There are not huge differences between most antidepressants within the same
family.  Some are said to have more or fewer side effects, some more anti
anxiety relief and so on, but I will bet most of this information is
propaganda.  Venlafaxine has not been well studied in nursing mothers and
their infants, but it has a relatively short half life, which is good, but a
low protein binding as well, which is not as good.  Dr. Hale says that its
high volume of distribution means significant penetration into the milk, but
I would guess that a large volume of distribution means much lower plasma
levels, which would diminish this concern.

Why not sertraline (Zoloft) or paroxetine (Paxil) which are much better
theoretically than this one?

Jack Newman, MD, FRCPC