Letters Bipolar disorder

Drugs for bipolar disorder while breast feeding

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f508 (Published 30 January 2013) Cite this as: BMJ 2013;346:f508
  1. Joanna C Girling, consultant obstetrician1
  1. 1West Middlesex University Hospital, Isleworth TW7 6AF, UK
  1. joanna.girling{at}wmuh.nhs.uk

Mental health problems remain a leading cause of maternal morbidity and mortality in the UK.1 In their clinical review of bipolar disorder Anderson and colleagues misleadingly say that “breast feeding is contraindicated on lithium, lamotrigine, and clozapine.”2 They rightly say that patients must be “engaged and enabled to make informed choices” about maintenance or prophylactic treatment, and this should extend to decisions about lactation

The National Institutes of Health has an excellent and up to date website about drugs in breast feeding that can provide clinicians with accurate information to inform discussions with patients.3 For example, there is much experience of women breast feeding while taking lamotrigine and olanzapine, and lithium use and breast feeding are not always incompatible.

The maternal and neonatal benefits of breast feeding are as valuable to women with bipolar disorder as to the rest of the population. Doctors caring for such women must make sure they advise them effectively.


Cite this as: BMJ 2013;346:f508


  • Competing interests: None declared.