dysthymic disorder and medication

[Sincerity]

Hi,

I've recently received a prescription from my psychiatrist for the following medication: Sertraline, Oxazepam and Temazepam. Oxazepam until the Sertraline kicks in and incidental use of temazepam to help me get to sleep.

My baby is currently unable to breastfeed so I'm expressing 5 times a day. Is the medicine I've been prescribed safe to use and breastfeed? Should I wait X hours after taking the medicine before pumping to get a lower dosage in my milk? Will it have any side effects on my baby?

We are still attempting to get him to drink from the breast (he'll do so in the morning and at night but refuse the breast in the afternoon). If we do try that am I still able to take the medication or is pumping after x hours preferred?

My son is currently four months old.

[admin-james]

Hi, thanks for your post.

Sertraline is just fine while breastfeeding. It is very well studied in both breastfeeding moms and babies and is generally regarded as compatible. In fact, sertraline is the best choice out of its drug class from a strictly lactation safety perspective.

Oxazepam shows up in the breastmilk in fairly small amounts. Studies suggest that the infant gets about 1% of what mom takes throughout the day. We give this drug an L2 (out of 5) ("probably compatible") with regard to its lactation safety. Temazepam is not as well studied, but should theoretically behave like oxazepam. We give temazepam an L3 because of the lack of direct studies.

The half-life of temazepam is around 12 hours, so there's not much benefit to a pump-and-dump strategy. However, the drug level in your blood will be lowest just before you take your evening dose.

With these drugs, you should monitor the baby for signs of sedation such as difficulty awakening, not breastfeeding vigorously, etc. Standard SIDS precautions should be practiced, as with all babies.

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

-James Abbey, MD