Antidepressant treatment during breast-feeding.
Antidepressant treatment during breast-feeding.
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母乳喂养期间的抗抑郁治疗。
DOI：
10.1176/ajp.153.9.1132
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
Findling,RL
中科院分区：
文献类型：
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作者：
Wisner,KL;Perel,JM;Findling,RL
目的对哺乳期抗抑郁药物使用的相关文献进行综述。本文还提出了抑郁母乳喂养母亲的临床管理策略。方法通过MEDLINE计算机检索文章。该综述包括从哺乳婴儿中获得血清药物水平的研究。结果15篇已发表的报告提供了以下9种抗抑郁药物的信息：阿米替林、去甲替林、地西帕明、氯米帕明、多塞平、多硫平、氟西汀、舍曲林和安非他酮。结论在新生儿中未发现咪替林、去甲替林、地西帕明、氯丙帕明、多硫平、舍曲林等可量化的不良反应。因此，这些都是母乳喂养妇女的首选药物。一些母亲在母乳喂养期间用多虑平或氟西汀治疗的婴儿出现了不良反应。集体血清水平数据表明，10周以上的婴儿发生三环类药物不良反应的风险较低，没有证据表明会累积。研究需要包括扩大母婴血清水平的数据库，哺乳期间婴儿的行为评估，以及哺乳者的纵向发育评估。给哺乳期妇女开抗抑郁药是一个具体的风险-收益决定。
ObjectiveThe primary purpose of this article is to review critically the literature about use of antidepressants during lactation. Strategies for the clinical management of depressed breast-feeding mothers are also suggested.MethodThe authors conducted a computerized search of MEDLINE for articles. The review includes studies in which serum levels of drugs were obtained from nursing infants.ResultsFifteen published reports were located that provided information for the following nine antidepressants: amitriptyline, nortriptyline, desipramine, clomipramine, doxepin, dothiepin, fluoxetine, sertraline, and bupropion.ConclusionsAmitriptyline, nortriptyline, desipramine, clomipramine, dothiepin, and sertraline were not found in quantifiable amounts in nurslings, and no adverse effects were reported. Therefore, these are the drugs of choice for breast-feeding women. Adverse effects were described in some young infants whose mothers had been treated with doxepin or fluoxetine during breast-feeding. The collective serum level data suggest that infants older than 10 weeks are at low risk for adverse effects of tricyclics, and there is no evidence of accumulation. Research needs include an expanded database of mother-baby serum levels, behavioral assessments of infants during nursing, and longitudinal developmental evaluation of nurslings. Prescription of an antidepressant for a breast-feeding woman is a case-specific risk-benefit decision.