Is Maprotilina [INN-Spanish] Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Maprotilina [INN-Spanish]? Is Maprotilina [INN-Spanish] safe for nursing mother and child? Does Maprotilina [INN-Spanish] extracts into breast milk? Does Maprotilina [INN-Spanish] has any long term or short term side effects on infants? Can Maprotilina [INN-Spanish] influence milk supply or can Maprotilina [INN-Spanish] decrease milk supply in lactating mothers?

If Maprotilina [INN-Spanish] is required by the mother, it is not a reason to discontinue breastfeeding. However, because there is little published experience with Maprotilina [INN-Spanish] during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.

Although it is structurally a tetracyclic compound, Maprotilina [INN-Spanish] has pharmacologic actions similar to the tricyclic antidepressants. Follow-up for 1 to 3 years in a group of 20 breastfed infants whose mothers were taking a tricyclic antidepressant found no adverse effects on growth and development.[3] Two small controlled studies indicate that other tricyclic antidepressants have no adverse effect on infant development.[4][5] In another study, 25 infants whose mothers took a tricyclic antidepressant during pregnancy and lactation were tested formally between 15 to 71 months and found to have normal growth and development. One of the mothers was taking Maprotilina [INN-Spanish].[6]

Maprotilina [INN-Spanish] has caused increased serum prolactin levels and galactorrhea in nonpregnant, nonnursing patients.[6][7] The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed. An observational study looked at outcomes of 2859 women who took an antidepressant during the 2 years prior to pregnancy. Compared to women who did not take an antidepressant during pregnancy, mothers who took an antidepressant during all 3 trimesters of pregnancy were 37% less likely to be breastfeeding upon hospital discharge. Mothers who took an antidepressant only during the third trimester were 75% less likely to be breastfeeding at discharge. Those who took an antidepressant only during the first and second trimesters did not have a reduced likelihood of breastfeeding at discharge.[8] The antidepressants used by the mothers were not specified. A retrospective cohort study of hospital electronic medical records from 2001 to 2008 compared women who had been dispensed an antidepressant during late gestation (n = 575) to those who had a psychiatric illness but did not receive an antidepressant (n = 1552) and mothers who did not have a psychiatric diagnosis (n = 30,535). Women who received an antidepressant were 37% less likely to be breastfeeding at discharge than women without a psychiatric diagnosis, but no less likely to be breastfeeding than untreated mothers with a psychiatric diagnosis.[9] None of the mothers were taking Maprotilina [INN-Spanish].