Antidepressants during breastfeeding

Depression is a common mental health condition that can be treated using talking therapy and medication, including during breastfeeding. The symptoms of depression include a low mood, a loss of interest in normal activities and a lack of motivation. These symptoms may also arise or persist during breastfeeding. Patients need to be careful when using medication to treat depression while breastfeeding because suddenly stopping the medication may lead to withdrawal symptoms. Inadequate treatment of depression during breastfeeding may result in a relapse.

Causes of depression

The causes of depression include certain predispositions, an imbalance of neurotransmitters in the brain as well as psychological and personal factors. Depression can occur at any age and can affect anyone, no matter their life circumstances. In particular, depression could arise during pregnancy and while breastfeeding following childbirth.

Use of antidepressants during breastfeeding

Depression is mainly treated using talking therapy and medication. Patients can generally start or continue to take medication to treat depression while breastfeeding. Depression can be treated using a range of different medications or active ingredients. You may have questions about how safe these medications are while breastfeeding:

• Monoamine oxidase inhibitors, e.g. moclobemide (Aurorix)
• Noradrenergic and specific serotonergic antidepressants (NaSSA), e.g. mirtazapine (Remergil SolTab)
• Selective serotonin reuptake inhibitors (SSRI), e.g. citalopram (Cipramil, Citalon), escitalopram (Cipralex, escitalopram), paroxetine (Seroxat), sertraline (Zoloft)
• Selective serotonin and noradrenaline reuptake inhibitors (SSNRI), e.g. duloxetine (Cymbalta, Yentreve, Duloxalta), venlafaxine (Trevilor), milnacipran (Milnaneurax)
• Tricyclic antidepressants (TCA), e.g. amitriptyline (Saroten, Syneudon), clomipramine (Anafranil), doxepin (Aponal, Mareen)
• Other antidepressants, e.g. agomelatine (Valdoxan, Agomelatin Neuraxpharm), bupropion (Elontril), esketamine (Spravato), tianeptine (Tianeurax)
• Herbal medicines, e.g. St John’s wort (Jarsin, Nervoregin, Neuroplant)

Accompanying symptoms such as trouble sleeping, anxiety and feelings of nervousness, panic and fear can be treated using other medication including tranquilizers, anxiolytics and sleep medication.

• Benzodiazepine derivatives, e.g. alprazolam (Tafil), chlordiazepoxide (Librium), lorazepam (Tavor), oxazepam (Adumbran, Praxiten), prazepam (Demetrin), flurazepam (Dalmadorm, Staurodorm), lormetazepam (Loredam), midazolam (Dormicum), temazepam (Remestan), triazolam (Halcion), brotizolam (Lendormin), nitrazepam (Mogadon), flunitrazepam (Rohypnol)
• Other anxiolytics, e.g. buspirone (Anxut)
• Antihistamines, e.g. diphenhydramine (Betadorm-D, Moradorm, Sediat), doxylamine (Sedaplus, Valocordin), hydroxyzine (Atarax)
• Other sleep medication, e.g. tryptophan (Ardeydorm, Ardeytropin), chloral hydrate (Chloraldurat), melatonin (Circadin, Slenyto)
• Herbal medicines to aid sleep, e.g. valerian root (Baldrivit, Luvased, Sedonium), passion flower herb (Kytta-Sedativum, Pascoflair, Passidon), valerian root and hops (Alluna, Ardeysedon Nacht, Euvegal, Luvased Nacht), valerian root and melissa leaves (Sandrin)

Risks of antidepressants during breastfeeding

There is a chance that babies of patients with severe depression during breastfeeding may have a greater risk of developmental problems, such as aggressive behaviour, anxiety, depression and hyperactivity. It is therefore very important that depression continues to be treated correctly using suitable talking therapy and/or medication during breastfeeding. There are certain medications of choice for treating depression during breastfeeding and these should be prioritised wherever possible.

Find out whether your medication for depression is safe for you and your baby while you are breastfeeding

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