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Seroquel and venlafaxine and lymes

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  • Seroquel and venlafaxine and lymes

    I have a pt on both of these and she has been told not to breastfeed- she is also concerned about lymes and breastfeeding ?

  • #2
    Dear Cathyh

    Lyme disease is caused by infection with the spirochete, borrelia burgdorferi. Antigenic material from the spirochete is found in human milk, although we do not know if it is infectious. If diagnosed in a breastfeeding mother, the mother should be treated immediately. Because the spirochete antigen has been found in breast milk, breastfeeding should be withheld until treatment with an appropriate antibiotic is instituted. Once treatment is initiated, I would suggest breastfeeding may be resumed after 24hours.

    Quetiapine (Seroquel) is indicated for the treatment of psychotic disorders. New data suggests this neuroleptic drug penetrates milk poorly at a minimal dose of 200 mg/day. The relative infant dose would probably be <0.43%. No untoward effects were noted in the infant. However, this will be a function of maternal dose. No adverse effects were reported in the infants in one study, but the authors suggest monitoring the infant's progress and the infant's quetiapine serum concentrations.

    Venlafaxine (Effexor) is a new serotonin reuptake inhibitor antidepressant. The clinical dose of venlafaxine transferred via milk is about 6.4% for both metabolite and parent drug. Thus far, no reports of adverse effects have been found following exposure via milk. However, recent data has suggested that infants exposed in utero, may have adverse effects upon delivery. These include: respiratory distress, cyanosis, apnea, seizures, temperature instability, etc. It is not known if these adverse events are due to a direct toxic effect of venlafaxine on the fetus, or due to a discontinuation (withdrawal) syndrome.

    For further questions please contact the InfantRisk Center at 806-352-2519.

    Tassneem Abdel Karim MD
    InfantRisk Center

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