Management of venlafaxine withdrawals in the newborn

[KristinaAustralia]

Patient EDD mid February 2013 currently on Venlafaxine (Effexor XR) 375mg mane would like to put in place a management plan post-natally to reduce the withdrawal side effects of her newborn. She plans to breastfeed.
My research suggests a small weaning dose for the infant in conjunction with continued breastfeeding - how is that dose calculated and administered?
Any suggestions to effectively manage this patient and her infant?

[admin]

Kristina:

First, 70% of infants do not have a withdrawal effect following in utero exposure. Only about 30% are reported to have such symptoms.
I do not know of any protocol that recommends direct therapy to the INFANT to prevent withdrawal. Breastfeeding while consuming the antidepressant may be the best way to help prevent it, although in many instances, it does not because the dose of the the SSRI in milk is often not high enough.

I'd suggest direct therapy to the infant is not a good idea. Virtually all reports suggest infants with withdrawal symptoms do just fine after a few days and no one that I know of suggests directly treating the infants.

Tom Hale Ph.D.