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Depakote vs Zolofr

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  • Depakote vs Zolofr

    I have an anxiety/mood disorder. I started on Zoloft immediately after delivery. I picked this medication due to it's low transfer rate into milk. I ended up on about 75 mg but was still having anxiety. My doctor seemed concerned about the dosage and wanted to switch to depakote. Is depakote really safer for the baby than Zoloft? They said it would be less invasive for the baby. I want to know if either of these drugs would work for me... Which is preferable?
    Last edited by clh1728; 03-11-2013, 09:16 AM.

  • #2
    Dear clh1728,

    Sertraline (Zoloft) is one of the preferred SSRI's for use during breastfeeding as there are many studies, and we know minimal amounts are excreted into breastmilk. The minimal medication levels do not normally affect breastfeeding infants. These medications do take some time to work, sometimes up to about six weeks to two months so if you haven't been on the medication very long, you may need to wait a few more weeks to see if the medication is effective. Also, your dosage is fairly low. Often, it takes doses up to 150 mg to help with anxiety. Even at these higher doses, the amount in breastmilk is minimal so still compatible with breastfeeding. Your infant should be observed for sedation. Valproic acid (Depakote) also has minimal amounts in milk. Recent studies have found that valproic acid has caused neurodevelopmental complications in children exposed in utero so if you have the potential of becoming pregnant, this medication would not be a good choice. Dr. Hale doesn't believe the minimal amounts found in breastmilk would lead to these neurodevelopmental complications. If you do decide to use the valproic acid, you should use two forms of birth control and take a higher dose of folic acid (4 mg/day). Another option to talk with your physician about is Lamictal (lamotrigine). More of this medication enters breastmilk and varies among breastfeeding women; therefore, blood plasma levels should be done on your infant starting about two to three weeks after you start your medication, and then depending on that results, your pediatrician can make the decision on when further levels should be done. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5 CST.

    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

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    • #3
      Hi,

      I gained about 30 pounds from a cocktail of meds, depakote being one of them. I have a limited 1200-1400 calories a day diet and I excerise. It has to be the meds! I suppose Depakote does have that effect, since it does say so in the side effect info. I have another medical condition that coincides (unfortunately) with the weight gain, so I can't really say how much of it is from what. I do know that those meds you asked about do cause it though. There are alternatives that do not cause as much weight gain, but my drs won't put me on them.

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