Thioridazine and Breastfeeding

Summary of use during lactation

Because there is no published experience with thioridazine during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Phenothiazines cause galactorrhea in 26 to 40% of female patients.[1,2] Hyperprolactinemia appears to be the cause of the galactorrhea.[3-6] There is some evidence that thioridazine increases serum prolactin to a greater extent than other phenothiazines.[7] The hyperprolactinemia is caused by the drug's dopamine-blocking action in the tuberoinfundibular pathway.[8] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Alternative drugs to consider

Haloperidol, Olanzapine, Quetiapine, Risperidone

References

1. PolishukWZ KulcsarS Effects of chlorpromazine on pituitary function. J Clin Endocrinol Metab 1956 16 292 3 13286329 PubMed
2. HooperJHJr WelchVC ShackelfordRT Abnormal lactation associated with tranquilizing drug therapy. JAMA 1961 178 506 7 14448766 PubMed
3. TurkingtonRW Prolactin secretion in patients treated with various drugs: Phenothiazines, tricyclic antidepressants, reserpine, and methyldopa. Arch Intern Med 1972 130 349 54 4560178 PubMed
4. TurkingtonRW Serum prolactin levels in patients with gynecomastia. J Clin Endocrinol Metab 1972 34 62 6 5061776 PubMed
5. BeumontPJ GelderMG FriesenHG The effects of phenothiazine on endrocrine function: I Patients with inappropriate lactation and amenorrhoea. Br J Psychiatry 1974 124 413 9 4151788 PubMed
6. MeltzerHY FangVS The effect of neuroleptics on serum prolactin in schizophrenic patients. Arch Gen Psychiatry 1976 33 279 86 1259521 PubMed
7. GoodnickPJ RodríguezL SantanaO Antipsychotics: Impact on prolactin levels. Expert Opin Pharmacother 2002 3 1381 91 12387684 PubMed
8. MaguireGA Prolactin elevation with antipsychotic medications: Mechanisms of action and clinical consequences. J Clin Psychiatry 2002 63 Suppl 4 56 62 11913677 PubMed