Fluoxetine Hydrochloride

SSRI antidepressant. Single daily dose oral administration.

It is excreted in human milk in small to moderate amount ^{(Lopes 2018, Weisskopf 2017, Salazar 2016, Berle 2004, Heikkinen 2003, Suri 2002, Hendrick 2001, Kristensen 1999, Yoshida 1998, Burch 1992, Isenberg 1990)}, although greater (relative dose > 10%) than that of other antidepressants from the same SSRI group. ^{(Pogliani 2019, Sriraman 2015, Sachs 2013, Taddio 1996, Nordeng 2001)}

The plasma levels of infants whose mothers took fluoxetine were very low or below the detection limit. ^{(Weissman 2004, Epperson 2003, Hendrick 2001, Birnbaum 1999, Brent 1998, Yoshida 1998)}

Occasional colic, irritability, insomnia, anorexia and decreased weight gain have been reported ^{(Kristensen 1999, Chambers 1999, Lester 1993)}, but problems have not been observed in most publications especially outside the neonatal period ^{(Taddio 1996)}. There are many published cases with no short- or long-term adverse effects on infant weight or neurodevelopment. ^{(Pogliani 2019, Gashlin 2016, Epperson 2003, Heikkinen 2003, Hendrick 2003, Nulman 2002, Hendrick 2001, Birnbaum 1999, Yoshida 1998)}

There may be adaptation problems during the immediate neonatal period or serotonin hyperstimulation in term or preterm infants born with high plasma levels because their mothers were taking fluoxetine during pregnancy. ^{(Kieviet 2015, Morris 2015, Hale 2010, Nordeng 2001)}

Fluoxetine, like other antidepressants, can cause problems of galactorrhea and/or hyperprolactinemia. ^{(Suthar 2018, Kaba 2017, Trenque 2011, Papakostas 2006, Peterson 2001, Egberts 1997, Arya 1995)}

Various medical societies and expert consensus consider the use of this medication safe during breastfeeding. ^{(Hale, Lactmed, Uguz 2021, Amir 2011, Berle 2011, Lanza 2009, ABM 2008, Pomp 2001)}

Known safer alternatives may be preferable during breastfeeding, especially during the neonatal period and in the case of prematurity. ^{(Davanzo 2011, Patil 2011, Gentile 2005, Rubin 2004, Weissman 2004, Gjerdingen 2003, Wisner 2002, Nordeng 2001, Wisner 1996)}

Women suffering from depression during pregnancy need more breastfeeding support due to their increased risk of problems and of early cessation of breastfeeding. ^{(Grzeskowiak 2018, Leggett 2017, Venkatesh 2017, Gorman 2012)}

 

See below the information of this related product:

• Maternal Depression (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)