Both Paxil (paroxetine) and Prozac (fluoxetine) are relatively 'new
antidepressants'.  There are selective serotonin reuptake inhibitors and
are considered first line treatments for depression by many clinicians.
Therefore, I suspect you will continue to see moms who are treated with
these meds.  The side effects from these meds are GENERALLY less
bothersome than with the older antidepressants.  From the limited data
available about the use of these drugs in breastfeeding moms it appears
that the child is exposed to the drug but at a much reduced quantity.  I
doubt that you will find any reference that says unequivocally that it is
OK to use these drugs in the bf moms since we don't know what the long
term effects of the small or minimal exposure might be to the child.  I
believe you need to weigh the risks and the benefits of drug treatment
and if use of the medication means that the mom's depression is resolved
and she is better able to parent then the benefit outweighs the risk (IMO).

Good luck with your clients,
Julie Cold Kissack


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Julie Cold, Pharm.D., BCPP                      office # 770 986-3208
Assistant Professor of Pharmacy Practice        fax #    770 986-3384
Mercer University Southern School of Pharmacy   digital beeper 404 225-2404
Atlanta, GA. 30341
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