Is Buspirone safe while breastfeeding?

Effects on the breastfed infant

Possible drug-induced seizure-like activity and cyanosis occurred in a breastfed 3-week-old whose mother was taking buspirone 15 mg 3 times daily as well as fluoxetine and carbamazepine during pregnancy and breastfeeding. The authors thought that this reaction, if drug induced, was most likely caused by fluoxetine.[ 1 ] One exclusively breastfed 11-week-old infant was breastfed during maternal therapy with buspirone 10 mg daily and venlafaxine 300 mg daily. No adverse reactions were reported by the mother or in the medical records.[ 3 ]

Effects on milk supply

Buspirone increases serum prolactin.[ 4 - 7 ] Galactorrhea was reported in a woman taking venlafaxine after buspirone was added to her regimen. However, when buspirone was discontinued, galactorrhea persisted.[ 8 ] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Levels in milk

Maternal Levels. A woman was taking buspirone 15 mg 3 times daily during pregnancy and postpartum. On day 13 postpartum, buspirone was undetectable in breastmilk by HPLC assay (limit of detection and time of sample not stated).[ 1 ] Nine women taking buspirone 7.5 to 30 mg twice daily donated milk samples collected at 1, 2, 4, 6, 8, 10, and 12 hours after a dose to a human milk repository. Levels of buspirone and its active metabolite 1-(2-pyrimidinyl) piperazine were measured. Buspirone was not detected ( 1.5 mcg/L) in any samples, but the metabolite was found in all samples. The relative infant dose was estimated to average 0.91% (range 0.21 to 2.17%).[ 2 ] Infant Levels. In the exclusively breastfed infant of a mother who was taking buspirone 15 mg 3 times daily, buspirone was undetectable in the infant's serum by HPLC assay (limit of detection and time of sample not stated) on days 13 and 21 postpartum.[ 1 ]

Alternatives LactMed lists

• Lorazepam
• Oxazepam