A few months ago, I wrote for advice regarding therapy for a nursing mother
with worsening symptoms of adult Attention Deficit Disorder.  Multiple
suggestions were made for alternative therapies, but no feedback was
received regarding the use of prescription medications for treatment.  The
mother has given a trial of the various alternative therapies without much
apparent change.  Her baby has passed one year of age and the mother is
considering weaning so that she may receive treatment for her ADD.  She
would prefer to keep nursing however, as she nursed her older children for
2+ years each.

From what I've read, stimulants are not recommended in nursing mothers and
would likely concentrate in the milk.  I wonder, if it is possible to use
the short acting ones and still nurse on a limited basis, such as in the
morning before dosing and at bedtime?  The child is in good health and
weighs about 25 pounds.  He nurses mostly ams and pms at present.

Also, there is a new drug, atomoxetine, recently approved for the treatment
of ADD which is supposed to be due out soon.  It is a selective
norepinephrine uptake inhibitor.  Can anyone comment on the potential use of
this drug in nursing mothers?

Your replies are much appreciated.

Catharine Decker, MD
Family Medicine/Urgent Care
Luther-Midelfort/Mayo Health System


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