Contemporary models of severe psychotic forms of mental illness assume it is triggered by dysregulation of dopamine, i.e. chemical imbalance, arising from adverse interaction of predisposing risk genes and environmental factors. All successful antipsychotic agents have the ability to act as a D2 receptor antagonist (dopamine inhibitor), raising the question as to whether those with have or at risk of psychosis are susceptible to onset or exacerbation of psychosis when prescribed D2 agonists (dopamine activator).

Early postnatal period is a time of high risk for psychosis. The underlying pathophysiological mechanisms of postpartum psychosis are poor understood.

FDA recommends against the practice of prescribing D2 agonists (activator) due to longstanding evidence about cardiovascular disease and neurological risks.

Pharmacological Lactation Suppression with D2 Receptor Agonists and Risk of Postpartum Psychosis – Dr Josephine Power, International Marce Society Conference 2016.

Reference

Snellen et al. 2016. Pharmacological lactation suppression with D2 receptor agonists and risk of postpartum psychosis: A systematic review.