The Basics

What is Chlorpromazine?

Used to treat the symptoms of schizophrenia.

Brand names for Chlorpromazine

Thorazine

How Chlorpromazine is classified

Antipsychotic Agents, Phenothiazines

Chlorpromazine During Pregnancy

Chlorpromazine pregnancy category

Category N/ANote 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 Chlorpromazine while pregnant

Safety for the use of Thorazine (chlorpromazine) during pregnancy has not been established. Therefore, it is not recommended that the drug be given to pregnant patients except when, in the judgment of the physician, it is essential. The potential benefits should clearly outweigh possible hazards. There are reported instances of prolonged jaundice, extrapyramidal signs, hyperreflexia or hyporeflexia in newborn infants whose mothers received phenothiazines. Reproductive studies in rodents have demonstrated potential for embryotoxicity, increased neonatal mortality and nursing transfer of the drug. Tests in the offspring of the drug-treated rodents demonstrate decreased performance. The possibility of permanent neurological damage cannot be excluded.

Taking Chlorpromazine While Breastfeeding

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

Chlorpromazine is detectable in the milk of some mothers during therapy, but levels appear not to correlate well with the maternal dose or serum level. Some breastfed infants become drowsy during maternal chlorpromazine therapy. Very limited long-term follow-up data indicate no adverse developmental effects when the drug is used alone. However, using it in combination with haloperidol can negatively affect development. Monitor the infant for excessive drowsiness during breastfeeding and for developmental milestones, especially if other antipsychotics are used concurrently.

Maternal / infant drug levels

Chlorpromazine is detectable in the milk of some mothers during therapy, but levels appear not to correlate well with the maternal dose or serum level. Some breastfed infants become drowsy during maternal chlorpromazine therapy. Very limited long-term follow-up data indicate no adverse developmental effects when the drug is used alone. However, using it in combination with haloperidol can negatively affect development. Monitor the infant for excessive drowsiness during breastfeeding and for developmental milestones, especially if other antipsychotics are used concurrently.

Possible effects of Chlorpromazine on milk supply

Phenothiazines cause galactorrhea in 26 to 40% of female patients.[13][14] Hyperprolactinemia appears to be the cause of the galactorrhea.[15][16][17] The hyperprolactinemia is caused by the drug’s dopamine-blocking action in the tuberoinfundibular pathway.[18]

Chlorpromazine has been used to enhance milk production,[8][19] although this use has been supplanted by the use of less sedating drugs such as metoclopramide and domperidone.[20]

Possible alternatives to Chlorpromazine

Haloperidol, Olanzapine, Risperidone.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Blacker KH, Weinstein BJ, Ellman GL. Mother’s milk and chlorpromazine. Am J Psychiatry. 1962;119:178-9. PMID: 14480810
2. Citterio C. Riconoscimento e dosaggio di derivati fenotiazinici nella secrezione lattea. Neuropsichiatria. 1964;20:141-6.
3. Uhlir F, Ryznar J. Appearance of chlorpromazine in the mother’s milk. Acta Nerv Super (Praha). 1973;15:106. PMID: 4752633
4. Wiles DH, Orr MW, Kolakowska T. Chlorpromazine levels in plasma and milk of nursing mothers. Br J Clin Pharmacol. 1978;5:272-3. Letter. PMID: 656275
5. Ohkubo T, Shimoyama R, Sugawara K. Determination of chlorpromazine in human breast milk and serum by high-performance liquid chromatography. J Chromatogr. 1993;614:328-32. PMID: 8314947
6. Sugawara K, Shimoyama R, Ohkubo T. Determinations of psychotropic drugs and antiepileptic drugs by high-performance liquid chromatography and its monitoring in human breast milk. Hirosaki Med J. 1999;51(Suppl):S81-6.
7. Yoshida K, Smith B, Craggs M et al. Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med. 1998;28:81-91. PMID: 9483685
8. Bonello FJ. Chlorpromazine in general practice. Int Rec Med Gen Pract Clin. 1956;169(4):197-212. PMID: 13318732
9. Lacey JH. Dichloralphenazone and breast milk. Br Med J. 1971;4:684. Letter. PMID: 5134581
10. Kris EB, Carmichael DM. Chlorpromazine maintenance therapy during pregnancy and confinement. Psychiatr Q. 1957;31:690-5. PMID: 13518422
11. Kris EB. Children born to mothers maintained on pharmacotherapy during pregnancy and postpartum. Rec Adv Biol Psychiatry. 1962;4:180-7. PMID: 4954450
12. Ayd FJ. Children born of mothers treated with chloropromazine during pregnancy. Clin Med. 1964;71:1758-63.
13. Polishuk WZ, Kulcsar S. Effects of chlorpromazine on pituitary function. J Clin Endocrinol Metab. 1956;16:292-3. PMID: 13286329
14. Hooper JH Jr, Welch VC, Shackelford RT. Abnormal lactation associated with tranquilizing drug therapy. JAMA. 1961;178:506-7. PMID: 14448766
15. Turkington RW. Prolactin secretion in patients treated with various drugs: phenothiazines, tricyclic antidepressants, reserpine, and methyldopa. Arch Intern Med. 1972;130:349-54. PMID: 4560178
16. Turkington RW. Serum prolactin levels in patients with gynecomastia. J Clin Endocrinol Metab. 1972;34:62-6. PMID: 5061776
17. Meltzer HY, Fang VS. The effect of neuroleptics on serum prolactin in schizophrenic patients. Arch Gen Psychiatry. 1976;33:279-86. PMID: 1259521
18. Maguire GA. Prolactin elevation with antipsychotic medications: mechanisms of action and clinical consequences. J Clin Psychiatry. 2002;63 (Suppl 4):56-62. PMID: 11913677
19. Nemba K. Induced lactation: a study of 37 non-puerperal mothers. J Trop Pediatr. 1994;40:240-2. PMID: 7932939
20. Anderson PO, Valdes V. A critical review of pharmaceutical galactagogues. Breastfeed Med. 2007;2:229-42. PMID: 18081460

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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