Aripiprazole

It is an atypical antipsychotic used in the treatment of schizophrenia, bipolar disorder, major depressive disorder, irritability associated with autism and Tourette syndrome. Oral (or intramuscular) administration once daily.

Its pharmacokinetic data (low oral bioavailability, large volume of distribution, moderately elevated molecular weight and high plasma protein binding) explains the negligible or zero passage into breast milk observed. ^{(Nordeng 2014, Watanabe 2011, Lutz 2010, Schlotterbeck 2007)}

No problems were observed in infants whose mothers were taking it ^{(Nordeng 2014, Tarikh 2014, Lutz 2010).} The plasma levels of these infants were undetectable or very low. ^{(Watanabe 2011)}

Its relationship with prolactin is controversial because it lowers prolactin levels and has been used to treat prolactinomas and hyperprolactinemia induced by the use of other antipsychotics ^{( Propst 2016, Bakker 2016, Ranjbar 2015, Raghuthaman 2015, Safer 2013, Byerly 2009, Wolf 2007, Lorenz 2007, Goodnick 2002)} and several cases of decreased milk production have been reported ^{(Komaroff 2021, Walker 2019, Yskes 2018, Morin 2017, Frew 2015, Mendhekar 2006)}, although there are also cases of hyperprolactinemia-galactorrhea triggered by aripiprazole. ^{(Gunes 2018, Sogawa 2016, Prost 2016, Saraf 2014, Mendhekar 2005, Ruffatti 2005)}

Expert authors consider the use of this medication possible during breastfeeding ^{(Hale, Cuomo 2018, Larsen 2015, Parikh 2014)}. Monitor for possible drowsiness in the infant. ^{(Hale 2017 p.74)}

Due to its slow elimination and the risk of affecting milk production, it may be worthwhile using other compatible antipsychotics with a shorter half-life, especially during the neonatal period and in case of prematurity. ^{(Uguz 2021 & 2016)}

See below the information of this related product:

• Maternal Psychotic Disorder. Maternal psychosis, schizophrenia, bipolar disorder (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)