Open Letter regarding the use of, and potential of negative side effects from, the medication domperidone when used as a lactation aid.  
To whom it may concern,

We the undersigned are concerned about side effects and withdrawal symptoms related to the medication domperidone when prescribed as a long term lactation aid.  We have had, or have direct experience as support workers with people who have had, negative experiences with this medication.  These experiences include, but are not limited to:

-Panic attacks
-Intrusive thoughts
-Physical discomfort
-Involuntary movement
-Psychotic thoughts/episodes
-Suicidal ideation
-Extreme emotional distress

We are concerned that the off label usage of domperidone as a lactation aid has not been adequately researched, and that the potential negative impacts are being underestimated.  We note that the post partum period is a particularly fragile period for mental health, and we are concerned that side effects may go unrecognized in favor of post-partum mental health diagnosis.

We urge the medical community to ensure that:

1. Nursing people taking domperidone be advised of the potential for serious psychological disturbance resulting from withdrawal from domperidone, appropriate tapering schedules, and the warning signs that they are experiencing adverse side effects.

2. Prescribing physicians adequately advise patients that this is an off label usage of the medication.
A warning label should be affixed to this prescription advising of the potential for suicidal ideation.  

3. Further research be conducted on the side effects of domperidone in long term usage and the potential adverse effects of withdrawal.  

4. That Health Canada and the medical and research communities further research and consider the approval of/guidance regarding the use of domperidone as a lactation support.

We thank you for your time and concern,

Best regard.

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