Management of depression in breastfeeding mothers – Are reboxetine, venlafaxine, duloxetine, mirtazapine, agomelatine and MAOIs safe?

· UKMi

  • Reboxetine, venlafaxine, duloxetine, mirtazapine, agomelatine and moclobemide are not considered first line antidepressants for use in breastfeeding mothers.
  • Because of the absence of data on use in lactation and their potential to cause serious interactions with some foods and drugs, first generation MAOIs should be avoided in lactation.
  • Limited data indicate that reboxetine, duloxetine and mirtazapine pass into milk in small amounts and estimated infant intake via milk has been calculated at values of up to 2% of the weight adjusted maternal dose. Values for venlafaxine are higher at 3.5 – 9.2%.
  • Venlafaxine via breast milk may attenuate neonatal withdrawal symptoms where the drug is used close to term.
  • Apart from two cases of reduced weight gain with venlafaxine, no adverse effects have been reported for infants exposed to reboxetine, duloxetine, mirtazapine,moclobemide or agomelatine.
AgomelatineDuloxetineMental health and illnessMirtazapineMoclobemideObstetrics and gynaecologyPaediatric and neonatal medicinePhenelzineQ&AReboxetineSafety in LactationTranylcypromineVenlafaxine