Can anyone school me on antidepressants and nursing?

DarcyLongfellow · April 2010

So, I've been trying to treat my PPD with just therapy and exercise, but I had a bad, bad day Monday. I talked to my therapist, and she's referring me to a psychiatrist to get a prescription for an antidepressant.

Boo. But yay for hopefully finally feeling better.

So, is there an online resource for what antidepressants are safe to take while nursing? I don't have high hopes that the psychiatrist will be up on that sort of thing, so I want to be prepared.

Thanks :-)

jmubride2 · April 2010

My therapist said Prozac and Zoloft were. I don't have a link though. My therapist was very knowledgeable on the topic and I am getting the perscription through my ob.

Sunrise6 · April 2010

Zoloft is safe while breastfeeding. I'm taking the generic Sertraline and was prescribed it by my ob who knows that I'm exclusively breastfeeding. I've been on it for two months now and am feeling MUCH better! I'm really glad that you will be getting to feeling better soon! The medicine does take some time to work - the first week I felt weird and out of it - but then after that I started feeling much better. kellymom.com is an excellent resource for questions about the safety of medicines and breastfeeding : )

jenny1980 · April 2010

Zoloft is the gold standard for BFing women and it's also really effective with anxiety disorders/OCD type stuff.

Keep in mind that it can take a looooong time for it to work on anxiety (my doc said a couple months once you get to a therapeutic dose, which tends to be higher for OCD than other anxiety disorders or depression). They'll also start you at a low dose and work you up (I am now up to 100mg from 25mg, but I've been on it for 8 weeks now). I am doing well on it and don't have too many side effects. That said, you may feel kind of out of it/groggy or more anxious when you first start or up your dose. You just need to hang in there with it.

I'm sorry to hear you had a rough Monday. Have you looked into CBT? I am having a good deal of success going that route.

homebird · April 2010

I'm taking lexapro. The doc tried me on zoloft, but I had a bad reaction to it. Lexapro is fine in small doses ... it's a benefits outweigh the risk type situation for me. Baby is doing fine, and doesn't seem to be experiencing any side effects. Just talk to the psychiatrist and let them know that you're nursing. They're professionals and will know what medicine is best to give you. If you're going to a psychiatrist that isn't "up" on that type of situation, I'd find another psychiatrist ASAP.

DarcyLongfellow · April 2010

I didn't have any concerns about my psychiatrist in particular, I've just found that, in general, doctors are less informed about what's safe to take when nursing than they should be (they tend to be overly cautious).

Jenny -- good to know we're on the same thing! I saw the psychiatrist yesterday, and he prescribed zoloft (generic). He actually said he'd prefer for me to be on Lexapro (just because it has fewer side effects), but because it's so much more expensive with my insurance, he figured we'd start on Zoloft.

He started me at 50mg. So far I've had nausea all day, which I'm hoping isn't related. Or at least that it clears up once my body is used to it! He also mentioned that for OCD the dosage would likely be higher than for just depression.

Yeah, Monday was bad. And it "shouldn't" have been -- I took a walk outside with Abigail in the gorgeous weather, chatted with neighbors, had a long, good talk with a friend on the phone. Then, that afternoon, I was just hit with all sorts of negative thoughts. I kept thinking about dying -- not suicidal thoughts, just -- if I died, DH wouldn't know what to feed DD. If I died, would DH know which convertible carseat I want DD to have? That sort of thing (over, and over). I called DH and asked him to come home, then got in to see my therapist at 8am the next morning. Thankfully I was able to see the psychiatrist the next day!

I did talk to the psychiatrist about CBT. He actually said that the therapist I'm seeing is one he'd recommend for that, so I'm going to talk to her about it next week. He also recommended I get a book to start working through some stuff on my own -- I can't remember the name right now, but it was something like The Anxiety Workbook. He said that had some CBT strategies (is that the right word?) in it as well.

jenny1980 · April 2010

Oh, I've so been there! It's awful.

Sounds like you are in really good hands. I felt pretty nauseous for the first few days I took Zoloft (also on the generic), but that cleared up quickly. If you feel like the side effects are too much, you can talk to your doc about starting at 25 mg and working up from there (50mg was too much for me at first--I felt really out of it and my anxiety was worse).

I've heard good things about the Anxiety Workbook. You might also consider Overcoming Obsessive Thoughts: Take Control of Your OCD and Imp of the Mind (which does a really good job of explaining intrusive thoughts during the postpartum period).

rainah77 · April 2010

https://depression.emedtv.com/zoloft/zoloft-and-pregnancy.html

DarcyLongfellow · April 2010

I'm glad the nausea might go away! It's not intolerable, but I wouldn't want to feel like this for months.

I've only been on it 24 hours so far (just took my second dose), but today was a really good day. I felt like I was feeling more normal and like myself. I'm 100% sure this is totally placebo effect (probably relief that I'm maybe finally going to get better), but I'll take it!

I'll check out those two books, thanks!

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