Kelly
The use of tricyclic antidepressants during lactation is generally
safe. They do vary in half-life, plasma binding etc, but there are
many that have been studied and are safe to use. Their use overall
has reduced in recent years in lactating and non-lactating people,
as newer antidepressants with fewer side effects have been developed.

 A study in 1995 concluded that the effect of  exposure to dothiepin
via breastmilk was undetectable long term (Buist A, Janson H, Effect
of exposure to dothiepin and northiaden in breast milk on child
development. British J Psych 167:370-373).

Another review of the literature examined 16 studies that had
measured infant serum levels of various antidepressants. Of the
tricyclics studied, amitriptyline, nortriptyline, desipramine,
clomipramine and dothiepin were not found in quantifiable amounts in
the infants. Adverse effects were described in some young infants
whose mothers were treated with doxepin. (Wisner KL, Perel JM,
Findling RL, Antidepressant treatment during breast-feeding. American
J Psych 1996 153(9):1132-1137).
Another useful reference is Misris S, Sivertz K, Tricyclic drugs in
pregnancy and lactation, a preliminary report. International J Psych
Med 1991 21:157-171.

Hope this helps

Fiona



Fiona Coombes MBBS IBCLC               [log in to unmask]
Lactation Consultant, Family Physician
Perth Western Australia