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MotherToBaby

Medications and More during pregnancy and breastfeeding

Amitriptyline

Selected References:

  • Breyer-Pfaff U, et al. 1995. Secretion of amitriptyline and metabolites into breast milk. The American Journal of Psychiatry; 152(5):812-813.  
  • Brixen-Rasmussen L, et al. 1982. Amitriptyline and nortriptyline excretion in human breast milk. Psychopharmacology; 76:94-95. 
  • Heinonen OP, et al. 1977. Birth Defect and Drugs in Pregnancy. Publishing Sciences Group Inc., Litteton, Mass. 
  • Huybrechts KF, et.al. 2014. Antidepressant use in pregnancy and the risk of cardiac defects. N Engl J Med; 370(25):2397-2407. 
  • Huybrechts KF, et al. 2015. Antidepressant use late in pregnancy and risk of persistent pulmonary hypertension of the newborn. JAMA; 313(21):2142-2151.  
  • Kronenfeld, N, et al. 2018. Chronic use of psychotropic medications in breastfeeding women: is it safe?. PloS One, 13(5): e0197196.  
  • Leutritz AL, et al. 2023. Psychotropic medication in pregnancy and lactation and early development of exposed children. British Journal of Clinical Pharmacology; 89(2):737-750.  
  • Lusskin SI, et al. 2018. Pharmacotherapy for perinatal depression. Clin Obstet Gynecol; 61(3):544-561. 
  • Marhofer D, et al. 2021. Schmerztherapie in der Schwangerschaft [Pain management during pregnancy: an expert-based interdisciplinary consensus recommendation.] Schmerz; 35:382–390. 
  • McElhatton PR, et al. 1996. The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants. A collaborative study of the European Network of Teratology Information Service (ENTIS). Reprod Toxicol; 10:285-294. 
  • Misri S, Sivertz K. 1991. Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psych Med; 21:157–171.  
  • Nulman I, et al. 1997. Neurodevelopment of children exposed in utero to antidepressant drugs. NEJM; 336(4):258-262. 
  • Nulman I, et al. 2002. Child development following exposure to tricyclic antidepressants or fluoxetine throughout fetal life: a prospective controlled study. Am J Psychiatry; 159(11):1889-1895. 
  • Palmsten K, et al. 2013. Antidepressant use and risk for preeclampsia. Epidemiology; 24(5):682-691. 
  • Phillips K, et al. 2026. Migraine, associated treatments and risk of miscarriage: a matched cohort study and nested case-control study using the CPRD pregnancy register. Cephalalgia; 46(1):3331024251414634.  
  • Sarayani A, et al. 2023. Real-world effect of a potential drug-drug interaction between topiramate and oral contraceptives on unintended pregnancy outcomes. Contraception; 120:109953.  
  • Schoretsanitis G, et al. 2021. Antidepressant transfer into amniotic fluid, umbilical cord blood & breast milk: a systematic review & combined analysis. Prog Neuropsychopharmacol Biol Psychiatry; 107:110228.  
  • Singh S, et al. 2024. Indian consensus on the role of amitriptyline in migraine prophylaxis. Cureus; 16(2):e54270.  
  • Suthar N, et al. 2018. Galactorrhea with antidepressants: a case series. Indian Journal of Psychiatry; 60(1):145-146. 
  • Tamai H, Kinugasa M. 2015. Pregnancy complicated by cyclic vomiting syndrome successfully treated with amitriptyline. Obstet Gynecol; 125(6):1487-1489.  
  • Tang KY. 2018. Amitriptyline poisoning at 34 weeks of pregnancy. Clin Toxicol (Phila); 56(4):301-303. 
  • Uguz F. 2017. Poor feeding and severe sedation in a newborn nursed by a mother on low dose amitriptyline. Breastfeed Med; 12:67-68. 
  • Uguz, F. 2021. A new safety scoring system for the use of psychotropic drugs during lactation. American journal of therapeutics; 28(1):e118-e126.  
  • Vree PH, et al. 1985. A newborn infant with amitriptyline poisoning. Ned Tijdschr Geneeskd; 129(19):910-912. 
  • Wang XY, et al. 2023. Antidepressant use during pregnancy and the risk for gestational diabetes: a systematic review and meta-analysis. J Matern Fetal Neonatal Med; 36(1):2162817.  
  • Weissman AM, et al. 2004. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. The American J of Psychiatry; 161(6):1066-1078.  
  • Yoshida K, et al. 1997. Investigation of pharmacokinetics and possible adverse effects in infants exposed to tricyclic antidepressants in breast-milk. J Affective Disord; 43:225-37. 

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