pospartum depression--Prozac--and breastfeeding ?
Q.Question for all of you moms who had or have postpartum depression--I had a beatiful baby boy four weeks ago and I'm having a hard time dealing with lack of sleep, caring for the baby, and dealing with my parents who are visiting to help take care of the baby, and my husband who has some issues with my parents. In addition, it's wintertime and I'm always more "down" during winter. A psychiatrist said to try first light therapy boxes, which I started on Sunday and I think it helps but I'm going to see her again on Monday and we are supposed to decide if I should go on medication.
A.Women with postpartum depression can safety use sertraline while breastfeeding without appreciably affecting peripheral serotonin transport in their infants, Yale University researchers report in the American Journal of Psychiatry for October. According to a second paper in that issue, the use of venlafaxine during pregnancy does not increase the risk of birth defects. Dr. Neill Epperson and associates in New Haven, Connecticut measured platelet levels of serotonin in women and their infants before and 6 to 16 weeks after sertraline treatment was initiated. At the time the sampling was conducted during drug treatment, the dosage ranged from 25 to 200 mg daily. For 13 mothers, the mean maternal serotonin level before taking sertraline was 158.7 ng/mL, which declined to 18.7 ng/mL during drug treatment. For the 11 assessable infants, the sertraline concentrations did not differ significantly before and after exposure to sertraline, 227.0 ng/mL and 223.7 ng/mL, respectively. Depression is an illness that has a major impact on women’s lives. Canadian studies have consistently shown that women are more likely to experience depression than men, and surveys of women’s health interests consistently rate it as a major concern. Depression is most common in women between puberty and menopause. Many drug treatments have been developed for depression, and the use of a group of drugs known as Selective Serotonin Reuptake Inhibitors (SSRI) by women of childbearing age is now widespread. Drugs in this group include paroxetine (Paxil), and setraline (Zoloft). Women taking these drugs to treat depression sometimes fear that the drugs will have a negative affect on their baby, if they become pregnant. Fortunately, studies done at the University of Toronto and elsewhere in the last several years have shown that these drugs are safe during pregnancy. Whether women took the drugs in the first trimester or throughout pregnancy, there appeared to be no increase in birth defects, miscarriages, still births or premature deliveries. ``This study provides compelling data that Paxil is a viable treatment option for mothers who would like to continue breast-feeding.'' Reassuring Data for Nursing Moms and their Infants Results from this unique study provide the first detailed characterization of Paxil excretion into human breast milk as well as extensive information on infant exposure during breast-feeding. Participants in the study included postpartum women treated with Paxil (10-50 mg/day for >10 days) and their newborn infants. Blood samples were obtained from all mothers within 2-5 hours after the daily Paxil dose and from the infants within 1-5 hours after nursing. The majority of the infants were fully breast-fed with no supplemental nutrition. The key finding was that all infant blood samples had no detectable concentrations of the medication. Furthermore, the definition for detection (
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