Serum Fluvoxamine Levels in Breastfed Infants

Background: Between 10% and 15% of newmothers will experience an episode of postpartum depression.Although antidepressants are effective agents for the treatmentof postpartum depression, minimal data are available to supporttheir safety in infants of breastfeeding mothers.

Method: In this article, we present 2cases of nursing mother-infant pairs in which the mother wastreated with fluvoxamine and in which infant serum fluvoxaminelevels were obtained. Both mothers began the fluvoxaminetreatment postpartum, and serum levels were obtained from mothersand infants after a minimum of 7 days on a stable maternal dose.One level was obtained from the infant in case 1, and 2 levelswere obtained from the infant in case 2.

Results: Each of the infant serumfluvoxamine levels obtained was too low to quantify (at a limitof detection of 2.5 ng/mL). Neither of the infants experiencedadverse events related to the mother’s treatment withfluvoxamine. Each of the infants is reportedly healthy 2 to 3years after the exposure.

Conclusion: While these results areencouraging, they are limited and cannot be generalized to allcases of infants exposed to fluvoxamine. Additional mother-infantserum fluvoxamine levels and infant behavioral observations willfacilitate the risk-benefit decision-making process for women whochoose to breast-feed while taking fluvoxamine.