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Pregnancy and Breastfeeding

Antidepressants, breastfeeding and pregnancy information resources

Breastfeeding expert Dr.Hale provides a heirarchy of antidepressant choice and summary discussion of pros and cons. See summary of Hale's seminar here: Antidepressants

Zoloft is the number one choice, Lexapro is further on down the line. The main reasons are that Zoloft is not excreted in the breastmilk, Lexapro is in very small quantities. There are reports of this causing sonomulance (sleepiness) in newborns.

However there are very few reported cases (only two as of this report) and the risk seems to be minimal for older infants. Weight gain and sexual side effects as described by (poster) are possible with all the SSRIs and it seems that some people are more sensitive to these than others.

My doc says that Lexapro has the lowest level of reported side effects of any of the SSRIs. One important possible side effect to watch out for is increase or intro of suidical or other thoughts of harming self or others. Doctors recently realized this is a risk with all SSRIs. With Lexapro, it can happen about 2-3 weeks after starting the meds and 2-3 weeks after med increases. It's important to be monitored closely by a doc during these times. I've been taking Lexapro (while pregnant) since October '05 or so. It's been like a miracle for me.

My fibromyalgia specialist prescribed it because of the SSRIs it tends to have *fewer* side effects, especially of the sort GW described (though they do happen to some) and because it one of the better SSRIs for treating FMS in addition to treating depression.

http://www.kellymom.com/health/meds/antidepressants-hale10-02.html
http://www.kellymom.com/health/meds/antidepressant-ref.html

Excerpt from one user's opinion: "I've been on Lexapro 20 mg since my 2nd trimester, no side effects seen in the newborn at this point (12 days old)."

It is considered the "cleanest" among the SSRIs but it is excreted in BM and there are no long term clinical studies on it and lactation or pregnancy. Anecdotally, there have been a handful of reported cases of newborn sleepiness. Zoloft is usually the top recomended medication for lactating women, it is not excreted in breastmilk in any appreciable amounts.