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Arch Womens Ment Health. 2007;10(2):39-51. Epub 2007 Feb 12.

SSRIs during breastfeeding: spotlight on milk-to-plasma ratio.

Author information

1
Department of Mental Health ASL Salerno 1, Mental Health Center n.4, Cava de' Tirreni (Salerno), Italy.

Abstract

OBJECTIVE:

To investigate the usefulness of the milk-to-plasma (M/P) ratio for assessing the risks for the breastfed infant associated with the maternal use of SSRIs.

DATA SOURCES:

Medline, Toxnet, Embase, Current Contents, and PsycInfo indexed articles from 1980 to September 2006.

STUDY SELECTION AND DATA EXTRACTION:

All studies reporting the M/P ratio in mothers taking SSRIs while breastfeeding or studies which such an information could be calculated from data reported in the article.

DATA SYNTHESIS:

Higher M/P ratios were rarely associated with a clinically significant impact on the babies during the early phases of breastfeeding.

CONCLUSIONS:

So far no evidence-based information seems to support the hypothesis that SSRIs characterized by a M/P ratio <1.0 should be preferred. Hence, physicians should consider different parameters when attempting to choose the safest SSRI for the breastfeeding woman. These parameters might be represented by the number of well-documented published adverse event reports and the tendency of each SSRI of inducing in the infants serum concentrations that are elevated above 10% of average maternal serum levels. In any case, if the mother wishes to breastfeed her infant while taking a SSRI, the baby should be closely monitored in order to promptly detect any iatrogenic event.

PMID:
17294355
DOI:
10.1007/s00737-007-0173-0
[Indexed for MEDLINE]
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