Harry, thank you for your thoughtful comments. THey certainly are thought
provoking for me, as I do not have much experience with drugs and
ppdepression in bf mothers. I am saving this one for future reference. Ah,
the beauty of email files... <G>



>Dear Lactnet associates,
>   Any discussion of antidepressant use in the bf'ing mother has to be
>tempered by the statement of the American Academy of Ped's Committee on
>Drugs published in Pediatrics Vol 93 pp.137-50 (1/94).  In that article that
>Committee lists ALL antidepressant drugs in the category of "Drugs whose
>effect on nursing infants is unknown but may be of concern."  It goes on to
>explain that "no case reports of adverse effects in bf'ing infants, these
>drugs do appear in human milk and this could *conceivably* alter short-term
>and long-term central nervous system funtion"
>   Nontheless many physicians have successfully treated bf'ing mothers with
>antidepressants without apparent adverse effects on the infant.  Certainly
>the older class of drugs, the tricyclic antidepressants such as
>nortriptyline (Pamelor and others) have the longest track record of apparent
>safety for bf'ing moms and their infants.  (see also the input in this
>regard from Cindy Smith.)  However this class of drugs has many side effects
>which limit usefulness.
>   Newer drugs such as the selective serotonin reuptake inhibitors (SSRI's)
>such as Prozac (fluoxetine), Zoloft, Paxil and now others have been a great
>advance in the field of psychopharmacology because of their tolerability
>and perhaps more rapid onset of action.  Before I forget, let me comment on
>some writers' concerns with messing with serotonin.  Realize that serotonin
>is a neurotransmitter, BUT so is norepinephrine, dopamine, acetylcholine and
>others.  All antidepressants affect one or another neurotransmitter.  That
>is how they work!  I am not aware of any greater need for concern when it
>comes to drugs that affect serotonin versus other neurotransmitters in the
>bf'ing mother.

Thomas Hale mentioned this to me, the concern specifically with Serotonin
uptake inhibitors.

>KB

**********************************************************
Kathleen B. Bruce RN, BSN, IBCLC
Williston, Vermont USA
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To err is human, to really screw up you need a computer...*wink*
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