Taken from Nice.org.uk
Which antidepressants are thought to be safe during breastfeeding?
- When deciding on antidepressant use in a woman who is breastfeeding, consider the age of the baby, the weight of the baby, and the nature of feeding (that is, whether the baby is completely breastfed or partially weaned).
- Ideally, sick, premature, or low birthweight infants should not be exposed to antidepressant drugs via breast milk. However, the decision on whether to treat with an antidepressant will depend on the woman's circumstances — seek specialist advice.
- If the woman has been treated with an antidepressant during pregnancy, or has had a good response to a particular antidepressant in the past, consider continuing or prescribing this antidepressant. See specialist advice.
- Provided the infant is healthy and his or her progress is monitored:
- All tricyclic antidepressants (TCAs), except doxepin, can safely be given to a women who is breastfeeding. Imipramine and nortriptyline are preferred.
- The selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline can safely be given to a woman who is breastfeeding. Citalopram and fluoxetine are not recommended, but could be considered if the woman has been successfully treated with one of these drugs during pregnancy.
- Consider seeking specialist advice if considering antidepressant treatment in a breastfeeding woman.
- The use of other antidepressants, such as monoamine oxidase inhibitors, venlafaxine, duloxetine, mirtazapine, and reboxetine, is not recommended first line in breastfeeding women.
- The use of St John's wort is not recommended for the management of depression when breastfeeding.
- For more information on prescribing antidepressants, see Prescribing information.