Details

Autor(en) / Beteiligte

• Uguz, Faruk
• Sharma, Verinder

Titel

Mood stabilizers during breastfeeding: a systematic review of the recent literature

Ist Teil von

• Bipolar disorders, 2016-06, Vol.18 (4), p.325-333

Ort / Verlag

Denmark: Blackwell Publishing Ltd

Erscheinungsjahr

2016

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Objective This review examined the safety of mood stabilizers in exposed breastfed infants. Methods PubMed was searched for English language reports between 1 January 1995 and 30 August 2015 by using combinations of key words breastfeeding, lactation, postpartum period, puerperium, mood stabilizers, lithium, lamotrigine, valproate, carbamazepine, and oxcarbazepine. Case reports, case series, and prospective or cross‐sectional studies including relevant data such as relative infant dose, milk‐to‐plasma ratio, infant drug plasma levels, and adverse events were identified. Results A total of 26 of 604 relevant reports in PubMed were included in the study. These reports included lamotrigine (122 cases in 12 reports), lithium (26 cases in five reports), carbamazepine (64 cases in five reports), valproate (nine cases in three reports), and oxcarbazepine (two cases in two reports). Of 26 reports, one report included both carbamazepine and valproate. The reports suggest that a considerable amount of lithium and lamotrigine are excreted into breast milk. There is a paucity of data on valproate and oxcarbazepine; however, the infant/maternal ratio of serum drug concentration seems to be lower in valproate exposure compared to other mood stabilizers. The incidence of adverse events in infants exposed to mood stabilizers is reported to be very low. Conclusions The current data suggest that mood stabilizers can be prescribed without any adverse events in most infants in lactating women. The available reports also suggest a low prevalence rate of laboratory abnormalities including hepatic, kidney, and thyroid functions in the infants. Additional studies examining short‐term and especially long‐term effects of mood stabilizers on breastfed infants are required.