Almost every woman notices some immediate feelings of sadness, otherwise known as postpartum blues, after childbirth. This probably occurs as a response to the anticlimactic feeling after birth and is related to hormonal shifts as the levels of oestrogen, progesterone and gonadotropin-releasing hormones in her body decline or rise.
Antidepressants and breastfeeding: Dealing with postpartum depression
In some women, postpartum blues may last longer than one year. In addition to an over-all feeling of sadness, a woman may exhibit extreme fatigue, an inability to stop crying, increased anxiety about her own or her infant’s health, insecurity, psychosomatic symptoms, depressive or manic mood fluctuations. These manifestations are an indication of postpartum depression. In such cases, the use of antidepressants for treatment is recommended.
Antidepressants and breastfeeding: SSRIs
Lactating women undergoing postpartum depression are best treated with selective serotonin reuptake inhibitors (SSRIs). Side effects from SSRIs are most common in the first three months postpartum; so with an older baby, there is little concern. Common SSRIs doctors prescribe include Zoloft, Paxil, Celexa, Effexor and Prozac.
Antidepressants and breastfeeding: Benefits of SSRIs
- No addictive component
- No associated buzz
- Mild withdrawal or “discontinuation syndrome” in some patients
- More rapid onset as compared to older tricyclics
- Side effects generally wane over time
- Reported 60%-70% response rate in patients.
Antidepressants and breastfeeding: Medication taken during pregnancy
Research was done in 1996 to review past studies conducted on the use of antidepressants during lactation by The American Journal of Psychiatry. It was concluded that amitriptyline, nortriptyline, desipramine, clomipramine, dothiepin, and sertraline were not found in quantifiable amounts in breastfed infants, and no negative effects were reported. A long-term study was conducted on a group of children whose mothers were prescribed Prozac or antidepressants for bipolar disorder during the first trimester. They were followed from infancy to preschool. Lee S. Cohen, professor of psychiatry from Harvard, says, “There were no significant differences in IQ, temperament, behavior, reactivity, mood, distractibility, or activity level between exposed and nonexposed children”.
Antidepressants and breastfeeding: Lack of comprehensive research
However, research needs to include behavioural assessments and long-term developmental studies of infants during nursing. Because of the lack of comprehensive research about the effects of antidepressants on breastfeeding, doctors need to weigh the risks and benefits of antidepressants on a case-by-case basis before making a decision.
If you are suffering from postpartum depression, do make sure to discuss the effects of the medication that your doctor has prescribed to you.
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