Antidepressant medicine can provide effective treatment
for women with
postpartum depression, including those who are
breast-feeding. Your doctor may start you out with a low dose to
help you adjust to the medicine.
Selective serotonin reuptake inhibitors (SSRIs). An SSRI is usually the preferred
medicine for treating postpartum depression. Certain SSRIs are commonly
prescribed for breast-feeding women and pose no known risks to their babies.
Tricyclic antidepressants. Most tricyclics have not caused
problems in breast-feeding babies and are not passed on to a breast-feeding
baby in measurable amounts.1Nortriptyline has been studied the most for breast-feeding mothers.2Doxepin (Sinequan, Zonalon) is not recommended for
You may start to feel better within 1 to
3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8
weeks to see more improvement. If you have questions or concerns about your
medicines, or if you do not notice any improvement by 3 weeks, talk to your
Antidepressants are used for at least 6 months, first to
treat postpartum depression, and then to prevent a relapse of symptoms. Women who have had several bouts of depression may need to take medicine for a long time.
Women who take an SSRI during pregnancy have a slightly higher chance of having a baby with birth defects. But not treating depression can also cause problems during pregnancy and birth. If you become pregnant again, you and your doctor must weigh the risks of taking an SSRI against the risks of not treating depression.
FDA Advisory. The U.S. Food and Drug
Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. The FDA does not recommend that people stop using these medicines.
Instead, a person taking antidepressants should be watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when the doses are changed.
Brockingham I (2004). Postpartum psychiatric
disorders. Lancet, 363(9405): 303-310.
Weissman AM, et al. (2004). Pooled analysis of
antidepressant levels in lactating mothers, breast milk, and nursing infants.
American Journal of Psychiatry, 161:
Primary Medical Reviewer
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer
Lisa S. Weinstock, MD - Psychiatry
June 14, 2010
WebMD Medical Reference from Healthwise
June 14, 2010
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