" Mom is
being treated for depression is on prozac, amitripyline as well as tagamet
and oxybutrin. Her physician is aware shes breastfeeding. Sorry this is so
long." Chris Clark RCP, IBCLC

Dear Chris,

My psychiatic background signals some red flags here.  I could be off but if
all of the details are here, though more info would be helpful, this woman
sounds as if she may be experiencing PP psychosis with its inherent obsessive
thoughts.  The other striking problem may well be the meds she's on;  both
amitriptyline (Elavil) and ooxybutynin (Ditropan-had to look this one up) are
anticholinergics which could decrease milk supply.  In fact Hale's says that
oxybutynin has the following concerns," ...hallucinations infrequently
occur...suppression of lactation has been reported."  and "potentiates the
anticholinergic effects of tricyclic antidepressants (Elavil is one of
these).  Worse yet is that Elavil should not be used with Prozac-'due to
serotonergic crisis."  Have you asked her if you have her permission to speak
with her Dr?  These are just some areas to explore and according to Hale I'd
do so ASAP, maybe her behavior has to do with these drugs
interactions-certainly could be reason for drop in milk supply.  Tom, Jack
what are your opinions?

Good luck with this Mom.
Barbara Latterner, BSN,RN,IBCLC

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