Psychotropic Drugs in Lactation

Breast feeding is accompanied by numerous clinical and psychosocial advantages for both the mother and her child. Since most drugs will pass into human milk in some amount, the lactating mother who requires pharmacotherapy adds complexity to the risk-benefit assessment for clinicians making treatment decisions. In the case of psychotropic medications this issue is particularly worrisome since women who are not well controlled will have impaired bonding with their child. Moreover, these women may not necessarily recognize adverse events or abnormal outcomes in her infants. In an ideal situation, the patient would receive pharmacotherapy to assist in disease management, while at the same time successfully breastfeed her child. This goal of this presentation is to discuss the disposition of drugs in lactating patients and to outline the available literature concerning the use of psychotropic drugs in lactating women. Part of the continuum of treating women with psychiatric disease in pregnancy concerns the treatment of women after delivery, and for many, this will include drug treatment during lactation. The goal of today's discussion is to describe the issues and outline what is currently known about the use of psychotropic drugs in breastfeeding women.