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HERO ID
7386871
Reference Type
Journal Article
Subtype
Review
Title
Psychotropic Drug Use During Breastfeeding: A Review of the Evidence
Author(s)
Fortinguerra, F; Clavenna, A; Bonati, M
Year
2009
Is Peer Reviewed?
1
Journal
Pediatrics
ISSN:
0031-4005
EISSN:
1098-4275
Volume
124
Issue
4
Page Numbers
E547-E556
Language
English
PMID
19736267
DOI
10.1542/peds.2009-0326
Web of Science Id
WOS:000270274300034
Abstract
OBJECTIVE:
The objective of this study was to review the existing literature on the use of various classes of psychotropic medications during breastfeeding to provide information about infant exposure levels and reported adverse events in breastfed infants.
METHODS:
A bibliographic search in the Medline (1967 through July 2008), Embase (1975 through July 2008), and PsycINFO (1967 through July 2008) databases was conducted for studies on breastfeeding and psychotropic medications for a total of 96 drugs. References of retrieved articles, reference books, and dedicated Web sites were also checked. The manufacturers were contacted for drugs without published information. Original articles and review articles that provide pharmacokinetic data on drug excretion in breast milk and infant safety data were considered, to estimate the "compatibility level" of each drug with breastfeeding.
RESULTS:
A total of 183 original articles were eligible for analysis. Documentation was retrieved for 62 (65%) drugs. In all, 19 (31%) psychotropic drugs can be used during lactation according to an evidence-based approach. For 28 drugs, the available data do not permit an evaluation of the drug's safety profile during breastfeeding and, for an additional 15 drugs, the exposure dose or observed adverse effects make their use unsafe.
CONCLUSIONS:
Although most drugs are considered safe during breastfeeding, compatibility with breastfeeding has not been established for all psychotropic drugs. There is a need for additional research and accumulation of experience to guarantee a more rational use of psychotropic drugs during breastfeeding.
Keywords
breastfeeding; psychotropic drugs; drug therapy; adverse effects; human; systematic review
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