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. 2021 Jan-Feb;28(1):e118-e126.
doi: 10.1097/MJT.0000000000000909.

A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation

Faruk Uguz  1
Affiliations

A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation

Faruk Uguz. Am J Ther. 2021 Jan-Feb.

Abstract

Background: Psychotropic drugs are frequently used to treat postpartum women with psychiatric diagnoses, especially psychotic disorder, major depression, and bipolar mood episodes. Pharmacotherapy in breastfeeding mothers is a major challenge.

Study question: This article presents a new safety scoring system for the use of psychotropic drugs during lactation.

Study design: The scoring system is based on the following 6 safety parameters: reported total sample, reported maximum relative infant dose, reported sample size for relative infant dose, infant plasma drug levels, prevalence of reported any adverse effect, and reported serious adverse effects. The total score ranges from 0 to 10. Higher scores represent a higher safety profile.

Results: According to this scoring system, sertraline and paroxetine, respectively, had the highest scores representing "very good safety profile." Citalopram, olanzapine, and midazolam were assigned to "good safety profile." Among drugs evaluated in this article, trifluoperazine, aripiprazole, amisulpride, clozapine, doxepin, zaleplon, and zolpidem are not recommended owing to safety scores ≤3.

Conclusions: Most psychotropic drugs examined in this article have "moderate" or "low" safety profile.

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Conflict of interest statement

The author has no conflict of interest to declare.

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References

    1. Freeman MP, Smith KW, Freeman SA, et al. The impact of reproductive events on the course of bipolar disorder in women. J Clin Psychiatry. 2002;63:284–287.
    1. Russell EJ, Fawcett JM, Mazmanian D. Risk of obsessive-compulsive disorder in pregnant and postpartum women: a meta-analysis. J Clin Psychiatry. 2013;74:377–385.
    1. Munk-Olsen T, Laursen TM, Mendelson T, et al. Risks and predictors of readmission for a mental disorder during the postpartum period. Arch Gen Psychiatry. 2009;66:189–195.
    1. Sharma V. Treatment of postpartum psychosis: challenges and opportunities. Curr Drug Saf. 2008;3:76–81.
    1. Hahn-Holbrook J, Cornwell-Hirichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psychiatry. 2018;8:248.
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