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Antipsychotics and Lactation

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Perinatal Psychopharmacology

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.

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Author information

Authors and Affiliations

  1. Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Joshua Niforatos & Carol Swetlik

  2. Department of Psychiatry, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA

    Adele Viguera

Authors
  1. Joshua Niforatos
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  2. Carol Swetlik
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  3. Adele Viguera
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Correspondence to Adele Viguera .

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Editors and Affiliations

  1. Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Faruk Uguz

  2. Psychopharmacological, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK

    Laura Orsolini

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Niforatos, J., Swetlik, C., Viguera, A. (2019). Antipsychotics and Lactation. In: Uguz, F., Orsolini, L. (eds) Perinatal Psychopharmacology. Springer, Cham. https://doi.org/10.1007/978-3-319-92919-4_8

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  • DOI: https://doi.org/10.1007/978-3-319-92919-4_8

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  • Online ISBN: 978-3-319-92919-4

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