Domperidone Use as a Galactagogue and Infanticide Ideation: A Case Report

Abstract

Objectives: Domperidone is an antiemetic that is commonly used as an off-label prescription to induce lactation. Neuropsychiatric adverse effects of domperidone such as akathisia and depression are previously described. It has never been reported to be associated with infanticide ideation. The aim of this article is to discuss the occurrence of infanticide ideation following domperidone usage in an adoptive mother and the potential mechanisms by which these may occur. Methods: With Institutional Review Board approval, we herein report a nulliparous adoptive mother who developed infanticide ideation after 3 months of exposure to domperidone. The infanticide ideation was intrusive, recurrent, ego-dystonic, causing significant depressive symptoms and affecting the patient's functions. Physical examination and relevant biological investigations were unremarkable. Results: The patient is treated as domperidone-induced obsessional thought with adjustment disorder. The domperidone was stopped immediately. Serotonin and norepinephrine reuptake inhibitors was started. The infanticide ideation gradually resolved and patient achieved complete remission after 10 months of treatment. Conclusion: The infanticide ideation following consumption of domperidone is a potential neuropsychiatric adverse event that warrants further examination into the safety of domperidone as an "off-labeled" galactagogue. Comprehensive psychological assessment of mother who wishes to use domperidone as galactagogue is recommended.

Keywords: domperidone; galactagogue; induced lactation; infanticide ideation; obsessive–compulsive symptoms.