Piontek C M, Wisner K L, Perel J M, Peindl K S
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
J Clin Psychiatry. 2001 Feb;62(2):111-3. doi: 10.4088/jcp.v62n0207.
Between 10% and 15% of new mothers will experience an episode of postpartum depression. Although antidepressants are effective agents for the treatment of postpartum depression, minimal data are available to support their safety in infants of breastfeeding mothers.
In this article, we present 2 cases of nursing mother-infant pairs in which the mother was treated with fluvoxamine and in which infant serum fluvoxamine levels were obtained. Both mothers began the fluvoxamine treatment postpartum, and serum levels were obtained from mothers and infants after a minimum of 7 days on a stable maternal dose. One level was obtained from the infant in case 1, and 2 levels were obtained from the infant in case 2.
Each of the infant serum fluvoxamine levels obtained was too low to quantify (at a limit of detection of 2.5 ng/mL). Neither of the infants experienced adverse events related to the mother's treatment with fluvoxamine. Each of the infants is reportedly healthy 2 to 3 years after the exposure.
While these results are encouraging, they are limited and cannot be generalized to all cases of infants exposed to fluvoxamine. Additional mother-infant serum fluvoxamine levels and infant behavioral observations will facilitate the risk-benefit decision-making process for women who choose to breast-feed while taking fluvoxamine.
10%至15%的初产妇会经历产后抑郁发作。尽管抗抑郁药是治疗产后抑郁的有效药物，但支持其在母乳喂养母亲的婴儿中安全性的数据极少。
在本文中，我们呈现了2对母婴案例，其中母亲接受了氟伏沙明治疗，并获取了婴儿血清中的氟伏沙明水平。两位母亲均在产后开始氟伏沙明治疗，在母亲剂量稳定至少7天后，获取母亲和婴儿的血清水平。案例1中从婴儿获取了1个水平的数据，案例2中从婴儿获取了2个水平的数据。
所获取的每个婴儿血清氟伏沙明水平均过低无法定量（检测限为2.5纳克/毫升）。两名婴儿均未出现与母亲接受氟伏沙明治疗相关的不良事件。据报道，在接触药物2至3年后，每个婴儿都很健康。
虽然这些结果令人鼓舞，但具有局限性，不能推广到所有接触氟伏沙明的婴儿案例。更多的母婴血清氟伏沙明水平数据以及婴儿行为观察，将有助于为选择在服用氟伏沙明时进行母乳喂养的女性提供风险效益决策依据。
