The key words in Selective Serotonin Reuptake Inhibitor is "SELECTIVE"!

Because both drugs "bathe" the postsynaptic nerve terminals with serotonin,
does not mean that the action of them is the same.  Many of the actions,
including the ADRENEGENIC the NOREPINEPHREINE AND DOPAMINE connections and
others make them VERY dissimilar. As I have said before, just because one
author or ONE study asserts somthing does not mean that that is fact and is
written in stone. I still stand by the school that dopamine and
norepinephrine are crucial in cocaines toxicity, euphroric effects and
addictive effects. A single, non reproduced study is not enough to sway
decades of research to the contrary. Or to sway me.

Colleen, please get a copy of Tomas Hale's "Medications in Mother's Milk"
this is an invaluable resource for anyone dealing with the nursing dyad and
drug or herbal therapy. I might also suggest "Breastfeeding and Human
Lctation" Riordan and Auerbach, "The Breastfeeding Answer Book" Stock and
Morbacher, and even "The Womanly Art of Breastfeeding" for an intro to the
science of lactation as well as the struggles we have made agaist fear of
treating the lactating mother for illness or other conditions in the past
decades. Also Dr. Jack Newman's Book (which has a different name in the US
and Canada and I am getting confused, but will buy it as soon as I get to
the Conference on Sunday!) for the well thought out argument(his as well as
White's and plenty of others) that in Lactation it is of utmost importance
to understand that depriving the baby of her mother's milk for even a short
period of time is usually MORE dangerous than feeding the child milk with a
small and usually inconsequential amount of medication in it. Dr. Jack
says, "In most cases Drugs in lactation should be considered safe until
proven otherwise." (I may be paraphrasing here....)

One more question or statement. St. John's Wort has been mentioned quite a
bit in these discussions. Thomas Hale considers SJW NOT compatible with
breastfeeding due to the Monoamine Oxidase Inhibition effect that may be
possible.(as well as other problems with the herb) If SJW is NOT a MAO
inhibitor than WHAT is it's action? "Bathing the post synaptic nerve
terminals with serotonin" would be a good hunch.(Because that is what many
antidepressants do.) Does this equate SJW with cocaine? If it does not have
that action then we are back to the MAO inhibiting effect theory. In
anybody's book toxic, definately more toxic than most SSRIs. Probably even
more toxic than cocaine itself? Hale (and many others) consider Paxil and
Zoloft compatible with BF, Prozac is a drug of concern, but not totally
contraindicated. Considering Paxil and Zoloft are not found in the majority
of tested baby's blood or serum and when the metabolites are found they are
in almost undetectable levels it is not much of an argument to consider
them a real danger. (One of Zoloft's effects is changes to platelet
serotonin levels, NONE of the baby's studied had any change in platelet
serotonin.)

I'm done beating this horse, really, I can't help it, being compulsive and
all. <g>

The real argument is that the days of scaring women away from drug therapy
or forcing them to wean to take meds are for the most part, over. I don't
ever want to go back to those days. We, who are educated in lactation, know
that the majority of drugs in the pharmaecopia CAN be taken safely by the
breastfeeding mother without fear of harming her child. I am not going to
fight an already WON battle again! Colleen, please read some basic
lactation texts and books, read Lactnet archives and leave yourself open
the the fact that in most cases, the mother's continuing to nurse, even if
a drug needs to be administerd is the BEST course of action.

I'm tired, I'm going to take my Zoloft, nurse my toddler and go to bed.


Have a Blast on Independence Day, USA Lacnetters!!!!

Mary Jozwiak IBCLC
Private Practice

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