Domperidone for lactation support does not carry risk of new-onset psychosis

Postpartum initiation of domperidone to support lactation does not appear to increase the risk of new-onset psychosis or emergency department (ED) visits or hospital admissions with mental health diagnoses, according to a retrospective study.

The study included women who did and did not fill a prescription for domperidone within 56 days of delivery. These domperidone-exposed and unexposed women were matched according to propensity score.

The primary outcome was any healthcare contact for incident psychosis in the subsequent 365 days, while the secondary outcome was any psychiatric ED visit or hospitalization.

Researchers looked at 2,237,806 births and identified 4,629 domperidone-exposed and 116,644 unexposed women. The propensity-score matched population consisted of 4,585 domperidone-exposed participants and an equal number of those who were unexposed, with good balance across all measured baseline characteristics.

Compared with unexposed women, those with exposure to domperidone use were not more likely to receive a diagnosis of psychosis (6.4 vs 6.4 per 1,000 person-years; hazard ratio [HR], 1, 95 percent confidence interval [CI], 0.60–1.67) in the postpartum period.

Moreover, domperidone exposure was not associated with ED visits or hospital admissions with mental health diagnoses compared with nonexposure (38 vs 43.4 per 1,000 person-years; HR, 0.88, 95 percent CI, 0.71–1.08).