Methamphetamine

The Basics

What is Methamphetamine?

Used to treat ADHD by changing the amounts of certain natural substances in the brain.

Brand names for Methamphetamine

Desoxyn

How Methamphetamine is classified

Street Drugs, Sympathomimetics, Dopamine Agents, Central Nervous System Stimulants, Adrenergic Agents

Methamphetamine During Pregnancy

Methamphetamine pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Methamphetamine while pregnant

N/A

Taking Methamphetamine While Breastfeeding

What are recommendations for lactation if you're taking Methamphetamine?

Because there is no published experience with methamphetamine as a therapeutic agent during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Methamphetamine should not be used as a recreational drug by nursing mothers because it may impair their judgment and child care abilities. Methamphetamine and its metabolite, amphetamine, are detectable in breastmilk and infant’s serum after abuse of methamphetamine by nursing mothers. However, these data are from random collections rather than controlled studies because of ethical considerations in administering recreational methamphetamine to nursing mothers. Other factors to consider are the possibility of positive urine tests in breastfed infants which might have legal implications, and the possibility of other harmful contaminants in street drugs. In mothers who abuse methamphetamine while nursing, withholding breastfeeding for 48 to 100 hours after the maternal use been recommended, although in many mothers methamphetamine is undetectable in breastmilk after an average of 72 hours from the last use.[1][2] Nevertheless, breastfeeding is generally discouraged in mothers who are actively abusing amphetamines.[3][4][5][6] One expert recommends that amphetamines not be used therapeutically in nursing mothers.[7]

Maternal / infant drug levels

Because there is no published experience with methamphetamine as a therapeutic agent during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. Methamphetamine should not be used as a recreational drug by nursing mothers because it may impair their judgment and child care abilities. Methamphetamine and its metabolite, amphetamine, are detectable in breastmilk and infant’s serum after abuse of methamphetamine by nursing mothers. However, these data are from random collections rather than controlled studies because of ethical considerations in administering recreational methamphetamine to nursing mothers. Other factors to consider are the possibility of positive urine tests in breastfed infants which might have legal implications, and the possibility of other harmful contaminants in street drugs. In mothers who abuse methamphetamine while nursing, withholding breastfeeding for 48 to 100 hours after the maternal use been recommended, although in many mothers methamphetamine is undetectable in breastmilk after an average of 72 hours from the last use.[1][2] Nevertheless, breastfeeding is generally discouraged in mothers who are actively abusing amphetamines.[3][4][5][6] One expert recommends that amphetamines not be used therapeutically in nursing mothers.[7]

Possible effects of Methamphetamine on milk supply

A single oral dose of 0.2 mg/kg to a maximum of 17.5 mg of d-methamphetamine was given to 6 subjects (4 male and 2 female). Serum prolactin concentrations were unchanged over a period of 300 minutes after the dose.[10]

In 2 papers by the same authors, 20 women with normal physiologic hyperprolactinemia were studied on days 2 or 3 postpartum. Eight received dextroamphetamine 7.5 mg intravenously, 6 received 15 mg intravenously and 6 who served as controls received intravenous saline. The 7.5 mg dose reduced serum prolactin by 25 to 32% compared to control, but the difference was not statistically significant. The 15 mg dose significantly decreased serum prolactin by 30 to 37% at times after the infusion. No assessment of milk production was presented. The authors also quoted data from another study showing that a 20 mg oral dose of dextroamphetamine produced a sustained suppression of serum prolactin by 40% in postpartum women.[11][12]

A study compared 31 methamphetamine-dependent subject to 23 non-dependent subjects. The serum prolactin concentrations in the methamphetamine-dependent subjects were elevated at days 2 and 30 of abstinence. The elevation was greater in women than in men.[13] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed.

In a retrospective Australian study, mothers who used intravenous amphetamines during pregnancy were less likely to be breastfeeding their newborn infants at discharge than mothers who abused other drugs (27% vs 42%). The cause of this difference was not determined.[14]

A prospective, multicenter study followed mothers who used methamphetamine prenatally (n = 204) to those who did not (n = 208). Mothers who used methamphetamine were less likely to breastfeed their infants (38%) at hospital discharge than those who did not use methamphetamine (76%).[15]

Possible alternatives to Methamphetamine

(Therapeutic use) Amphetamine, Dextroamphetamine, Lisdexamfetamine, Methylphenidate.