Selegiline and Breastfeeding

Summary of use during lactation

A minimal amount of clinical use of selegiline during breastfeeding has been reported. Although no adverse reactions have been reported in the breastfed infants, an alternate drug may be preferred, especially while nursing a newborn or preterm infant. The manufacturer of the selegiline transdermal patch recommends that breastfeeding is not recommended during treatment and for 7 days after the final dose.

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. A woman with severe depression used a selegiline patch 6 mg per day during pregnancy and postpartum. She exclusively breastfed her infant. A blood sample taken from the infant on day 12 postpartum found no selegiline or its metabolite in the infant’s plasma. No details were provided regarding the assay or its detection limits.[1]

Effects in breastfed infants

A woman took selegiline 10 mg, levodopa 400 mg and benserazide 100 mg daily throughout pregnancy and continued them while breastfeeding her infant for 3 days. The child was followed for 10 years and no developmental abnormalities were found.[2] A woman with severe depression used a selegiline patch 6 mg per day during pregnancy and postpartum. She exclusively breastfed her infant for an unstated period of time. Pediatric follow-up at 5 months of age found that the infant was developing normally.[1]

Effects on lactation and breastmilk

Selegiline can decrease serum prolactin in women with migraine,[3] and in those taking neuroleptic drugs.[4,5] The clinical relevance of these findings in nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

References

1. BauerRL OrfeiJ WichmanCL Use of transdermal selegiline in pregnancy and lactation: A case report. Psychosomatics 2017 58 450 2 28501290 PubMed
2. KupschA OertelWH Selegiline, pregnancy, and Parkinson's disease. Mov Disord 1998 13 175 6 9452347 PubMed
3. CalabresiP SilvestriniM StrattaF l-Deprenyl test in migraine: Neuroendocrinological aspects. Cephalalgia 1993 13 406 9 8313454 PubMed
4. PerényiA BagdyG AratóM. An early phase II trial with L-deprenyl for the treatment of neuroleptic-induced parkinsonism. Pharmacopsychiatria 1983 16 143 6 6140692 PubMed
5. KodeshA WeizmanA AizenbergD Selegiline in the treatment of sexual dysfunction in schizophrenic patients maintained on neuroleptics: a pilot study. Clin Neuropharmacol 2003 26 193 5 12897639 PubMed