Both amytriptiline and sertraline (Zoloft) should be acceptable for
breastfeeding.  A depressed mother is potentially suicidal, and if drug
therapy seems the way to go, it should be prescribed and the mother
encouraged to breastfeed.  The mean peak plasma concentration of
sertraline is 0.19 micrograms/ml.  If the milk plasma ratio is 1, this
means that in a litre of milk the baby will get 1.9 mg of sertraline
(and in fact, that is the mean *peak* plasma concentration).  That's not
a lot.  The protein binding of sertraline is 98% which means that little
is available for excretion in the milk.

The mother should find a physician who is more supportive of
breastfeeding.

As far as griseofulvin is concerned, it too should be safe for
breastfeeding mothers.  I do not know of other effective treatments.

Jack Newman, MD, FRCPC