Lisdexamfetamine Mesilate

A prodrug that is metabolized directly in the intestine to dextroamphetamine. It is used to treat Attention Deficit Hyperactivity Disorder (ADHD) and bulimia.

Dextroamfetamine is a sympathomimetic drug, central nervous system stimulant, whose action and uses are similar to amphetamine (see information) which is its dextro isomer.

It is excreted in breast milk, concentrating about 3 times more than in plasma and resulting in a relative dose of around 6% for the infant (Ilett, 2007).
In infants whose mothers were taking dexamfetamine as treatment for ADHD, levels ranging from undetectable to 14% of maternal plasma levels have been measured and no problems were observed in the clinical follow-up of these infants (Ilett, 2007).

There is little information on the impact of amphetamine abuse on infant development and health (Oei, 2012, Wise, 2007; Moretti, 2000), but it is known that they are more exposed to social problems, domestic violence, and lower rates of breastfeeding (Oei, 2010).

There is controversy over the possibly mild negative effect of amphetamine on prolactin (Petraglia, 1987; DeLeo, 1983), but milk production in mothers who took it therapeutically was not affected (Öhman, 2015).

During breastfeeding, the therapeutic use (ADHD, bulimia) of amphetamine can be assessed, using the lowest possible effective dose and monitoring the occurrence of irritability, insomnia, lack of appetite and weight loss.

Its use as an illegal drug is totally discouraged (Oei, 2012).

• Dexamfetamine Sulfate (Low Risk probable)

Alternatives

• Methylphenidate (Very Low Risk)
• Dexamfetamine Sulfate (Low Risk probable)