A woman with treatment-resistant schizophrenia who is breastfeeding is being considered for antipsychotic therapy. Which antipsychotic should be avoided during lactation because of documented serious adverse effects in breastfed infants?
- A Olanzapine
- B Quetiapine
- C Clozapine ✓
- D Risperidone
Correct answer: C. Clozapine
Explanation
Clozapine reaches breast milk in substantial amounts, with a relative infant dose approaching 28 percent, and case reports describe infant sedation, seizures, and agranulocytosis, so it is considered contraindicated during breastfeeding and requires haematological vigilance if unavoidable. Olanzapine, quetiapine, and risperidone have far lower transfer rates and are regarded as compatible with careful infant monitoring.
Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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