Is Trihexyphenidyl safe while breastfeeding?
Here is what LactMed, the Drugs and Lactation Database published by the U.S. National Institute of Child Health and Human Development (NICHD), reports about Trihexyphenidyl. The text below is quoted from that source — it is not our own verdict.
Summary of use during breastfeeding
Limited information indicates that maternal doses of trihexyphenidyl up to 4 mg daily together with haloperidol or risperidone did not produce any adverse effects in breastfed infants. Long-term use of trihexyphenidyl might reduce milk production or milk letdown, but a single dose is not likely to interfere with breastfeeding. The prolactin elevating effect of concurrent antipsychotic agents might counteract any prolactin lowering effect of trihexyphenidyl. During long-term use, observe for signs of decreased lactation (e.g., infant insatiety and poor weight gain).
Effects on the breastfed infant
One woman with schizophrenia took trihexyphenidyl and haloperidol during 3 pregnancies and postpartum. The trihexyphenidyl dose was 4 mg daily in all 3 pregnancies. She breastfed (extent not stated) all 3 children for 6 to 8 months using the same doses. Development was age-appropriate in all children aged 16 months at 8 years of age at the time of assessment.[1]
A woman diagnosed with undifferentiated schizophrenia took risperidone 4 to 5 mg and trihexyphenidyl 2 mg daily throughout 5 pregnancies. She breastfed each infant for 20 to 24 months. No adverse developmental consequences were noted in any of the children. At the time of publication, the oldest three children, aged 26, 23 and 22 years, had completed their education and were employed, while the youngest two were 15 and 19 years old and were doing well academically in their education.[2]
Effects on milk supply
Anticholinergics can inhibit lactation in animals, apparently by inhibiting growth hormone and oxytocin secretion.[3-7] Anticholinergic drugs can also reduce serum prolactin in nonnursing women.[8] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
One woman with schizophrenia took trihexyphenidyl and haloperidol during 3 pregnancies and postpartum. She was able to breastfeed (extent not stated) all 3 children for 6 to 8 months.[1]
A woman diagnosed with undifferentiated schizophrenia took risperidone 4 to 5 mg and trihexyphenidyl 2 mg daily throughout 5 pregnancies. She successfully breastfed each infant for 20 to 24 months.[2]
Levels in milk
Maternal Levels. Relevant published information was not found as of the revision date.
Infant Levels. Relevant published information was not found as of the revision date.
Source: Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development (NICHD), via NCBI Bookshelf, record “Trihexyphenidyl” (LM769). LactMed on NCBI Bookshelf. LactMed is a registered trademark of the U.S. Department of Health and Human Services.
Educational summary of an authoritative source — not medical advice. Never start, stop, or change a medicine while breastfeeding without confirming with your doctor.