More Research Needed
From the prescribing information for Celexa and Zoloft:
Celexa:
As has been found to occur with many other drugs, citalopram is excreted in human breast milk. There have been two reports of infants experiencing excessive somnolence, decreased feeding, and weight loss in association with breastfeeding from a citalopram-treated mother; in one case, the infant was reported to recover completely upon discontinuation of citalopram by its mother and in the second case, no follow-up information was available. The decision whether to continue or discontinue either nursing or Celexa therapy should take into account the risks of citalopram exposure for the infant and the benefits of Celexa treatment for the mother.
Zoloft:
Well that sure doesn’t help clear things up for me. 2 reports? I mean, obviously one would hope for no negative side-effects. What what kind of risks are we looking at here? 2 out of how many?
So what’s my plan: find a Lactation Consultant to, err, consult with… which I can search for online. And then talk with the pediatrician about it. Then go from there.
Added:
Searching Toxnet for citalopram gave far more information.
Uneasy sleep that reversed with dosage reduction and partial formula supplementation was probably caused by citalopram in breastmilk in a 5-month-old infant.[5]
A group of 9 infants breastfed (6 exclusive, 3 received some formula beginning at 2 months) from birth to one year during maternal citalopram use had normal body weight and neurological development in all infants compared to 9 control infants whose mothers did not take citalopram.[2]
Three mothers who took an average citalopram dose of 15 mg once daily breastfed their infants exclusively for 4 months and at least 50% during months 5 and 6. Their infants had 6-month weight gains that were normal according to national growth standards.[6]
A study compared adverse reactions in 31 infants breastfed during maternal citalopram use to a control group of 31 breastfed infants whose mothers did not take an antidepressant. There were numerically more adverse events reported in the citalopram group (3 vs 1). However, the study found no statistical difference in the rate of adverse effects between the groups of infants and none of the side effects was serious. One mother reported infant irritability and restlessness after she began citalopram at 2 months postpartum. The side effects subsided after she stopped breastfeeding 2 weeks later.[7]
In 9 breastfed (extent not stated) infants aged 3 to 42 weeks whose mothers were taking citalopram an average of 24 mg daily, no adverse reactions were noted clinically at the time of the study.[3]
Interesting.
First I wanted to say that you look great! 30 weeks already wow!!!
So just wanted to share that my ob/gyn office was very uninformed about the antidepressants and breastfeeding.
Pediatrician was another story. Met with him about 1 month before the birth and he was adament (sp?) about no breastfeeding. He jumped all over that. And I figured that since he was going to be treating my son, I followed his instructions. It was hard for me to accept but I knew I needed my medications and I needed to be there happy and healthy for my son.
I think the problem is that is not enough long term studies have been done on the effects of the medications in the breast milk. It is a difficult decision for a new mom to be making. I heard so many times about risks outweigh the benefits and benefits outweigh the risk etc…It is confusing.
I just think that the peds and the ob/gyn need to get it together because they want everyone to breastfeed but also PPD is more public now and being treated.
Good Luck!
That’s what’s most frustrating to me… the OBs and the Peds don’t seem to be on the same page… one is trained for your health but not really very up to date on breastfeeding, the other side is all about the child and doesn’t really have anything to do with treating you. It really really makes me wish I was back in Canada. (One doctor, not three.)
I mean, I’m WAY into researching and double-checking facts and studies. What the hell do women who aren’t do? Who do they listen to? It’s damned confusing!
Depression is so common now… especially PPD…. they need to be having some better guidelines for this. I would NOT be capable of making an informed decision if I was only recently diagnosed and still off in crazy-land trying to get my bearings.
Read this blog and thought of you in the last paragraph :) http://mydustyovaries.blogspot.com/
Thanks for the link. :)