Antidepressant medication for postpartum depression
Antidepressant medication can provide effective treatment
for women with
postpartum depression, including those who are
breast-feeding. Your health professional may start you out with a low dose to
help you adjust to the medication.
Selective serotonin reuptake inhibitors (SSRIs). An SSRI is usually the preferred
medication for treating postpartum depression. Certain SSRIs are commonly
prescribed for breast-feeding women and pose no known risks to their babies.
SSRIs usually take 4 to 8 weeks to improve depression; postpartum women tend to
Tricyclic antidepressants. Most tricyclics have not caused
problems in breast-feeding babies and are not passed on to a breast-feeding
baby in measurable amounts.2, 1
Nortriptyline has been studied the most for breast-feeding mothers.3 Doxepin (Sinequan, Zonalon) is not recommended for
You may start to feel better within 1 to
3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8
weeks to see more improvement. If you have questions or concerns about your
medicines, or if you do not notice any improvement by 3 weeks, talk to your
Antidepressants are used for at least 6 months, first to
treat postpartum depression, and then to prevent a relapse of symptoms. Experts
recommend long-term antidepressant treatment—up to a year—for women who have
had three or more depressive episodes in the past.1
FDA Advisories. The U.S.
Food and Drug Administration (FDA) has issued:
A warning on the antidepressants Paxil and Paxil
CR (paroxetine) and birth defects. One new study showed that women who took
Paxil during their first 12 weeks of pregnancy had a slightly higher chance of
having a baby with birth defects.
The U.S. Food and Drug
Administration (FDA) has issued an
advisory on antidepressant medicines and the risk of
suicide. The FDA does not recommend that people stop using these medicines.
Instead, a person taking antidepressants should be watched for
warning signs of suicide. This is especially important
at the beginning of treatment or when the doses are changed.
Wisner KL, et al. (2002). Postpartum depression.
New England Journal of Medicine, 347(3): 194–199.
Brockingham I (2004). Postpartum psychiatric
disorders. Lancet, 363(9405): 303–310.
Weissman AM, et al. (2004). Pooled analysis of
antidepressant levels in lactating mothers, breast milk, and nursing infants.
American Journal of Psychiatry, 161:
How this information was developed to help you make better health decisions.