Last evening a mom who has schizophrenia delivered a full term baby in our
hospital.
Baby nursed well after delivery, when taken back to nursery for the bath she
began tremors, seizure like activity.  Before I left, the MD asked me to
check on moms medications and get information on them in regards to
breastfeeding. I got the list of the four meds she is on, and wanted to ask
for opinions about them. I have looked them all up, and have given them the
information, but would like comments on this from any  who may have
knowledge of these medications.

Paroxitene (Paxil)- 30 mg  q AM,  antidepressant, serotonin reuptake
inhibitor
(not reviewed by AAP, Hale seems to feel that 1% remains in plasma)- this is
one of the ones that is usually chosen for breastfeeding mothers I
understand


Lorazepam (1 mg) Ativan- one half to one tablet twice a day-antianxiety
drug,sedative,
Hale says may be of concern,also says that amount of drug secreted in milk
would be of little concern under most conditions


Carbamazepine 200 mg (Tegretol)- 2 tablets at bedtime-anticonvulsant  AAP
approved

Olanzapine (Zyprexa ) 10 mg-  2 tablets at bedtime-antipsychotic- use
caution-
Carbamazepine may increase clearance of olanapine by 50%. (This is the one I
am most concerned about)

I am also concerned about the additive effects of all these different
medications.
Looking for learned opinions........... baby  continues to nurse as far as I
know at this time.

Ann Calandro,RNC,IBCLC