However, the risk of medication use must to weighed against the risk of ongoing, untreated depression for both mother and child, and the risks associated with not breastfeeding. Alternatives treatments for depression are described in an article entitled, Non-Drug Treatments for Depression in Pregnant and Breastfeeding Women. Below is a brief summary of research regarding how medication transfers to infants during pregnancy and lactation, and its impact on infants.
Medications mothers take are transferred to their infants differently depending on whether mothers take them while pregnant or while breastfeeding. This is a summary of a much-larger literature on selective serotonin reuptake inhibitors SSRIs use in pregnancy and postpartum.
But it provides a starting place for understanding what we know about medication use in pregnant and postpartum women. In Utero Exposure. During pregnancy, medications transfer to babies via the placenta and amniotic fluid.
But medications differ in terms of how much they transfer, and using a medication that transfers in smaller amounts is one strategy for selecting a medication to use during pregnancy. The mean serum ratios ranged from 0. The lowest ratios were for sertraline Zoloft and paroxetine Paxil , and the highest for citalopram Celexa and fluoxetine Prozac Hendrick, They did note increased risk of three birth defects with SSRI use in the first trimester: omphalocele and septal defects with sertraline, and the heart defect right ventricular outflow tract obstruction with paroxetine.
Discontinuation syndrome includes acrocynaosis, tachypnea, temperature instability, irritability, and elevated drug levels Oberlander et al. Fortunately, these symptoms are generally mild and self-limiting, and can be managed with supportive care. Severe symptoms are rare, and no reported neonatal deaths have occurred that are attributable to in utero SSRI exposure.
Discontinuation syndrome can be distressing to both mothers and babies, but the symptoms are self-limiting, last for 24 to 48 hours, and do not require further treatment.
Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Principles of drug therapy in pregnancy and lactation. Modeling drug passage into human milk. Special populations: youth, women, and the elderly. Can J Psychiatry. Citalopram serum and milk levels in mother and infant during lactation.
Ther Drug Monit. Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram. J Perinatol. Bupropion and escitalopram during lactation. Ann Pharmacother. Serotonergic overstimulation in a preterm infant after sertraline intake via breastmilk. Antidepressants in breastmilk; comparative analysis of excretion ratios. Arch Womens Ment Health. Uguz F. Short-term safety of paroxetine plus low-dose mirtazapine during lactation.
Bupropion and breastfeeding: a case of a possible infant seizure. J Clin Psychiatry. Impact of serotonin reuptake inhibitor use on breast milk supply in mothers of preterm infants: a retrospective cohort study.
Br J Clin Pharmacol. Instructions for use of the reference guide. A new safety scoring system for the use of psychotropic drugs during lactation.
Am J Ther. Is it safe for me and my baby? No precise data on transfer is available. The use of cognitive counselling together with anti-depressant therapy has been shown to be advantageous. Sertraline has the lowest passage of SSRI drugs into breastmilk. Citalopram also passes into breastmilk in low levels. If a breastfeeding mother has found an antidepressant previously prescribed of benefit, that may influence the choice of drug prescribed It is important that post-natal depression is recognised and treated effectively as it may impair bonding between mother and child and enjoyment of an important period in the relationship.
Tri-cyclic anti-depressants Tricyclic antidepressants have been around for a considerable period and much is known of their metabolism, safety and side effects. Transfer of the antidepressant mirtazapine into breast milk. Br J Clin Pharmacol. Mirtazapine and breastfeeding: maternal and infant plasma levels. Am J Psychiatry. This website uses cookies to improve your experience but you can opt-out if you wish.
Close Privacy Overview This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website.
We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience. Necessary Necessary. Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website.
These cookies do not store any personal information. Non-necessary Non-necessary. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies.
However, research has also shown that when depression is left untreated during pregnancy, there could be an increased chance for pregnancy complications. This makes it hard to know if it is the medication, untreated depression, or other factors that are increasing the chance for these problems. For studies that have suggested an increased chance, the overall chance for this finding was low likely less than 1 in Will it cause withdrawal symptoms in my baby after birth? These symptoms are sometimes referred to as withdrawal.
In most cases, these symptoms are mild and go away within weeks with no treatment or with only supportive care. One small study followed eleven babies exposed to citalopram during pregnancy.
At one year of age there was no difference in their development compared to children who were not exposed to citalopram. Most studies also find that SSRIs do not appear to increase the chance of autism spectrum disorder ASD after considering the effects of maternal depression or other factors.
0コメント