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Perinatal Psychopharmacology pp 99–113Cite as

Antidepressants During Breastfeeding

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Abstract

Despite the severe repercussions of maternal depression on the infants’ well-being, women are often reluctant to seek treatment for postpartum depression, with fear of adverse events for the infant playing an important role in such considerations. However, the pharmacological approach to postpartum depression often represents one of the most effective options in a number of clinical conditions. Therefore, the necessity exists to establish the safety of antidepressants in the breastfed infant. The aim of this chapter was to discuss the main criteria that should be considered in the risk/benefit assessment of antidepressant treatment in lactating women. In accordance with the Breastfed Infant-Antidepressant Safety Index classification, sertraline and paroxetine should be considered as first-line medications in women who need to start antidepressant treatment during the postpartum period and wish to continue breastfeeding. Among TCAs, nortriptyline also shows reassuring information; however, primiparous women taking SSRIs are more likely to experience delayed secretory activation. Hence, the decision to start or to continue antidepressant treatment in lactating women should be taken on individual basis, after a careful evaluation of the severity of maternal symptoms and weighing the risk for the mother-infant dyad of exposure to mood symptoms against the risk for the baby of being exposed to antidepressants.

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Authors and Affiliations

  1. Department of Mental Health, ASL Salerno, Mental Health Center Cava de’ Tirreni - Vietri sul Mare, Cava de’ Tirreni, Salerno, Italy

    Salvatore Gentile

  2. Developmental Psychologist, Mental Health Institute, Naples, Italy

    Maria Luigia Fusco

  3. Developmental Psychology, Post-graduate School of Psychotherapy (SIPGI), Naples, Italy

    Maria Luigia Fusco

Authors
  1. Salvatore Gentile
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  2. Maria Luigia Fusco
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  1. Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Faruk Uguz

  2. Psychopharmacological, Drug Misuse and Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield, UK

    Laura Orsolini

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Gentile, S., Fusco, M.L. (2019). Antidepressants During Breastfeeding. In: Uguz, F., Orsolini, L. (eds) Perinatal Psychopharmacology. Springer, Cham. https://doi.org/10.1007/978-3-319-92919-4_6

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