Is fluoxetine or sertraline safe while breastfeeding?

Overview of Antidepressants and Breastfeeding
When it comes to managing mental health during breastfeeding, the safety of medications like fluoxetine and sertraline is a significant concern for many new mothers. Both of these medications belong to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which are commonly prescribed for depression and anxiety disorders. Understanding their safety profiles while breastfeeding is crucial for both maternal and infant health.
Fluoxetine: Safety Considerations
Fluoxetine, while effective for treating depression, presents some challenges when it comes to breastfeeding. Research indicates that fluoxetine is transferred into breast milk at higher levels compared to many other SSRIs. The active metabolite of fluoxetine, norfluoxetine, can also be detected in the serum of most breastfed infants during the first two months postpartum, and in some cases, even beyond that. This prolonged presence raises concerns about potential effects on infants, leading many healthcare providers to recommend caution.
While fluoxetine has been used by breastfeeding mothers for years, it is generally not the first choice. Experts suggest that if a mother has been on fluoxetine during pregnancy or if other antidepressants have not been effective, it may be acceptable to continue its use. However, the consensus leans towards recommending alternatives, particularly sertraline or paroxetine, which are considered safer options.
Sertraline: A Preferred Choice
In contrast, sertraline (commonly known by its brand name Zoloft) is often regarded as one of the safest antidepressants for breastfeeding mothers. It passes into breast milk in low concentrations, which minimizes the risk of adverse effects on the infant. Studies have shown that the side effects in breastfed infants exposed to sertraline are rare, although some cases of diarrhea, drowsiness, and restlessness have been reported.
A comprehensive review of the literature supports the use of sertraline during breastfeeding, highlighting its favorable risk-benefit profile. The available data suggest that the benefits of treating maternal depression with sertraline outweigh the potential risks to the infant.
Conclusion: Making Informed Choices
In summary, while both fluoxetine and sertraline can be used during breastfeeding, sertraline is generally preferred due to its lower concentration in breast milk and reduced risk of side effects in infants. Mothers should consult with their healthcare providers to weigh the benefits of treating their mental health conditions against any potential risks to their breastfeeding infants. Ultimately, the decision should be tailored to the individual circumstances of each mother and her baby, ensuring that both receive the care they need.

Can fluoxetine affect your breasts?

Less common or rare

• Abnormal dreams.
• breast enlargement or pain.
• change in sense of taste.
• changes in vision.
• feeling of warmth or heat.
• flushing or redness of the skin, especially on face and neck.
• frequent urination.
• hair loss.

What can I take for anxiety while breastfeeding?

Safe medication in breastfeeding
They include, in no particular order: SSRI antidepressants e.g. sertraline, citalopram, fluoxetine, paroxetine all have anti- anxiety activity. They take 4 to 6 weeks to exert full benefit. Tri-cyclic antidepressants e.g. amitriptyline, imipramine.

Can you take Prozac or Zoloft while breastfeeding?

All antidepressants are passed into breast milk. But for most people, the benefits of breastfeeding, and of getting treated for mental health conditions, outweigh the small risks of taking an antidepressant. Zoloft (sertraline) is one of the safest antidepressants to take while breastfeeding.

What is the lowest risk antidepressant in pregnancy?

Certain selective serotonin reuptake inhibitors (SSRIs).
SSRIs usually are an option during pregnancy. These include citalopram (Celexa), sertraline (Zoloft), escitalopram (Lexapro) and fluoxetine (Prozac). Risks include high blood pressure for the pregnant person and premature birth. These risks are small.

Can breastfed babies take Zoloft long term effects?

There is no evidence that a mother’s use of Zoloft during breastfeeding causes developmental delays. The majority of drugs aren’t contraindicated for use during breastfeeding, according to the American Academy of Pediatrics (AAP). There is no evidence of a relationship between Zoloft and autism in nursing babies.

How much sertraline is in breast milk?

In a pooled analysis of serum levels from published studies and 4 unpublished cases, the authors found that 15 mothers taking an average daily dosage of 83 mg (range 25 to 200 mg) had an average breastmilk sertraline level of 45 mcg/L (range 7 to 207 mcg/L).

Can I take sertraline while breastfeeding?

Sertraline and breastfeeding
It is one of the preferred antidepressants to take when breastfeeding and has been used by many breastfeeding mothers without any problems. Sertraline passes into breast milk in very small amounts and has been linked with side effects in very few breastfed babies.

How much weight do you gain on sertraline?

Zoloft is associated with more weight gain when compared with Prozac. However, it’s not much of a difference. One two-year study by the Journal of Clinical Medicine found that sertraline (generic Zoloft) users gained an average of 5.9 lbs compared to fluoxetine (generic Prozac) users who gained 4.6 lbs.

Can I take fluoxetine while breastfeeding?

If your doctor or health visitor says your baby is healthy, you can take fluoxetine while breastfeeding. Fluoxetine passes into breast milk, usually in fairly small amounts. It has been linked with side effects in a few breastfed babies, but has been used by many breastfeeding mothers without any problems.

What is the safest antidepressant while breastfeeding?

Sertraline and paroxetine (among SSRIs) and nortriptyline and imipramine (among TCAs) are the most evidence-based medications for use during breastfeeding because of similar findings across multiple laboratories, usually undetectable infant serum levels and no reports of short term adverse events.