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Is It Safe to Take Psychiatric Medications While Breastfeeding?

     

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One in seven women will face postpartum depression, and many will require medication to recover. Naturally, those that face this illness often find themselves wondering: Is it OK for me to take medication while breastfeeding? While this is an individual decision that should be made together with your health care provider, we would like to provide some important information to consider.

If you stopped taking medication during pregnancy and plan to resume, or if you are starting a new medication, it is important to know that less medicine is passed to the baby through breast milk than through the umbilical cord. With several psychiatric medications (such as fluoxetine, sertraline, escitalopram, citalopram, paroxetine, venlafaxine), research shows very little, if any, adverse effects in children. And, if there are adverse effects, they may be short-lived. Some reported adverse effects include sedation, fussiness, and colic. You should talk to your doctor or a perinatal psychiatrist about the risks and benefits of your particular medication.

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If you took psychiatric medication for mood or anxiety disorders while pregnant, it is generally advisable to continue the same medication during breastfeeding if it has worked well for you in the past and if the risks of the medication for your baby are low. Staying on the same medication or resuming a medication that has worked well for you in the past will give you the best chance for treating your mood or anxiety symptoms. Also, if you were taking an SSRI1 or an SNRI2 while pregnant, your child may have less risk of developing mild withdrawal symptoms known as poor neonatal adaptation syndrome. This is due to the fact that the small amount that they may receive in the breast milk may help wean them off of the medication.

If you are considering taking a medication or are currently taking medication while breastfeeding, make sure you talk about the risks and benefits with your psychiatrist or a perinatal psychiatrist.

If you and your doctor decide that medication is not worth the potential risk to your child, there are other treatment options available to you, such as cognitive behavioral therapy, behavioral activation, interpersonal therapy and light therapy.

No matter what you and your doctor decide, it is important to get help for mental health conditions. Untreated depression, anxiety or other disorders can significantly impair bonding with your child and your own self–care. Breastfeeding should be a time in which you can feel close and connected to your baby and untreated psychiatric illness, in many cases, can interfere with this.

More information

  1. SSRI = selective serotonin reuptake inhibitor (for example, sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil)
  2. SNRI = serotonin and norepinephrine reuptake inhibitor (for example, venlafaxine (Effexor), duloxetine (Cymbalta)

     

AnxietyDepressionPostpartum depression

 

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