Is Mirtazapine compatible with breastfeeding? Do we have alternatives for Mirtazapine?

Mirtazapine

April 16, 2015 (Very Low Risk)

Excreted into breast milk in a clinically non-significant amount.

Plasma level of breastfed infants from treated mothers with Mirtazapine are usually undetectable or very low.

Not significant clinically based side-effects in the infants both at short and long-term have been observed.

Isolated cases of galactorrhea have been reported.

The poor extrauterine adaptation that may appear in neonates just after birth when the pregnant woman has been treated with selective reuptake-inhibitors of Serotonin like Venlafaxine or Mirtazapine, is seen to be mild if the baby is breastfed.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • ミルタザピン
  • 6-Azamianserin
  • Mepirzepine
  • Org-3770
  • ميرتازابين
  • μιρταζαπίνη
  • Миртазапин
  • 米氮平

Drug trade names

References

  1. Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. Smit M, Wennink HJ, Heres MM, Dolman KK, Honig A. Mirtazapine in pregnancy and lactation: data from a case series. J Clin Psychopharmacol. 2015Abstract
  3. Schroeder K, Huber CG, Jahn H. Mirtazapine-induced galactorrhea: a case report. J Neuropsychiatry Clin Neurosci. 2013Abstract Full text (link to original source) Full text (in our servers)
  4. Kieviet N, Dolman KM, Honig A. The use of psychotropic medication during pregnancy: how about the newborn? Neuropsychiatr Dis Treat. 2013Abstract Full text (link to original source) Full text (in our servers)
  5. AEMPS. Mirtazapina. Ficha técnica. 2013 Full text (in our servers)
  6. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013Abstract Full text (link to original source) Full text (in our servers)
  7. Hübner-Liebermann B, Hausner H, Wittmann M. Recognizing and treating peripartum depression. Dtsch Arztebl Int. 2012Abstract Full text (link to original source) Full text (in our servers)
  8. Pfizer. Mirtazapine. Product Monograph. 2012 Full text (in our servers)
  9. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011Abstract
  10. Patil AS, Kuller JA, Rhee EH. Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv. 2011Abstract
  11. Berle JO, Spigset O. Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011Abstract Full text (link to original source) Full text (in our servers)
  12. Hale TW, Kendall-Tackett K, Cong Z, Votta R, McCurdy F. Discontinuation syndrome in newborns whose mothers took antidepressants while pregnant or breastfeeding. Breastfeed Med. 2010Abstract
  13. Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009Abstract Full text (link to original source) Full text (in our servers)
  14. Tonn P, Reuter SC, Hiemke C, Dahmen N. High mirtazapine plasma levels in infant after breast feeding: case report and review of the literature. J Clin Psychopharmacol. 2009Abstract
  15. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #18: use of antidepressants in nursing mothers. Breastfeed Med. 2008Abstract Full text (link to original source) Full text (in our servers)
  16. Kristensen JH, Ilett KF, Rampono J, Kohan R, Hackett LP. Transfer of the antidepressant mirtazapine into breast milk. Br J Clin Pharmacol. 2007Abstract Full text (link to original source) Full text (in our servers)
  17. Klier CM, Mossaheb N, Lee A, Zernig G. Mirtazapine and breastfeeding: maternal and infant plasma levels. Am J Psychiatry. 2007Abstract Full text (link to original source) Full text (in our servers)
  18. Gentile S. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf. 2005Abstract
  19. Aichhorn W, Whitworth AB, Weiss U, Stuppaeck C. Mirtazapine and breast-feeding. Am J Psychiatry. 2004Abstract Full text (link to original source) Full text (in our servers)
  20. Schüle C, Baghai T, Bidlingmaier M, Strasburger C, Laakmann G. Endocrinological effects of mirtazapine in healthy volunteers. Prog Neuropsychopharmacol Biol Psychiatry. 2002Abstract
  21. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002Abstract