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Fluoxetine in breast-milk and developmental outcome of breast-fed infants

Published online by Cambridge University Press:  02 January 2018

K. Yoshida
Affiliation:
Section of Perinatal Psychiatry, Institute of Psychiatry, University of London
B. Smith
Affiliation:
Section of Perinatal Psychiatry, Institute of Psychiatry, University of London
M. Craggs
Affiliation:
Section of Perinatal Psychiatry, Institute of Psychiatry, University of London
R. Channi Kumar*
Affiliation:
Section of Perinatal Psychiatry, Institute of Psychiatry, University of London
*
Professor R. Channi Kumar. Section of Perinatal Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF. Tel: 0171 9193212; Fax: 0171 7085919

Abstract

Background

Selective serotonin reuptake inhibitors are currently the most widely prescribed antidepressant drugs. There are only four published studies of breast-feeding mothers and their infants in which the mothers were taking fluoxetine.

Method

Four mothers who took fluoxetine and their breast-fed infants were studied. Samples of plasma, breast-milk and urine were taken from the mothers and of plasma and urine from infants for assays of drug and metabolite concentrations. Bayley Scales of Infant Development were repeatedly used to assess cognitive and psychomotor development of the infants.

Results

Fluoxetine and norfluoxetine were detected in all samples of maternal plasma (range of total concentration 138–427 ng/ml) and in breast-milk (range 39–177 ng/ml). Amounts of both fluoxetine and norfluoxetine in infants' plasma and urine were below the lower limit of detection. All infants were observed to be developing normally and showed no abnormal findings on neurological examination.

Conclusions

Much larger databases are needed but these four cases do not provide any evidence to suggest that women who are maintained on therapeutic doses of fluoxetine should discontinue breast-feeding their infants if they wish to breast-feed.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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