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Antidepressant Medicine for Postpartum Depression

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 breast-feeding mothers.

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 doctor.

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.

Citations

  1. Brockingham I (2004). Postpartum psychiatric disorders. Lancet, 363(9405): 303-310.

  2. Weissman AM, et al. (2004). Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. American Journal of Psychiatry, 161: 1066-1078.

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Last Revised June 14, 2010

WebMD Medical Reference from Healthwise

Last Updated: June 14, 2010
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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