Aripiprazole and breastfeeding: A retrospective, multi-site, case series

BackgroundAripiprazole is a partial dopamine agonist antipsychotic used for schizophrenia and bipolar disorder. Where most antipsychotics increase prolactin, aripiprazole, due to its novel action, lowers prolactin levels. This novel action can also suppress lactation.AimThe aim of this study was to understand the rates of breastfeeding (exclusive or supplemented) while on aripiprazole.MethodsUsing a retrospective, chart review, electronic prescribing reports were used to identify when aripiprazole was prescribed in maternity units in six hospital sites in Queensland, Australia. Electronic charts were then used to identify cases of breastfeeding whilst on aripiprazole. Rates of breastfeeding were compared to a general population.FindingsThirty-four cases of breastfeeding whilst on aripiprazole were identified. Twenty-three (73.5%) ceased breastfeeding by the last midwife appointment. Eight (23.5%) were supplementing breastfeeding with artificial feeds. Only one mother was able to exclusively breastfeed. The effect may be dose related.ConclusionThis study further supports the current case reports in the literature and suggests that women taking aripiprazole appear to have very low rates of exclusive breastfeeding. This effect appears to be dose related.