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[Antidepressive agents and breast feeding]
1Farmasøytisk avdeling, Rogaland psykiatriske sjukehus, Stavanger.
Summary
Postpartum depression affects many mothers, but some antidepressants are safe for breastfeeding. Nortriptyline, amitriptyline, and sertraline are preferred over others like doxepin and lithium due to lower infant doses.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Psychiatry
Context:
- Postpartum blues affect 50-80% of women, with a small percentage developing serious postpartum depression requiring treatment.
- Breastfeeding is increasingly encouraged for mothers with postpartum depression.
- Data on antidepressant transfer into breast milk is crucial for infant safety.
Purpose:
- To review available data on antidepressant transfer into breast milk.
- To calculate infant relative doses for various antidepressants.
- To provide guidance on antidepressant selection for breastfeeding mothers.
Summary:
- Nortriptyline and amitriptyline show minimal infant transfer and are suitable for breastfeeding.
- Doxepin and lithium have significant transfer and should be avoided.
- Sertraline and possibly paroxetine are safer alternatives to fluoxetine due to lower transfer and shorter half-life, though more data is needed for paroxetine.
Impact:
- Informs clinical decisions regarding antidepressant use in breastfeeding mothers.
- Highlights the need for more research on antidepressant transfer and infant outcomes.
- Emphasizes the importance of monitoring infants for side effects when mothers use antidepressants.