Lamictal is probably the best drug for this mother to take, since recent
research shows it is particularly effective for bipolar depression
without pushing patients into mania, a risk with traditional
antidepressants.
Dr Hale used to be concerned about the potential for hypersensitivity
rash in breastfeeding infants, but has since reconsidered, as infants
need to be immunocompetent to get the rash.  There have not been any
reports of infants receiving lamictal through breast milk getting the
rash, which can occasionally progress to Stevens-Johnson syndrome in
children given lamictal directly.
Lamictal is currently being widely used in children with epilepsy, even
young children.  The dose is titrated very slowly, and this seems to
greatly reduce the risk of rash.  Other than the rash, it seems to be a
very safe drug, particularly for an anticonvulsant.
Catherine Watson Genna, BS, IBCLC  NYC

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