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Review
. 2024 Jun 22;16(7):847.
doi: 10.3390/pharmaceutics16070847.

Assessment of Infant Exposure to Antidepressants through Breastfeeding: A Literature Review of Currently Available Approaches

Leah Arbitman  1 , Shirley Chen  1 , Brian Kim  1 , Melinda Lee  1 , Peng Zou  2 , Bennett Doughty  1 , Yanyan Li  1 , Tao Zhang  1
Affiliations
Review

Assessment of Infant Exposure to Antidepressants through Breastfeeding: A Literature Review of Currently Available Approaches

Leah Arbitman et al. Pharmaceutics. .

Abstract

Despite the prevalence of depression in lactating mothers, there is a lack of knowledge about the excretion of antidepressants into breast milk and its potential adverse effects on infants. This creates concern, making depressed lactating mothers more likely to avoid pharmacological treatment. Clinical lactation studies are the most accurate and direct method to predict and demonstrate the excretion of antidepressants into human breast milk, and results from clinical studies can be included in drug labels to help physicians and patients make decisions on antidepressant use during lactation. However, there are limited clinical trials and studies on the pharmacokinetics of antidepressants in lactating women because of a lack of enrollment and ethical and confounding factors, creating a lack of knowledge in this area. To bridge this gap in knowledge, alternative methods should be sought to help estimate the antidepressant concentration in breast milk, which is used to assess the safety and transfer of antidepressants into breast milk. We provide a comprehensive review of the usage of these cost-effective, time-efficient, and ethically feasible methods that serve to provide a valuable estimation of the safety and transfer of antidepressants into breast milk before conducting clinical studies.

Keywords: M/P ratio; antidepressants; breastfeeding; depression; lactation; nursing infant.

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Conflict of interest statement

Author Zou P is an employee of Daiichi Sankyo Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Methods for evaluating the safety of antidepressant transfer into breast milk.
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