Serotonin reuptake inhibitors and breastfeeding: a systematic review. (January 2015)

• Record Type: Journal Article
• Authors: Orsolini, Laura; Bellantuono, Cesario
• Is Part Of: Human psychopharmacology. Volume 30:Number 1(2015:Jan.)
• Page Start: 4
• Page End: 20
• Publication Date: 2015-01
• Subjects: Psychopharmacology -- Periodicals; Psychotropic drugs -- Periodicals; Psychopharmacology -- Periodicals; Psychotropic Drugs -- pharmacology -- Periodicals; 615.78
• DOI: 10.1002/hup.2451
• Languages: English
• ISSNs: 0885-6222

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hup2451-sec-0001" sec-type="section"> <title>Objective</title> <p>The postnatal period represents a critical phase for mothers because of physiological hormonal changes, the increase of emotional reactions and a greater susceptibility for the onset/recrudescence of psychiatric disorders. Despite the evidence of an increasing utilization of antidepressant drugs during breastfeeding, there is still few reliable information on the neonatal safety of the selective serotonin reuptake inhibitors (SSRIs) and selective noradrenergic reuptake inhibitors (SNRIs) [serotonin reuptake inhibitors (SRIs)] in nursing mothers. The aim of this study is to provide a systematic review on the neonatal safety profile of these drugs during breastfeeding, also assessing the limits of available tools.</p> </sec> <sec id="hup2451-sec-0002" sec-type="section"> <title>Methods</title> <p>MEDLINE and PubMed databases were searched without any language restrictions by using the following set of keywords: ((<italic>SSRIs</italic> OR <italic>selective serotonin inhibitor reuptake</italic> OR <italic>SNRIs</italic> OR <italic>selective serotonin noradrenaline inhibitor reuptake</italic>) AND (<italic>breastfeeding</italic> OR <italic>lactation</italic> OR <italic>breast milk</italic>)). A separate search was also performed for each SSRIs (<italic>paroxetine, fluvoxamine, fluoxetine, sertraline, citalopram</italic> and <italic>escitalopram</italic>) and SNRIs (<italic>venlafaxine</italic> and <italic>duloxetine</italic>).</p> </sec> <sec id="hup2451-sec-0003" sec-type="section"> <title>Results</title> <p>Sertraline and paroxetine show a better neonatal safety profile during breastfeeding as compared with other SRIs. Less data are available for fluvoxamine, escitalopram and duloxetine. Few studies followed up infants breastfeed for assessing the neurodevelopmental outcomes.</p> </sec> <sec id="hup2451-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Literature review clearly indicates paroxetine and sertraline as the drugs that should be preferred as first line choice in nursing women who need an antidepressant treatment. Copyright © 2014 John Wiley & Sons, Ltd.</p> </sec> </abstract>