To      :Anne Stiller
Re      :Zoloft

We now have quite a bit of new data on Zoloft,  two studies and 4 patients, in
which all the studies concur that little or no Zoloft is detectible in the
breastfed infant's plasma,  even though it is detectible in milk samples. There
may be a problem with poor oral bioavailability in the infant, etc,  but it
apparently is not making it past the liver to the plasma compartment.  This is
good news.

As to why you can use this during pregnancy,  and not lactation?  Please
remember that during pregnancy,  the mom takes care of metabolism and EXCRETION
for the baby.  Therefore,  significant buildup in the infant is unlikely.
However,  this is not necessarily so in the breastfed infant, where he/she has
to do the metabolism and excretion as best they can.  This is why all prenatal
medications should be reviewed immediately postpartum for their role in a
breastfeeding situation.

Lastly, it is becoming increasing evident that there is a potential withdrawal
response when patients on Zoloft, Effexor, Paxil are precipitously withdrawn.
It does not apparently occur with Prozac due to its long half-life metabolite.
Therefore patients on the shorter acting antidepressants should taper off their
medication rather than precipitously withdrawing.

Regards
Tom Hale