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Domperidone Use as a Galactagogue and Infanticide Ideation: A Case Report
Rosnadia Suain Bon1, Asma Assa'edah Mahmud1
1Department of Psychiatry, Faculty of Medicine and Defense Health, National Defense University of Malaysia, Kuala Lumpur, Malaysia.
Domperidone, used off-label for lactation, may cause rare neuropsychiatric side effects like infanticide ideation. This case highlights the need for careful psychological screening before prescribing domperidone to mothers.
Area of Science:
- Neuropsychiatry
- Pharmacology
Background:
- Domperidone is frequently prescribed off-label to induce lactation.
- Known neuropsychiatric adverse effects include depression and akathisia.
Observation:
- A case report details a nulliparous adoptive mother experiencing intrusive infanticide ideation after three months of domperidone use.
- The ideation was ego-dystonic, accompanied by depressive symptoms, and impacted daily functioning.
Findings:
- Domperidone was discontinued, and the patient was treated for domperidone-induced obsessional thought with adjustment disorder.
- Treatment with serotonin and norepinephrine reuptake inhibitors led to gradual resolution of ideation and complete remission within ten months.
Implications:
- Infanticide ideation is a potential, previously unreported neuropsychiatric adverse event associated with domperidone.
- Further research is needed to assess the safety of domperidone as a galactagogue.
- Pre-prescription psychological evaluations are recommended for mothers seeking domperidone for lactation induction.
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