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01-04-2015 | Review Article

Sertraline and breastfeeding: review and meta-analysis

Authors: Emily Pinheiro, Debra L. Bogen, Denada Hoxha, Jody D. Ciolino, Katherine L. Wisner

Published in: Archives of Women's Mental Health | Issue 2/2015

Abstract

We examined the risk-benefit profile of sertraline treatment during breastfeeding, summarized the available literature on sertraline use, presented previously unpublished data, and performed a correlation-based meta-analysis of sertraline serum levels in mother-infant pairs. We conducted a search of PubMed and the National Library of Medicine LactMed database. We performed a meta-analysis to examine correlations between maternal and infant serum sertraline levels in the existing literature and in previously unpublished data. Of 167 available infant sertraline levels, 146 (87.4 %) were below the limit of detection, and the meta-analysis found no significant relationship between maternal and infant sertraline concentrations. Of 150 infant desmethylsertraline levels, 105 (70.0 %) were below the limit of detection. The correlation analysis revealed a significant relationship between maternal and infant desmethylsertraline concentrations, but this metabolite has only a fraction of the activity of sertraline. A significant relationship was also found for the sum of sertraline and desmethylsertraline, which stems primarily from the contribution of desmethylsertraline. Sertraline is a first-line drug for breastfeeding women due to documented low levels of exposure in breastfeeding infants and very few adverse events described in case reports. Based on the current literature, neither routine serum sampling nor genotyping is warranted for breastfeeding mothers taking sertraline and/or their infants. Routine pediatric care is appropriate monitoring for breastfed infants of women who take sertraline monotherapy.

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Title: Sertraline and breastfeeding: review and meta-analysis
Authors: Emily Pinheiro
Debra L. Bogen
Denada Hoxha
Jody D. Ciolino
Katherine L. Wisner
Publication date: 01-04-2015
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 2/2015
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-015-0499-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sertraline and breastfeeding: review and meta-analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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