I am not making any judgement on how to treat this problem, of which I
know nothing.

Given the choice of drugs mentioned in the post, setraline (Zoloft),
followed by paroxetine (Paxil) would be the best choices for a nursing
mother.  Fluvoxamine (Luvox) sounds not too bad either.  Increasing
the dose of these medications does not result in out of proportion
increases in the milk (though this is possible with certain drugs).
Prozac would probably be a poor choice given the alternatives.

Clomipramine (Anafranil) is in a different category, being not an SSRI
antidepressant, but rather a tricyclic antidepressant.  Most
tricyclics get into the milk in only tiny amounts, but the side
effects for the mothers limit their use.

Jack Newman, MD, FRCPC