Case reports have been published recently that document abnormal bleeding
time in persons treated with selective serotonin reuptake inhibitors
(SSRIs), such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine
(Paxil) and sertraline (Zoloft).  Abnormal bleeding in the person
taking an SSRI may be noted as a bruise, as a nosebleed, abnormally
heavy or long menstrual periods, or gastrointestinal bleeding.

Most of the limited data that has been published about the amounts of
SSRIs that reach the nursing child through the breastmilk indicate that
there is a small drug exposure for the nursling.  Regardless, clinicians
need to be aware that the SSRIs have been reported to affect bleeding
time and the nursling may be at risk also.

Alderman CP, Seshadri P, Ben-Tovim DI.  Effects of serotonin reuptake
inhibitors on hemostasis. The Annals of Pharmacotherapy, November
1996;30:1232-4.

Am glad to hear that mom is doing better on the Paxil.

Julie Cold Kissack, Pharm.D., BCPP