Serum fluvoxamine levels in breastfed infants.
BACKGROUND
Between 10% and 15% of new mothers will experience an episode of postpartum depression. Although antidepressants are effective agents for the treatment of postpartum depression, minimal data are available to support their safety in infants of breastfeeding mothers.


METHODS
In this article, we present 2 cases of nursing mother-infant pairs in which the mother was treated with fluvoxamine and in which infant serum fluvoxamine levels were obtained. Both mothers began the fluvoxamine treatment postpartum, and serum levels were obtained from mothers and infants after a minimum of 7 days on a stable maternal dose. One level was obtained from the infant in case 1, and 2 levels were obtained from the infant in case 2.


RESULTS
Each of the infant serum fluvoxamine levels obtained was too low to quantify (at a limit of detection of 2.5 ng/mL). Neither of the infants experienced adverse events related to the mother's treatment with fluvoxamine. Each of the infants is reportedly healthy 2 to 3 years after the exposure.


CONCLUSIONS
While these results are encouraging, they are limited and cannot be generalized to all cases of infants exposed to fluvoxamine. Additional mother-infant serum fluvoxamine levels and infant behavioral observations will facilitate the risk-benefit decision-making process for women who choose to breast-feed while taking fluvoxamine.
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
C M
CM
Piontek
K L
KL
Wisner
J M
JM
Perel
K S
KS
Peindl
D001942:Breast Feeding / Q000009:adverse effects / Q000706:statistics & numerical data; D002851:Chromatography, High Pressure Liquid; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy*; D005260:Female; D016666:Fluvoxamine / Q000032:analysis* / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D008895:Milk, Human / Q000737:chemistry*; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000032:analysis* / Q000097:blood* / Q000627:therapeutic use
D016666:Fluvoxamine; D017367:Selective Serotonin Reuptake Inhibitors