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A guide to the safety of CNS-active agents during breastfeeding.

Publication ,  Journal Article
Chisholm, CA; Kuller, JA
Published in: Drug Saf
August 1997

For most agents with CNS activity, there are limited data regarding their safety in breastfeeding. Any decision to institute treatment for a neurological or psychiatric disorder must weigh the benefits of maternal treatment against the potential harm to the breastfeeding mother of withholding medication which may improve her illness. For the neonate, one must balance the risk of medication exposure against the benefit of receiving breast milk. Most tricyclic antidepressants can be used in lactating women. Because of the limited data, selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors should only be used with due consideration of the potential adverse effects. Breastfeeding is best avoided by women who require lithium therapy, because of both the immature excretory systems in the infant and relatively high doses received by the infant. There is little information about the safety of antipsychotic medications in breastfeeding. Concerns include toxicity and abnormal neurological development in the infant. These agents may be used with caution. Most agents which cause depression of the CNS, including opiates and sedatives, can be used in small doses and for short courses in breastfeeding mothers. Most anticonvulsants can be used in lactating women. Reference texts and consultation with experts are useful adjuncts to discussion of the risks and benefits of therapy with the patient. The scope of this review is limited to drugs with therapeutic uses, thus drugs of abuse are not discussed, nor are caffeine and alcohol (ethanol).

Duke Scholars

Published In

Drug Saf

DOI

ISSN

0114-5916

Publication Date

August 1997

Volume

17

Issue

2

Start / End Page

127 / 142

Location

New Zealand

Related Subject Headings

  • Pharmacology & Pharmacy
  • Humans
  • Female
  • Central Nervous System Agents
  • Breast Feeding
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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Chisholm, C. A., & Kuller, J. A. (1997). A guide to the safety of CNS-active agents during breastfeeding. Drug Saf, 17(2), 127–142. https://doi.org/10.2165/00002018-199717020-00005
Chisholm, C. A., and J. A. Kuller. “A guide to the safety of CNS-active agents during breastfeeding.Drug Saf 17, no. 2 (August 1997): 127–42. https://doi.org/10.2165/00002018-199717020-00005.
Chisholm CA, Kuller JA. A guide to the safety of CNS-active agents during breastfeeding. Drug Saf. 1997 Aug;17(2):127–42.
Chisholm, C. A., and J. A. Kuller. “A guide to the safety of CNS-active agents during breastfeeding.Drug Saf, vol. 17, no. 2, Aug. 1997, pp. 127–42. Pubmed, doi:10.2165/00002018-199717020-00005.
Chisholm CA, Kuller JA. A guide to the safety of CNS-active agents during breastfeeding. Drug Saf. 1997 Aug;17(2):127–142.
Journal cover image

Published In

Drug Saf

DOI

ISSN

0114-5916

Publication Date

August 1997

Volume

17

Issue

2

Start / End Page

127 / 142

Location

New Zealand

Related Subject Headings

  • Pharmacology & Pharmacy
  • Humans
  • Female
  • Central Nervous System Agents
  • Breast Feeding
  • Adult
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences