Permission has been given by patient to post.

I have a case that I feel has resolved well except for one point, which I am 
seeking help on.

A patient, currently without primary health care, reached out to me yesterday 
stating that she "had to stop breastfeeding." I inquired why she shared that 
prior to pregnancy she had received a diagnosis of schizophrenia and had been 
on Respiradol 1mg 2x/dy.  She had been told that the medication was 
dangerous to the baby and shouldn't breastfeed.  Her symptoms had been in 
remission throughout the pregnancy up until 4 days ago (baby is four months 
old and exclusively breastfed).  She doesn't want to stop breastfeeding, but 
stated that "I know I need my medication."  We talked for awhile I provided 
her the information on LACTMED re: risperidone and possible alternatives as 
listed.  Given the nature of the situation (she has support and the baby was 
safe) she agreed to meet me at the hospital and be seen in our Psychiatric 
ER.  Prior to her arrival I met with two docs there and told them the situation.  
Everything went smoothly and the mother was a wonderful self advocate for 
herself and her child.

Here's the question:  the doctor(s) prescribed Haloperidol at 1mg 2x/dy and 
benztropine mesylate, which apparently is bromocriptine, at a similar low 
dosage.  LACTMED pretty clearly states that benztropine mesylate is a 
lactation suppressant--short acting but with multiple possible side effects.  
Does anyone have experience with this pairing?  I have told the mother to 
watch for any signs that her supply is dropping and to contact me immediately 
if she does.  This is not my area of expertise so I am hoping someone might be 
familiar with the medication in question and give me some insight into how 
much it might effect her supply, if it does is it long lasting?

Thanks for reading this missive.

Lea

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