Breast feeding and bipolar medications
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Breast feeding and bipolar  medications

Q: hi i was diagnosed with bi-polar 6+ years ago . i went off my meds 15 months ago because i got pregnate my son is now 5 1/2 months old . i am brest feeding so i'm still off my meds i was doing great until a week ago .i've been having alot of major up's and downs my son refuses a bottle so i cant break him from breast feeding yet. do you have any advise of any meds i can take while i breast feed? that wont harm my baby. or anything i can do to keep my head level??? i feel like i'm going crazy.....
i know i need my meds but my baby comes first...... do you have any advise....?
 
thank you               colleen

Dear Colleen --
The only mood stabilizer that is currently "accepted" for use while breastfeeding is Depakote.  Lithium gets into breast milk too much; the data on carbamazepine (Tegretol, Carbatrol) are less clear but don't look good.  And we have too little data on all the rest.  Even the Depakote data are pretty slim, but it was enough for the American Academy of Pediatrics; and to my knowledge there are no known "horror stories", at least not in the published literature.  

Then there's the line of thought you've probably heard plenty by now: your son is probably better off with a mother who's not feeling like she's going crazy than with breast milk anymore.  He got his good antibodies from you already.  There's probably more benefit to be had, but not if it costs him his mother's mental health.  If you can't get controlled quickly on Depakote, time to strongly consider weaning and getting on whatever you need for good symptom control.

Dr. Phelps


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