Mirtazapine and Breast-Feeding

WOLFGANG AICHHORN, M.D., ALEXANDRA B. WHITWORTH, M.D., ULRIKE WEISS, M.D., and CHRISTOPH STUPPAECK, M.D.
Innsbruck and Salzburg, Austria

Am J Psychiatry 161:2325, December 2004

(A mirtazapine Magyarországon Mirzaten, Mizapin és Remeron neveken van forgalomban.)

To the Editor: Postpartum depression occurs in approximately 10% of childbearing women, and for many of them, treatment with an antidepressant may be necessary. The benefit of breast-feeding for the infant and the mother is well established; clinicians are therefore asked to make a careful risk-benefit decision on the use of antidepressants. The literature on antidepressants and breast-feeding consists mainly of case series of selective serotonin reuptake inhibitors and tricyclics, whereas information on newer antidepressants is scarce (1). We describe what we believe to be the first reported data on mirtazapine treatment in a breast-feeding woman.

Ms. A, a 27-year-old woman, was admitted to a psychiatric hospital 3 weeks after delivery of her daughter. She was suffering from a severe depressive episode with suicidal thoughts. Ms. A had a history of a first depressive episode at age 18 that was not treated. At the time of admission to the mother-child unit, Ms. A was breast-feeding her child and had so far not received antidepressive treatment. A routine diagnostic assessment, including a physical examination, laboratory studies, and a cerebral computerized tomography scan were normal.

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