Date:    Fri, 28 Jul 1995 18:31:34 -0400
From:    "Rebecca Black, IBCLC" <[log in to unmask]>
Subject: Re: Zoloft

You will probably be beseiged by entries on Zoloft as we are all back from
ILCA with our latest addition of Thomas Hale's book, Medications and Mother's
Milk.  Here is what he says:

"No specific information is currently available.  Some is probably secreted
in milk.  The long half-life (26-65 hours!) of this medication could produce
elevated levels in neonates. Use extreme caution with this medication during
lactation.  Observe for diarrhea, nausea, tremor and increased sweating."

Zoloft (Sertaline) is not mentioned (that I could find) in the AAP reference,
Pediatrics  1994-93(1):137-50.  Other antidepressants are on the "Drugs whose
effect on nursing infants is unknown but may be of concern"  list.  At the
top of this list is a disclaimer to the effect of "concern especially if
given to the mom for a long period of time."  There have been no reports of
adverse effects in breastfeeding infants for the anti-depressants though but
they do appear in the milk.

Hello?  any pharmacists/LC/MD's out there to help on this one as we have a
similar situation here and have left it up to the MD to decide.

Becca
clueless as to a catchy nickname

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Date:    Fri, 28 Jul 1995 16:08:59 -0700
From:    "A. Montgomery" <[log in to unmask]>
Subject: Hello and reply re:Zoloft

Hi!  I'm a new subscriber, and had fun scrolling through the
discussions.  I'm a family physician, faculty member at the St. Peter
Hospital FP residency, an accredited LLL leader (currently on Leader
Reserve), and the mother of a 5-year-old boy (who finally got around to
weaning a few months ago!).

Regarding Zoloft (and other SSRIs), as requested by Nicole Touchet:  The
major concern about these meds that they haven't been around long enough
to have a track record. Folks I've talked to think they'll probably be
safe for BF moms, but urge caution at this point. A
breastfeeding-friendly psychiatrist tells me he thinks desipramine is
currently the drug of choice if you're going to medicate for depression
in pregnancy and lactation since it's been around a while and has caused
no known problems and has fewer side effects than some other tricyclics.
Concern as with all CNS meds is long-term cognitive development, so I'd
only use SSRIs if other things don't work--would discuss with mom the
possible subtle risks of drug vs. known benefits of breastfeeding and
need to adequately treat depression.
--
Anne Montgomery, M.D.
[log in to unmask]

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