Aripiprazole and hypogalactorrhea in postpartum.

Introduction: Aripiprazole is a second generation antipsychotic, frequently use in women with psychotic or affective disorders that can appear or relapse during postpartum period. However, very little is known about the effect of aripiprazole in breastfeeding. Objectives: - Perform a literature search on case reports published about the use of aripiprazole and lactation. - Report a case of hypoprolactinemia and consequently hypogalactorrhea after aripipirazole initiation in postpartum woman. Methods: A systematic search of the literature (case reports) published, was carried out in the database MEDLINE (PubMed) between 2000 and 2018. We describe a case of unexpected hypogalactorrhea in a postpartum woman due to aripiprazole. Results: Four case reports have been published regarding maternal use of aripiprazole during breastfeeding; two of them described failure of lactation associated to aripiprazole treatment. We describe a case of a 41 years old postpartum woman, who after urgent caesarean section for preeclampsia and admission to ICU, presents anxiety, depressive symptoms, hypocondriform thoughts and checking compulsions, which interfered with bonding. She was treated with sertraline 200mg/d maintaining breastfeeding. Two months later Aripiprazole 5mg/d was added, with adequate tolerance. However, 2-3 days later the patient reported decreased milk production. Prolactin levels decreased from a previous 30,18 ng/ml to 5,02 ng/ml. Milk production normalized in less than a week after stopping aripiprazole. Conclusions: Both published cases and the present case suggest aripiprazole may possible cause hypoprolactinemia and therefore a milk production decrease in lactating women. This factor should be considered when starting aripiprazole in nursing mothers. [ABSTRACT FROM AUTHOR]