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Am J Psychiatry 1996; 153:1132-1137
Copyright © 1996 by American Psychiatric Association
Antidepressant treatment during breast-feeding
KL Wisner, JM Perel and RL Findling
Mood Disorders Program, Case Western Reserve, University School of Medicine, Cleveland, OH 44106, USA.
OBJECTIVE: The primary purpose of this article is to review critically the
literature about use of antidepressants during lactation. Strategies for
the clinical management of depressed breast-feeding mothers are also
suggested. METHOD: The authors conducted a computerized search of MEDLINE
for articles. The review includes studies in which serum levels of drugs
were obtained from nursing infants. RESULTS: Fifteen published reports were
located that provided information for the following nine antidepressants:
amitriptyline, nortriptyline, desipramine, clomipramine, doxepin,
dothiepin, fluoxetine, sertraline, and bupropion. CONCLUSIONS:
Amitriptyline, nortriptyline, desipramine, clomipramine, dothiepin, and
sertraline were not found in quantifiable amounts in nurslings, and no
adverse effects were reported. Therefore, these are the drugs of choice for
breast-feeding women. Adverse effects were described in some young infants
whose mothers had been treated with doxepin or fluoxetine during
breast-feeding. The collective serum level data suggest that infants older
than 10 weeks are at low risk for adverse effects of tricyclics, and there
is no evidence of accumulation. Research needs include an expanded database
of mother-baby serum levels, behavioral assessments of infants during
nursing, and longitudinal developmental evaluation of nurslings.
Prescription of an antidepressant for a breast- feeding woman is a
case-specific risk-benefit decision.
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K. L. Wisner, B. L. Parry, and C. M. Piontek
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July 1, 1999;
104(1):
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K. L. Wisner, J. M. Perel, and J. Blumer
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May 1, 1998;
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April 1, 1998;
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C. N. Epperson, G. M. Anderson, and C. J. McDougle
Sertraline and Breast-Feeding
N. Engl. J. Med.,
April 17, 1997;
336(16):
1189 - 1190.
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Are Antidepressants Safe During Breastfeeding?
Journal Watch Psychiatry,
November 1, 1996;
1996(1101):
5 - 5.
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Are Antidepressants Safe for Nursing Mothers?
Journal Watch Women's Health,
October 1, 1996;
1996(1001):
23 - 23.
[Full Text]
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