We performed an electronic search by using MEDLINE, PreMEDLINE, Current Contents, Biological Abstracts, and PsycINFO from June 2002 to December 2008 using the following terms: “antidepressant drugs”, “antidepressive agents”, “human milk”, “lactation”, and “breastfeeding” and the generic name of each antidepressant. Articles in the English language with reports of antidepressants in maternal serum or breast milk, infant serum, and short-term and long-term clinical outcomes in the infants were obtained. The search yielded a total of 31 empirical papers. Breastfeeding and antidepressant treatments are not mutually exclusive. Sertraline, paroxetine, nortriptyline, and imipramine are the most evidence-based medications for use during breastfeeding.
*Department of Neurosciences, Operative Unit of Psychiatry, University of Rome Tor Vergata Via Nomentana, Rome
†Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, O'Hara Street, Pittsburgh, Pennsylvania
Disclosures: Dr Katherine L. Wisner has received grant support from Pfizer in the past and is currently on the speaker's bureau of Glaxo-Smith-Kline. Dr Wisner's effort was supported primarily by National Institute of Mental Health R01 MH60335; also by National Institute of Mental Health R01 MH071825 and R01 MH075921. She receives research support from the State of Pennsylvania and the Heinz Foundation.
Correspondence: Katherine L. Wisner, MD, Women's Behavioral HealthCARE, Obstetrics and Gynecology and Reproductive Sciences, Epidemiology, and Women's Studies, Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center, 3811 O'Hara Street, Pittsburgh, PA. E-mail: WisnerKL@upmc.edu
Dr Teresa Lanza di Scalea reports no competing interests.