Forwarded with permission, in case anyone else is interested.

Begin forwarded message:

> From: "Nice, Frank (NIH/NINDS)"
>
> First of all, mirtazepine is only 50% bioavailable, so of the total
> dose,
> only potentially about 50% enters the mothers systemic circulation.
> The Volume of Distribution is 107 L, which is very high, which means
> smaller
> amounts gets into the breast milk as it is distributed widely though
> out the
> body.
> It is 85% protein bound, which is very high, and means that it is more
> difficult for the drug to enter into and bid with milk protein.
> The peak concentration in plasma is 1.5 to 2 hours, so avoiding that
> time
> period while breastfeeding would mean even less of the drug would be
> available to the child.
> Based on that information, I see no need to express at all and to
> continue
> to breastfeed normally except for the peak concentration times.
[snip]
> You can see why there have been no pediatric concerns reported.
>
[snip]
--
Lara Hopkins

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