Antidepressants are commonly used to treat
postpartum depression (PPD), usually in combination
with counseling and support.
- For moderate to severe PPD, experts recommend
an antidepressant combined with support and counseling.
experts recommend starting an antidepressant for prevention in women at high
risk for PPD, but so far no studies have shown this to be effective.6
Breast-feeding is good for you and your baby, both
physically and emotionally. For this reason, experts have studied which
antidepressants seem safest for breast-feeding babies. So you need not stop
breast-feeding while taking an antidepressant for postpartum
Whether or not you are
breast-feeding, your doctor is likely to recommend a selective serotonin
reuptake inhibitor (SSRI).2 This class of medicine is effective for
most women, with fewer side effects than tricyclics.
Most tricyclic antidepressants can also be used with minimal risk while a woman is
breast-feeding. But for the mother, side effects are sometimes a
Your doctor may start you out with a low dose to help you
adjust to the medicine.
Selective serotonin reuptake inhibitors (SSRIs) are
usually the first-choice medicine for treating postpartum depression. Most
SSRIs are thought to be safe for use while a woman is breast-feeding, because in
general SSRIs pass into the breast milk at low levels.
Tricyclics have not caused any known breast-feeding
baby problems and are not passed on to a breast-feeding baby in measurable
amounts (with the exception of doxepin [Silenor, Zonalon], which is not
considered safe while breast-feeding).6
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.
Depression: Taking Antidepressants Safely
Depression: Dealing With Medicine Side Effects
What To Think About
Antidepressants are typically
used for at least 6 months, first to treat postpartum depression and then to
prevent a relapse of symptoms. To prevent a relapse, your doctor may recommend
that you take medicine for up to a year before thinking about discontinuing it.
Women who have had several bouts of depression may need to take medicine for a long time.
Never suddenly stop taking an SSRI. An SSRI should
be tapered off slowly and only under the supervision of a doctor. Abruptly
stopping SSRI medicine can cause flu-like symptoms, headaches, nervousness,
anxiety, or insomnia.
If you are breast-feeding and taking an
antidepressant or any other medicine, let your baby's doctor know.
Taking an antidepressant you've taken before.
After having your baby, talk to your doctor before taking any medicine,
especially if you are breast-feeding. You may be more sensitive to medicine
side effects during your postpartum period, and you may need a lower dose than
before. Some medicines are considered safer than others for a woman who is
Estrogen treatment for PPD has been studied on a
limited basis.8Estrogen therapy is unlikely to become a
common treatment for PPD, because it increases the risk of blood clots (deep vein thrombosis) and of cancer in the uterine lining (endometrium).