Dh took me to the er Wednesday and they were gonna put me back on Abilify, the dr was hunky dorey about it since I took it at night and dd sttn. Then his boss vetoed it and recommended that I wean.
So does anyone know of any bfing friendly bipolar meds? Usually they like to do an anti depressant and mood stabilizer... But I'm open to doing whatever it takes to continue bf safely (for the two of us.)
Thanks!
Get a copy of medications and mother's milk. It has been sooo helpful to me!
abilify info:
| Aripiprazole CASRN: 129722-12-9 |  |
Drug Levels and Effects:
Summary of Use during Lactation:
Limited information indicates that maternal doses of aripiprazole up to 15 mg daily produce low levels in milk, but until more data become available, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Drug Levels:
Maternal Levels. A women who was 6 months postpartum was taking aripiprazole 15 mg by mouth daily. Milk levels after 11 and 12 days of therapy (times not stated) at that dose were 13 and 14 mcg/L.[1]
A woman took aripiprazole 15 mg daily by mouth during pregnancy and postpartum. At 3 days postpartum, aripiprazole was not detectable in colostrum because of an unknown substance that interfered with the assay. On day 27 postpartum, 3 additional milk samples were collected at 30 minutes before the dose (24 hours after the last dose), and 4 and 10 hours after the dose. The drug and its metabolite were undetectable (<10 mcg/L) in all samples. The authors estimated that a fully breastfed infant would receive less than 0.7% of the maternal weight-adjusted dosage.[2]
A woman was taking aripiprazole 18 mg daily. On day 6 postpartum, a breastmilk sample (time not reported) contained a concentration of aripiprazole of 38.7 mcg/L.[3]
Infant Levels. A woman was taking aripiprazole 18 mg daily during pregnancy and postpartum. On day 6 her breastfed infant had a serum concentration of 7.6 mcg/L, although some portion of the concentration could have been residual from transplacental transmission because of the drug's on half-life.[3]
Effects in Breastfed Infants:
A woman took aripiprazole 15 mg daily by mouth during pregnancy and postpartum. She breastfed her infant (amount not stated) and at 3 months of age, the infant was growing normally.[2]
Possible Effects on Lactation:
Unlike the phenothiazines, aripiprazole has a minimal effect on serum prolactin levels.[4][5][6] However, 2 cases of galactorrhea apparently caused by aripiprazole have been reported.[7][8]
One woman began taking aripiprazole 10 mg daily at week 20 of pregnancy. She underwent a cesarean section delivery at term, but was unable to establish lactation. The authors suggested that more data are needed to determine if aripiprazole adversely affects lactation.[9]
The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Alternate Drugs to Consider:
Haloperidol, Olanzapine
Because you're looking at combos of meds, I think this is definitely one case where a call to Dr. Hale's Infant Risk Center is warranted. They can give you the latest info available and counsel you on risks vs benefits of all of the potential medication options. This is the info: Each year, more than 4.3 million women give birth in the U.S. Virtually all of these women will use at least one medication during pregnancy or during breastfeeding.
Quoting K8wizzo:Because you're looking at combos of meds, I think this is definitely one case where a call to Dr. Hale's Infant Risk Center is warranted. They can give you the latest info available and counsel you on risks vs benefits of all of the potential medication options. This is the info: Each year, more than 4.3 million women give birth in the U.S. Virtually all of these women will use at least one medication during pregnancy or during breastfeeding.
The InfantRisk Center will be dedicated to providing up-to-date evidence-based information on the use of medications during pregnancy and breastfeeding. Our goal is to provide accurate information regarding the risks of exposure to mothers and their babies. By educating healthcare professionals and the general public alike, we aim to reduce the number of birth defects as well as create healthy breastfeeding relationships.We are now open to answer calls Monday-Friday 8am-5pm central time. Please contact us at (806)-352-2519.
The decision about continuing breastfeeding when the mother takes a drug is far more involved than whether the baby will get any in the milk. It also involves taking into consideration the risks of not breastfeeding, for the mother and the baby. And there are plenty of risks in not breastfeeding, so the question essentially boils down to: Does the addition of a small amount of medication to the mother’s milk make breastfeeding more hazardous than exclusive formula feeding? The answer is almost never. Breastfeeding with a little drug in the milk is almost always safer.
The following information comes from MEDICATIONS AND MOTHERS’ MILK by Thomas Hale, 2010. He assigns every drug a lactation risk category: L1, safest; L2, safer; L3, moderately safe; L4, possible hazardous; and L5, contraindicated. He also lists if a drug has been reviewed and/or approved by the American Academy of Pediatrics (AAP) for use in nursing mothers. Possible risks to mother and baby are listed as well as possible effect on milk supply.
ABILIFY
Listed as L3, moderately safe; not reviewed by the AAP; pediatric concerns: Several cases of somnolence in breastfed infants have been unofficially reported.
"Aripiprazole is a second-generation antipsychotic now first-line treatment for schizophrenia. In a small study of a single patient receiving 10 mg/day initially and then 15 mg subsequently, levels of aripiprazole in milk were reported to be 13 and 14 µg/L on two consecutive days (15 and 16 after initiation of therapy). Maternal plasma levels at the same time were 71 and 71µg/L. Levels were drawn in the morning before aripiprazole administration. Thus it appears from this brief report that they were drawn approximately 24 hours post dose.
Several reports (personal communication) of somnolence have been reported to this author. The infant should be monitored for somnolence."
caught the stomach flu and now i dont produce enough
- Missyify
on Jun. 25, 2012 at 7:44 PM