fluvoxamine and Depression--Postpartum

Topics: Adolescent; Adult; Ambulatory Care; Antidepressive Agents, Second-Generation; Depression, Postpartum; Female; Fluvoxamine; Humans; Middle Aged; Psychiatric Status Rating Scales; Treatment Outcome

Topics: Adult; Affect; Antidepressive Agents; Antipsychotic Agents; Aripiprazole; Bipolar Disorder; Clomipramine; Depression, Postpartum; Diagnosis, Differential; Female; Fluvoxamine; Humans; Lithium Compounds; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales

Depression and anxiety disorders are frequently seen in the postpartum period. Primary pharmacological agents for these disorders are antidepressants, especially selective serotonin reuptake inhibitors. Despite no adverse reports, data on safety for the maternal use of fluvoxamine on breastfed infants are limited. This case report presents diarrhea and vomiting in the breastfed baby of a woman using fluvoxamine at 50 mg/d.

Topics: Adult; Breast Feeding; Depression, Postpartum; Diarrhea; Female; Fluvoxamine; Humans; Infant; Selective Serotonin Reuptake Inhibitors; Vomiting

Topics: Adult; Affective Disorders, Psychotic; Antipsychotic Agents; Breast Feeding; Depression, Postpartum; Depressive Disorder; Dibenzothiazepines; Drug Therapy, Combination; Drug-Related Side Effects and Adverse Reactions; Female; Fluvoxamine; Humans; Pregnancy; Pregnancy Complications; Quetiapine Fumarate; Selective Serotonin Reuptake Inhibitors

This article presents an overview of the excretion of the SSRIs citalopram, paroxetine, fluoxetine, fluvoxamine and sertraline in breast milk.. Published articles on selective serotonin reuptake inhibitors and excretion in breast milk were identified and reviewed. In addition, drug concentrations were measured in milk from eight women using paroxetine (n = 4), citalopram (n = 3) or fluvoxamine (n = 1).. Data from the literature indicate that the relative dose to the infant is lowest for fluvoxamine and sertraline, somewhat higher for paroxetine and highest for citalopram and fluoxetine. Adverse effects were reported in three of the 119 breastfed infants. Our own results show minimal excretion of fluvoxamine, small excretion of paroxetine and higher excretion of citalopram into breast milk.. If treatment with a selective serotonin reuptake inhibitor is started during the postpartum period, fluoxetine should not be the first alternative. High doses of citalopram should also be used with caution. However, when the use of an SSRI is clearly indicated in a breastfeeding woman, available data generally indicate that the positive effects of breast-feeding outweigh the risks for pharmacological effects in the infant.

Topics: Antidepressive Agents; Breast Feeding; Citalopram; Depression, Postpartum; Female; Fluoxetine; Fluvoxamine; Humans; Infant; Infant, Newborn; Milk, Human; Paroxetine; Selective Serotonin Reuptake Inhibitors; Sertraline

The pharmacological treatment of depression in nursing women requires information on the magnitude of medication exposure to the infant that may occur through breast milk.. To examine serum concentrations of antidepressants in infants exposed to these medications through breast-feeding.. Maternal and infant serum concentrations of sertraline, paroxetine and fluvoxamine were determined with high-performance liquid chromatography (limit of detection=1 ng/ml).. No detectable medication was present in any infant exposed to paroxetine (n=16) or fluvoxamine (n=4). Among infants exposed to sertraline (n=30), detectable medication was present in 24% of serum samples. A significant negative correlation was found between infant age and infant serum concentration. Sertraline was significantly more likely to be detected in an infant if the mother's daily dose was 100 mg or higher. No adverse sequelae occurred in any infant.. This study shows that paroxetine, fluvoxamine and sertraline produce minimal exposure to infants when taken by nursing mothers.

Topics: Breast Feeding; Chromatography, High Pressure Liquid; Depression, Postpartum; Female; Fluvoxamine; Humans; Infant, Newborn; Paroxetine; Regression Analysis; Risk Assessment; Selective Serotonin Reuptake Inhibitors; Sertraline

Topics: Adult; Antidepressive Agents, Second-Generation; Chromatography, High Pressure Liquid; Depression, Postpartum; Female; Fluvoxamine; Humans; Infant, Newborn; Milk, Human; Spectrophotometry, Ultraviolet