Serum Fluvoxamine Levels in Breastfed Infants
J Clin Psychiatry 2001;62(2):111-113
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Background: Between 10% and 15% of new
mothers will experience an episode of postpartum depression.
Although antidepressants are effective agents for the treatment
of postpartum depression, minimal data are available to support
their safety in infants of breastfeeding mothers.
Method: In this article, we present 2
cases of nursing mother-infant pairs in which the mother was
treated with fluvoxamine and in which infant serum fluvoxamine
levels were obtained. Both mothers began the fluvoxamine
treatment postpartum, and serum levels were obtained from mothers
and infants after a minimum of 7 days on a stable maternal dose.
One level was obtained from the infant in case 1, and 2 levels
were obtained from the infant in case 2.
Results: Each of the infant serum
fluvoxamine levels obtained was too low to quantify (at a limit
of detection of 2.5 ng/mL). Neither of the infants experienced
adverse events related to the mother's treatment with
fluvoxamine. Each of the infants is reportedly healthy 2 to 3
years after the exposure.
Conclusion: While these results are
encouraging, they are limited and cannot be generalized to all
cases of infants exposed to fluvoxamine. Additional mother-infant
serum fluvoxamine levels and infant behavioral observations will
facilitate the risk-benefit decision-making process for women who
choose to breast-feed while taking fluvoxamine.