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Prozac 20mg, 3wks pregnant, breastfeeding

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  • Prozac 20mg, 3wks pregnant, breastfeeding

    During my last pregnancy I was prescribed 20mg Prozac which I took for depression from week 8 to week 20. I stopped taking it for 2 months but resumed my prescription for the Duration of the pregnancy. I switched to 30mg Paxil after my daughter was born November 29 2013. I stayed on Paxil for the postpartum, about 4 months... then weaned off of it. My daughter is growing fantastically, no detected birth defects, above average cognitive ability.
    I recently started taking Paxil 15mg (my prescription halved) about 4 weeks ago. Now that my test came back positive, I am wondering about the Prozac 20mg and breastfeeding.
    I know that Paxil is class D and prozac is class C for pregnancy. I also know that Paxil transfers less to Breastmilk than prozac which is why my Dr. Had me switch at birth...
    Is the low dosage of 20mg Prozac okay for breastfeeding?
    Also, I had REALLY bad nightmares while on Prozac before... does Zoloft have similar side effects? Is Zoloft safe for breastfeeding? I am honestly afraid to go to sleep when I'm on Prozac, but the anxious depression I suffer from is manageable with it. Paxil is my favorite but obviously I can't take that right now.

  • #2
    Hi, thanks for your post.

    Both sertraline (Zoloft) and fluoxetine (Prozac) have been used in millions of mothers over the last 2 decades. While there are some reports of complications, they are generally minimal. Overall, fluoxetine and sertraline are quite suitable for breastfeeding mothers and their infants. We characterize sertraline as safer than fluoxetine because we know more about how it behaves in breastmilk. Remember, the risk of untreated depression is far higher than the risks of these medications.

    There is no way to predict if Zoloft will give you the same nightmares that Prozac did. The manufacturer lists insomnia as a side effect of Zoloft but doesn't mention bad dreams.

    Please call us at the InfantRisk Center if this has not completely answered your question.*(806)352-2519

    -James Abbey, MD

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