Question

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

Answer by DrLact: About Nefazodone usage in lactation

Limited information indicates that usual doses of nefazodone produce low but variable levels in milk that would not be expected to cause adverse effects in a breastfed infant, especially if the infant is older than 2 months. However, adverse effects in a breastfed preterm infant have been reported. If nefazodone is required by the mother of an older infant, it is not a reason to discontinue breastfeeding, but until more data become available, other drugs may be preferred, especially while nursing a newborn or preterm infant.

Nefazodone Side Effects in Breastfeeding

Drowsiness, lethargy, poor feeding and low body temperature occurred in a 2.1 kg breastfed 9-week-old infant who was born preterm at 27 weeks to a mother taking a dose of 300 mg of nefazodone daily. The symptoms were probably caused by nefazodone in breastmilk.[4]

Nefazodone Possible Effects in Breastfeeding

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.[5] 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.[6] None of the mothers were taking nefazodone.
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