Maternal doses of olanzapine up to 20 mg daily produce low levels in milk and undetectable levels in the serum of breastfed infants. In most cases, short-term side effects have not been reported, but sedation has occurred. Limited long-term follow-up of infants exposed to olanzapine indicates that infants generally developed normally. A safety scoring system finds olanzapine to be acceptable during breastfeeding.[1] Systematic reviews of second-generation antipsychotics concluded that olanzapine seems to be a first-line agent during breastfeeding.[2-4] Monitor the infant for drowsiness, irritability, poor feeding, and extrapyramidal symptoms, such as tremors and abnormal muscle movements, and developmental milestones, especially if other antipsychotics are used concurrently. No information is available on the use of samidorphan, which is a component of Lybalvi, during breastfeeding. If a mother requires olanzapine and samidorphan it is not a reason to discontinue breastfeeding. Because samidorphan is a partial opiate agonist, the combination might cause increased drowsiness or respiratory depression than olanzapine alone.
母亲每日服用高达20毫克的奥氮平，乳汁中的含量较低，母乳喂养婴儿的血清中检测不到。在大多数情况下，尚未报告短期副作用，但有嗜睡情况发生。对接触奥氮平的婴儿进行的有限长期随访表明，婴儿一般发育正常。一种安全评分系统认为奥氮平在母乳喂养期间是可接受的。[1] 对第二代抗精神病药物的系统评价得出结论，奥氮平似乎是母乳喂养期间的一线药物。[2-4] 监测婴儿是否出现嗜睡、烦躁、喂养困难和锥体外系症状，如震颤和异常肌肉运动，以及发育里程碑情况，尤其是在同时使用其他抗精神病药物时。关于Lybalvi的成分沙米多芬在母乳喂养期间的使用情况尚无信息。如果母亲需要奥氮平和沙米多芬，这不是停止母乳喂养的理由。由于沙米多芬是一种部分阿片类激动剂，与单独使用奥氮平相比，联合使用可能会导致嗜睡或呼吸抑制加重。
