whichever comes first but need the mood stabilizing help. Does anybody have any studies showing the risks, side effects, and safety of using these while breastfeeding?

    My daughter breast feeds mostly first thing in the morning before we're out of bed. And on and off during the day in short (less than 10 minute) bursts.
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  • #2
    Dear Adalaye,
    Geodon is a lactation risk category 2 (L2). This means that the drug has been studied in a limited number of breasteeding women without an increase in adverse effects in the infant. And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote. Geodon has also been shown to penetrate milk poorly. This however is dose dependent and the recommended dose is 20-80 mg twice a day. Although it is unlikely to bother your 16 month old, we still recommend you monitor the baby for signs of sedation. These include increased sleepiness and poor appetite. Abilify is an L3 which means we do not have a lot of data on the use of this drug while breastfeeding. In one case report the amount that transferred to the baby was found to be approximately 1% of the maternal dose and although this is a small percentage this is only based on one possibly flawed study. Abilify also has a long half-life (75 hours) compared with Geodon which has a half life of 7 hours. My recommendation is that if Geodon works for you it is probably a good choice over Abilify since there is more data on it and it has a shorter half-life. I hope this is helpful. If you have any further questions you can contact us at 806-352-2519.
    Sincerely,
    Maria Milla, MD
    InfantRisk Center

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