Open AccessJournal Article
When breastfeeding mothers need CNS-acting drugs.
Evelyn Rubin,Amy Lee,Shinya Ito +2 more
Reads0
Chats0
TLDR
The findings indicate that the majority of the CNS-acting drugs, if taken by nursing women, result in average exposure levels to their breast-fed infants of less than 10% of the therapeutic doses per kg body weight.Abstract:
Background Breastfeeding is the ideal method of infant nutrition. However, if mothers need medications such as the central nervous system (CNS) acting drugs, infant safety concerns arise. Summarized information on infant exposure levels to drugs in milk and associated side effect profiles will help clinicians to rationalize and justify important drug therapy for a breastfeeding patient. Methods Electronic searches of MEDLINE and PsycINFO from 1966-2003, and of EMBASE from 1980-2003, were conducted for studies on breastfeeding or breast milk and medications in the following categories: antidepressants, antipsychotics, antiepileptics (or anticonvulsants) and anxiolytics. The infant exposure level (%) was defined as follows: [Drug concentration in milk (mg/mL)] x [Daily milk intake (mL/kg/d)] x 100 / Maternal dose (mg/kg/d). Results A total of 129 papers were eligible for analyses. Our findings indicate that the majority of the CNS-acting drugs, if taken by nursing women, result in average exposure levels to their breast-fed infants of less than 10% of the therapeutic doses per kg body weight. Exceptions are lithium, ethosuximide, phenobarbital, primidone, lamotrigine and topiramate. Adverse effect profiles do not always correlate with a higher exposure level. Overall, most reported adverse effect profiles appear benign. Where adverse effects were reported, they were often confounded by intrauterine exposure. Conclusions CNS-acting drugs taken by the mother do not appear to pose any major risks of immediate adverse effects to the breastfeeding infant, although with most of the newer drugs further research is needed to be conclusive.read more
Citations
More filters
Journal ArticleDOI
The International Society for Bipolar Disorders (ISBD) consensus guidelines for the safety monitoring of bipolar disorder treatments
Felicity Ng,Oommen Mammen,Ingeborg Wilting,Gary S. Sachs,I. Nicol Ferrier,Frederick Cassidy,Serge Beaulieu,Lakshmi N. Yatham,Michael Berk +8 more
TL;DR: These guidelines aim to provide recommendations that take into consideration the balance between safety and cost-effectiveness, to highlight iatrogenic and preventive clinical issues, and to facilitate the broad implementation of therapeutic safety monitoring as a standard component of treatment for bipolar disorder.
Journal ArticleDOI
Psychotropic Drug Use During Breastfeeding: A Review of the Evidence
TL;DR: Although most drugs are considered safe during breastfeeding, compatibility with breastfeeding has not been established for all psychotropic drugs, and there is a need for additional research and accumulation of experience to guarantee a more rational use of psychotropic medications during breastfeeding.
Journal ArticleDOI
Neonatal Benzodiazepines Exposure during Breastfeeding
TL;DR: This study supports the continued recommendation to initiate breastfeeding while taking benzodiazepines postpartum and indicates that mothers reporting adverse outcomes in themselves were more likely to be taking concomitantly a greater number of central nervous system depressants.
Journal ArticleDOI
Risk-benefit balance assessment of SSRI antidepressant use during pregnancy and lactation based on best available evidence – an update
Céline J. Fischer Fumeaux,Mathilde Morisod Harari,Etienne Weisskopf,Chin B. Eap,Manuella Epiney,Yvan Vial,Chantal Csajka,Myriam Bickle Graz,Alice Panchaud +8 more
TL;DR: In women suffering from major depression and responding to a pharmacological treatment, introduction or continuation of an SSRI should be encouraged in order to prevent maternal complications and to preserve maternal–infant bonding.
Journal ArticleDOI
Drug use and breastfeeding.
TL;DR: The benefits of breastfeeding to both mother and infant as well as the potential risks to the infant from maternal drug use are described and the extent of adverse drug-related events and the need for quality information on drug transfer is stated.
References
More filters
Journal ArticleDOI
Breastfeeding and the Use of Human Milk
TL;DR: Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad.
Journal Article
Transfer of drugs and other chemicals into human milk
R. J. Roberts,J. L. Blumer,R. L. Gorman,G. H. Lambert,B. H. Rumack,W. Snodgrass,D. R. Bennett,J. F. Cordero,J. C. Petricciani,S. A. Licata,M. Lund Mortensen,M. L. Pernoll,G. Troendle,S. J. Yaffe,R. E. Kauffman,A. R. Temple +15 more
TL;DR: Nicotine, psychotropic drugs, and silicone implants are 3 important topics reviewed in this statement that are important to protect nursing infants from untoward effects of maternal medication but also to allow effective pharmacologic treatment of breastfeeding mothers.
Journal ArticleDOI
Drug Therapy for Breast-Feeding Women
TL;DR: Recommendations suggest that in the absence of contraindications, women should breast-feed their infants for at least the first 12 months of life, but many mothers are likely to need to take medications at some point during this time.
Journal ArticleDOI
Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate, and during lactation.
TL;DR: The pharmacokinetics of lamotrigine (LTG) during delivery, during the neonatal period, and lactation is investigated to investigate the pharmacological properties of the drug during and after birth.
Book
Medications and Mothers' Milk
TL;DR: This massive new update has hundreds of new drugs, diseases, vaccines, and syndromes and it also contains numerous new tables and changes to hundreds of existing drugs.
Related Papers (5)
The pharmacology of bipolar disorder during pregnancy and breastfeeding
Seetal Dodd,Michael Berk +1 more