To      :Jill
Re      :Prozac

I know there has been a great deal of discussion of Prozac and its use in
breastfeeding mothers.  As with any drug,  some patients do just fine and
others have problems.  With Prozac I would bet that there are literally
thousands who have taken it and done just fine with their breastfed infants.
However, we do have some literature suggesting problems in some infants, and
I have received a number of calls (3) from mothers who voluntarily
discontinued Prozac because of problems in their breastfed infant(colic,
nervousness, etc) which went away upon discontinuing Prozac.

Further,  Prozac has a long half-life "active" metabolite(240 hrs) that
would/could build up in the breastfed infant over some time.  So it has the
right pharmacokinetics to be a problem drug for breastfeeding moms.

Many of us have concluded that given these circumstances,  it is better to
opt for what we consider a safer set of drugs such as Zoloft and Paxil,
which do not have long half-life metabolites that are 'active'.  Further,
several recent papers in the last two years appear to confirm this.

So I believe that we are in general opting for taking what we construe to be
safer drugs, rather than one considered less so.

Regards

Tom Hale, Ph.D.
Associate Professor of Pediatrics