In a message dated 97-01-05 10:24:48 EST, you write: << Date: Sun, 5 Jan 1997 10:34:34 -0500 From: Jack Newman <[log in to unmask]> Subject: Antidepressants It's getting depressing how often this subject comes up. There is no definite answer on antidepressants. Those of us that believe that breastfeeding is important and that the there are definite risks to artificial feeding believe that the mother can take antidepressants and continue to breastfeed. As many physicians believe that breastfeeding and bottle feeding are about the same, or even that artificial feeding is *better*, they will say the mother should not breastfeed. I would say that sertraline (Zoloft), for theoretical reasons (high protein binding and others) would be a better choice than fluoxetine (Prozac) although we have had many mothers breastfeed with fluoxetine without any discernable effect on the baby. A recent assay done in a nursing mother at our mother risk clinic in Toronto had the baby with undetectable levels of sertraline in his blood. This does not mean zero, but just below the detectable level of the lab. But it does mean very little. Thus, given the uncertainties of the long term effects of the antidepressants on the baby, what should we advise the mother? We should tell her that we do not know the long term possible risks, but we do know there are definite risks with artificial feeding, some of them serious. It is true that most babies fed artificially are do not get serious side effects, but then we do not know who will get the side effects, and there are quite likely other long term side effects we do not know about, given the very great differences between breastmilk and artificial baby milk. AND THE MOTHER, ONCE SHE HAS AS MUCH INFORMATION AS SHE NEEDS, SHOULD THEN MAKE HER CHOICE AND ALL OF US, INCLUDING THE PHYSICIAN, SHOULD SUPPORT HER. Jack Newman, MD, FRCPC >>