demethylmirtazapine and Depression--Postpartum

To investigate the transfer of mirtazapine and desmethylmirtazapine into milk and to calculate dose to the infant via milk.. Plasma and milk samples were obtained from eight breast-feeding women who were taking a median dose of 38 mg mirtazapine per day. Milk/plasma ratio (M/P) and infant doses were estimated by standard methods. The infants were examined clinically and in four infants blood was taken for analysis.. Mean (95% confidence interval) relative infant doses for mirtazapine and desmethylmirtazapine (n = 8) were 1.5% (0.8, 2.2) and 0.4% (0.2, 0.6) respectively. The mean M/P (area under curve n = 4, single or paired samples n = 3) was 1.1 (0.7,1.5) for mirtazapine and 0.6 (0.5, 0.7) for desmethylmirtazapine. No adverse effects were seen. Mirtazapine was detected (1.5 microg l(-1)) in only one of four infants tested.. We suggest that mirtazapine use by lactating women is safe for the breast-fed infant. Nevertheless, each decision to breast feed should always be made on the basis of an individual risk/benefit analysis.

Topics: Antidepressive Agents, Second-Generation; Antidepressive Agents, Tricyclic; Breast Feeding; Depression, Postpartum; Female; Humans; Infant; Infant, Newborn; Mianserin; Milk, Human; Mirtazapine; Pregnancy