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Which SSRI is least secreted in breast milk?

Understanding SSRIs and Breastfeeding
Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed antidepressants that can pose concerns for breastfeeding mothers due to the potential transfer of these medications into breast milk. The decision to use SSRIs during breastfeeding involves weighing the benefits of maternal mental health against the risks of infant exposure to these drugs.
Sertraline: The Least Secreted SSRI
Among the SSRIs, sertraline is noted for having the lowest levels of secretion in breast milk. Research indicates that the amounts of sertraline that pass into breast milk are minimal, resulting in very low concentrations in the serum of breastfed infants. Specifically, while sertraline itself is present in low levels, its metabolite, norsertraline, is often detectable but also at low concentrations. This suggests that infants are exposed to only a small fraction of the maternal dose, making sertraline a preferred choice for breastfeeding mothers who require antidepressant treatment.
Implications for Breastfeeding Mothers
The implications of using sertraline during breastfeeding are significant. Given its low transfer rate into breast milk, many healthcare providers consider it a safer option compared to other SSRIs. This is particularly important for mothers who are managing postpartum depression or other mental health issues while wanting to provide the best nutrition for their infants through breastfeeding.
Conclusion
In summary, sertraline stands out as the SSRI with the least secretion into breast milk, making it a viable option for breastfeeding mothers. This characteristic allows mothers to maintain their mental health with reduced risk to their infants, highlighting the importance of individualized treatment plans in postpartum care.

What antidepressants are not affecting breast milk?

In terms of selecting an appropriate antidepressant, one should try to choose an antidepressant for which there are data to support its safety during breastfeeding (i.e., sertraline, paroxetine, fluoxetine, tricyclic antidepressants).

Is Zoloft better than Prozac for breastfeeding?

Depressed mothers, in part, do not breastfeed because of their concern about potentially negative effects of antidepressants on their infants. Although sertraline (Zoloft) and paroxetine (Paxol) concentrations are not detectable in infants’ sera, fluoxetine (Prozac) and citalopram (Celexa) do have detectable levels.

Is Zoloft excreted in breastmilk?

Does Zoloft pass into breast milk? Yes, Zoloft can pass into breast milk. While more research is needed in this area, current research indicates that only a very small amount passes through. (Peak levels in the hindmilk were typically found 8 to 9 hours after a dose.)

What is the safest SSRI for breastfeeding?

Paroxetine and sertraline are the SSRIs of choice during breastfeeding. More evidence is available on the use of SSRIs during breastfeeding than other antidepressant groups and limited data show encouraging outcomes when considering longer term effects on infants. However, they all have relatively long half-lives.

What are the first line antidepressants for breastfeeding moms?

When initiating a drug postpartum it is important to consider the mother’s previous response to treatment. For new prescriptions postpartum, consider Sertraline first-line if no previous antidepressant has been tried. Other SSRIs and Mirtazapine can be used whilst breastfeeding.

What is the safest anxiety medication 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.

What is the best SSRI for postpartum?

Overall, sertraline is the SSRI with the most evidence in the treatment of PPD [60, 63, 64].

Is Lexapro excreted in breastmilk?

Escitalopram passes into breast milk in small amounts. It does not usually cause any problems but it has been linked with side effects including being unusually irritable or restless and being sick in a few breastfed babies.

Is Lexapro breastfeeding safe?

Escitalopram passes into breast milk in small amounts. It does not usually cause any problems but it has been linked with side effects including being unusually irritable or restless and being sick in a few breastfed babies.

Which SSRI is best for pregnancy?

In general, these antidepressants are options during 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).

Natasha Lunn

Tash is an IBCLC and Business Coach helping fellow IBCLCs create fun, profitable businesses that are more than just an expensive hobby. Before becoming an IBCLC and starting her private practice - The Boobala, Tash graduated as an Osteopath in 2008 and has been in Private Practice in South West Sydney. She was also a volunteer Breastfeeding Counsellor and Community Educator with the Australian Breastfeeding Association for 6 years. Through her business, Your Lactation Biz, Tash coaches and creates products to help new and seasoned IBCLCs build businesses that suit their personality and lifestyle.

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