title: Transfer of the antidepressant mirtazapine into breast milk.
abstract: OBJECTIVE
  To investigate the transfer of mirtazapine and desmethylmirtazapine into milk and to calculate dose to the infant via milk.
  
  
  METHODS
  Plasma and milk samples were obtained from eight breast-feeding women who were taking a median dose of 38 mg mirtazapine per day. Milk/plasma ratio (M/P) and infant doses were estimated by standard methods. The infants were examined clinically and in four infants blood was taken for analysis.
  
  
  RESULTS
  Mean (95% confidence interval) relative infant doses for mirtazapine and desmethylmirtazapine (n = 8) were 1.5% (0.8, 2.2) and 0.4% (0.2, 0.6) respectively. The mean M/P (area under curve n = 4, single or paired samples n = 3) was 1.1 (0.7,1.5) for mirtazapine and 0.6 (0.5, 0.7) for desmethylmirtazapine. No adverse effects were seen. Mirtazapine was detected (1.5 microg l(-1)) in only one of four infants tested.
  
  
  CONCLUSIONS
  We suggest that mirtazapine use by lactating women is safe for the breast-fed infant. Nevertheless, each decision to breast feed should always be made on the basis of an individual risk/benefit analysis.
authors.affiliation: Pharmacy Department, Women's and Children's Health Service, Subiaco, Australia.
authors.forename: J H
authors.initials: JH
authors.lastname: Kristensen
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Ilett
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rampono
authors.forename: Rolland
authors.initials: R
authors.lastname: Kohan
authors.forename: L Peter
authors.initials: LP
authors.lastname: Hackett
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects*; D001942:Breast Feeding; D019052:Depression, Postpartum / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives*; D008895:Milk, Human / Q000737:chemistry; D000078785:Mirtazapine; D011247:Pregnancy
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; C517416:desmethylmirtazapine; D008803:Mianserin; D000078785:Mirtazapine