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Antipsychotics and Lactation

  • Joshua Niforatos
  • Carol Swetlik
  • Adele VigueraEmail author
Chapter

Abstract

Clinical decisions regarding breastfeeding and antipsychotics should be based on a careful assessment of risks and benefits to both mother and infant, bearing in mind the serious detrimental effects of untreated mental illness and the many health and emotional benefits of breastfeeding. A thoughtful risk/benefit assessment is recommended, and ideally, such a discussion should occur in advance of delivery with the patient, her psychiatrist, and her infant’s pediatrician. In this chapter, a brief overview of general pharmacological and clinical considerations, regarding the use of antipsychotics during breastfeeding, will be presented. Commonly used first- and second-generation antipsychotics (FGAs and SGAs) will be critically evaluated to determine whether neonatal exposure through breast milk poses a significant risk in terms of adverse effects. At present, while there is an absence of high-quality studies to make definitive recommendations regarding antipsychotics and breastfeeding, most first-generation and second-generation antipsychotics appear to pose minimal risk to the infant. Clinically, antipsychotic use during breastfeeding should not be discouraged, and close clinical monitoring of the infant is indicated.

Keywords

Antipsychotics Breastfeeding Lactation Postpartum period Adverse effects Polypharmacy 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Joshua Niforatos
    • 1
  • Carol Swetlik
    • 1
  • Adele Viguera
    • 2
    Email author
  1. 1.Cleveland Clinic Lerner College of MedicineCase Western Reserve UniversityClevelandUSA
  2. 2.Department of Psychiatry, Neurological InstituteCleveland ClinicClevelandUSA

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