Dr. Hale recently posted something on paroxetine, that the milk/plasma
ratio was something like 0.09.  This is incredibly small.  Furthermore,
Dany, if you look in the CPS (not Canadian Paediatric Society, a pox on
them), but the Compendium (similar to US PDR), it says the following:

"Owing to the extensive distributon of paroxetine into the tissues, less
than 1% of the total drug in the body is believed to reside in the
systemic circulation".  In other words, with a milk/plasma ratio like
that, and the fact that there is almost none in the circulation, it is
likely the baby is getting zippo.  The CPS goes on to say that "mean
maximal plasma concentration was 41 ng/ml (that's 41 *millionths* of a
gram) at steady state".  I would think this information makes paroxetine
even a better choice for depression than sertraline (Zoloft), if the
mother needs a drug.

The makers of Paxil (SmithKline Beecham), if they had any guts, would
now put in their ads "The drug of choice for depression for
breastfeeding mothers".  This would make them a fortune (I know they are
going broke), while at the same time physicians would learn something
(since many only learn from drug reps and drug ads), and maybe so many
nursing mothers could continue breastfeeding while on an antidepressant.

Does Dr. Hale agree with the above interpretation?

I have never heard of Flercox, and it is not in the Compendium.

Jack Newman, MD, FRCPC