Which Psychiatric Medications Are Safe During Breastfeeding?

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breastfeeding postpartum depressionI’m often asked by mothers who want to breastfeed about which psychiatric medication is safe.

First, I want you to know that it is a myth that you must quit breastfeeding if you are going to be treated for postpartum depression. I’m always saddened to hear of moms who refuse to seek treatment because they are afraid they will be made to quit, or whose doctors tell them they must because they’ll be on medication.  That’s just not true.

Certainly, if you feel that it is better for you to formula feed that is a perfectly acceptable choice.  Also, therapy alone is a good option for some mothers.  If you need to take medication, though, you still don’t have to quit.  There are certain medications that have been fairly well studied and, according to the MGH Center for Women’s Mental Health, are “… considered to be relatively safe for use during breastfeeding when clinically warranted …”

I wanted to offer you some resources for those of you who plan to breastfeed but must also take an antidepressant or other psychiatric medication for the treatment of your postpartum depression or related illness:

Massachusetts General Hospital Center for Women’s Mental Health: Breastfeeding & Psychiatric Medications

MGH: Can Paxil Be Used While Breastfeeding? 

MGH: Lamotrigine and Breastfeeding

MGH: Can Women Taking Lithium Breastfeed Their Infants?

KellyMom: These are notes from a speech by Dr. Thomas Hale, author of Medications & Mother’s Milk.

InfantRisk: Antidepressant Use During Pregnancy & Breastfeeding

OTIS: Fluoxetine

OTIS: Sertraline

OTIS: Venlafaxine

OTIS: Buproprion

OTIS: Citalopram and Escitalopram

Note: The OTIS fact sheets have primarily information on taking these medications during pregnancy, but they address their use during breastfeeding toward the end of each fact sheet.

Also, when you read resources written by clinicians, you may notice they do not use the marketing or brand name of the drug but the clinical name, so I’m giving you a little glossary here so you’ll know to which medication they are referring:

fluoxetine = Prozac

sertraline = Zoloft

citalopram = Celexa

paroxetine = Paxil

venlafexine = Effexor

buproprion = Wellbutrin

escitalopram = Lexapro

lamotrigine = Lamictal

 

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  1. I stopped breast feeding after 4 months. I was put on medication that was not safe for baby. I will never forget the massive amount of tears shed over having to stop. It was such a sweet time, as well as the toughest time of my life and PPD/A. I am thrilled I had the opportunity to nurse, but still saddened by the thought that I had to cut it short. However, the benefit of the medications, BY FAR outweighed having to stop breastfeeding. Every woman is different, and must make the choice that is right for her and her family. I am eternally grateful for this site, and the helpful and honest information it provides. PPD/A/OCD, etc. are real and scary places. If medication is the key that unlocks the misery, it is a small price to pay for the gift of getting your life back. Breastfeeding or not!

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  3. Are you familiar with Deplin? It is the form of folic acid that the body actually uses. Since folic acid is required in higher doses for expectant mothers, this may be a safe and unique option. Hope this helps.

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