Haldol During Pregnancy & Breastfeeding

by on July 13, 2012

Haldol is a brand name medicine containing the substance haloperidol and it is used for the treatment of mental disorders, personality disorders, motor and verbal tics and other problems including schizophrenia, acute psychosis, Tourette’s syndrome, and bipolar disorder.

Pregnancy Category

Haldol has been assigned to pregnancy category C by the Food and Drug Administration. This means that the experiments on animals have revealed a teratogenic risk for the fetus but there are no adequate and well-controlled studies on humans. Still, in some cases the expected benefit can outweigh the potential risks.

Can Haldol Be Used During Pregnancy?

Haldol should be avoided during pregnancy as it could harm the developing fetus. However, pregnancy is known to aggravate the symptoms of psychoses.  Psychoses are very serious conditions and sometimes the use of certain antipsychotics during pregnancy may outweigh the risk. Haldol is sometimes administered during pregnancy under strict medical control and only if there is no other alternative. Whenever it is possible, its use during pregnancy should be avoided.

There are some studies stating that haloperidol can cause limb reduction defects if fetuses are exposed to it during the first trimester of pregnancy. If such exposure has occurred, ultrasound control performed by a specialist in the field is recommended.

Haldol is also to be avoided by women who are trying to get pregnant. If you want to become pregnant and you are currently treated with haloperidol, discuss it with your doctor. If you become pregnant while you are on Haldol, consult your doctor as soon as possible.

Haldoleridol has high lipid solubility and it easily passes the placenta and enters the fetal circulation. There is limited data that it can harm the developing brain of the fetus causing structural changes. Its use has also been associated with neural tube defects.

Haloperidol is clearly teratogenic in mice so possibly it is embryo and fetotoxic in people too.

There is a reported case of a neonate suffering from withdrawal symptoms since the mother has been using haloperidol during the pregnancy. The infant had abnormal tongue and hand movements. Fortunately, the symptoms resolved.

Haldol and Breastfeeding

Haldol is excreted in breast milk. Some studies suggest that at moderate doses it is safe provided its levels in breast milk and the infants’ plasma are monitored. However, there are not enough studies in order to say this for sure. On balance, the use of Haldol during breastfeeding should be avoided.

There are some reports of infants suffering from extrapyramidal symptoms (uncontrollable movements, muscle rigidity etc.) whose mothers have been using haloperidol and breastfeeding them. One study describes a decline in the development of an infant whose mother has been using a combination of two antipsychotics.  Other studies show no adverse effects on infants. However, probably there is a chance of development of negative effects in part of the neonates.

As a whole, avoiding Haldol during breastfeeding is recommended. If this is not possible, discontinuing of the breastfeeding should be considered.

Do not hesitate to discuss any issues concerning pregnancy and breastfeeding with your doctor.