Serum fluvoxamine levels in breastfed infants

Background: Between 10% and 15% of new mothers will experience an episode o f postpartum depression. Although antidepressants are effective agents for the treatment of postpartum depression, minimal data are available to suppo rt their safety in infants of breastfeeding mothers. Method: In this article, we present 2 cases of nursing mother-infant pairs in which the mother was treated with fluvoxamine and in which infant serum fluvoxamine levels were obtained. Both mothers began the fluvoxamine treatm ent postpartum, and serum levels were obtained from mothers and infants aft er a minimum of 7 days on a stable maternal dose. One level was obtained fr om the infant in case 1, and 2 levels were obtained from the infant in case 2. Results: Each of the infant serum fluvoxamine levels obtained was too low t o quantify (at a limit of detection of 2.5 ng/mL). Neither of the infants e xperienced adverse events related to the mother's treatment with fluvoxamin e. Each of the infants is reportedly healthy 2 to 3 years after the exposur e. Conclusion: While these results are encouraging, they are limited and canno t be generalized to all cases of infants exposed to fluvoxamine. Additional mother-infant serum fluvoxamine levels and infant behavioral observations will facilitate the risk-benefit decision-making process for women who choo se to breast-feed while taking fluvoxamine.