Venlafaxine and Breast-Feeding

VICTORIA HENDRICK, M.D., LORI ALTSHULER, M.D., AMY WERTHEIMER, B.A., and WILLIAM A. DUNN, M.S., F.T.S.-A.B.F.T., T.C.(N.R.C.C.)
Los Angeles, Calif.

Am J Psychiatry 158:2089-2090, December 2001

(A venlafaxine Magyarországon Efectin és Velaxin néven van forgalomban.)

To the Editor: Clinicians treating new mothers for depression require information about the safety of antidepressants if used while the mothers are breast-feeding. In contrast to extensive data on the use of selective serotonin reuptake inhibitor (SSRI) antidepressants by women who are breast-feeding (1–4), we know of only one small case series (N=3) on the use of venlafaxine by breast-feeding mothers (5). In this report, the estimated mean dose the infants received from breast milk was 7.6% of the maternal weight-adjusted dose. No adverse effects were noted in the infants, but the authors cautioned that this dose was high compared to the doses infants are estimated to receive when exposed to other antidepressants through breast milk. To add to the limited available data, we describe results we obtained for two mother-infant pairs in which the mothers were taking venlafaxine while breast-feeding.

Two nursing women taking stable daily doses of venlafaxine provided written informed consent for measurement of their and their infants’ serum levels of the drug. The analysis of venlafaxine and its metabolite, O-desmethylvenlafaxine, was accomplished by means of high-performance liquid chromatography, which has a detection limit of 10 ng/ml.

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