Eglynol and Esperide are from the group of drugs called sulpirides, they are predominantly used to treat schizophrenia and major depressive disorders, they are NOT merely a harmless antidepressant as so many claim, in fact, medical research shows that sulpirides are not effective as a stand alone treatment for depression or post natal depression at all and recommend several other, far more effective and safe treatments for PND.
These drugs are often prescribed off label (not for their intended use) as a lactation aide for breastfeeding mothers.
The regulated dose is anywhere from 1 to 3 tablets three times a day for schizophrenia and major depressive disorders such as bipolar and mania, lower doses taken in conjunction with antidepressants are used to enhance the effects of the antidepressants for patients with mild depression or panic and anxiety disorders, these doses coincide with the doses regularly recommended for lactating mothers.
Side effects of these drugs include:
Akathisia — a sense of inner restlessness that presents itself with the inability to stay still
Parkinsonism Somnolence (not a very prominent adverse effect considering its lack of α1 adrenergic, histamine and muscarinic acetylcholine receptor affinity)
Weight gain or loss
Hyperprolactinemia (elevated plasma levels of the hormone, prolactin which can, in turn lead to sexual dysfunction, galactorrhea, amenorrhea, gynecomastia, etc.)
Tardive dyskinesia — a rare, often permanent movement disorder that, more often than not, results from prolonged treatment with antidopaminergic agents such as antipsychotics. It presents with slow (hence tardive), involuntary, repetitive and purposeless movements that most often affect the facial muscles.
Neuroleptic malignant syndrome — a rare, life-threatening complication that results from the use of antidopaminergic agents. Its incidence increases with concomitant use of lithium (medication) salts
Blood dyscrasias — rare, sometimes life-threatening complications of the use of a number of different antipsychotics (most notably clozapine) which involves abnormalities in the composition of a person’s blood (e.g. having too few white blood cells per unit volume of blood). Examples include:- Agranulocytosis — a significant drop in white blood cell count, leaving individuals wide open to life-threatening opportunistic infections
Torsades de pointes
Unknown incidence adverse effects include
QTc interval prolongation which can lead to potentially fatal arrhythmias.
Elevated liver enzymes
Primary biliary cirrhosis
Photosensitivity — sensitivity to light
Diaphoresis — sweating without a precipitating factor (e.g. increased ambient temperature)
Hypotension — low blood pressure
Hypertension — high blood pressure
Venous thromboembolism (probably rare)
Clinical research regarding the use of sulpirides in pregnancy and lactation are as follows:
Pregnancy: Animal studies did not reveal any embryotoxicity or fetotoxicity, nor did limited human experience. Due to insufficient human data, pregnant women should be treated with sulpiride only if strictly indicated. Additionally, the newborns of treated women should be monitored, because isolated cases of extrapyramidal side effects have been reported.
Lactation: Sulpiride is found in the milk of lactating women. Since the consequences are unclear, women should not breastfeed during treatment.
If you are taking enough of a medication for you to have the effects of the noted side effects (ie: Hyperprolactinemia), then you are taking enough of the drug for it to affect the intended area of treatment, in this case, your brain.
There are several other options that are both safer and more effective as a galactagogue, none as effective however as the frequent removal of milk from the breast.
Additional resources : (click on the links to access the pages)