CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
According to the manufacturer, the extent of excretion of buspirone and its metabolites into human milk is not known, and buspirone administration during breast-feeding should be avoided if possible. Buspirone and its metabolites are excreted in the milk of lactating rats. In one case report, a woman took buspirone (45 mg/day), fluoxetine (20 mg/day), and carbamazepine (600 mg/day) throughout pregnancy and for 3 weeks postpartum. She reported seizure-like activity in the infant at 3 weeks, 4 months, and months of age. While both fluoxetine and carbamazepine were present in the breast milk and infant serum samples, buspirone was undetectable. The infant's neurological exam and electroencephalography were normal. The authors were unable to determine the cause of the seizure-like activity. Although the American Academy of Pediatrics (AAP) does not specifically address the use of buspirone during breast-feeding, the AAP cautions that psychotropic medications affect neurotransmitter function in the developing central nervous system, and therefore, the accurate prediction of long-term adverse effects may not be possible. Due to individual variability in the response to buspirone and other anxiolytics, it may be prudent to continue the existing regimen if ongoing treatment is deemed necessary during breast-feeding. However, because a pooled analysis found that maternal use of paroxetine usually produced undetectable or low drug concentrations in infant serum, this agent may be preferred when initiating therapy for generalized anxiety disorder in a breast-feeding mother. A short-acting benzodiazepine such as lorazepam may be beneficial when immediate relief of anxiety symptoms is required, although the AAP classifies many benzodiazepines as drugs for which the effects on a nursing infant are unknown but may be of concern, particularly with prolonged exposure. If any benzodiazepine is used by a breast-feeding mother, the infant should be monitored for adverse effects, such as sedation. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. If a breast-feeding infant experiences an adverse effect related to a maternally ingested drug, healthcare providers are encouraged to report the adverse effect to the FDA.