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  • Antidepressant

    Dear Professor Hale.

    Thank you for your response to my Levofloxacin query below. I have another query regarding my antidepressant medication.

    I am still breastfeeding my 15 month old infant. I suffer with anxiety and depression, more so now then ever before as my mom has just passed away unexpectedly and suddenly.

    I have always taken Eglonyl ( Sulpiride) 50 mg once daily throughout my pregnancy and breastfeeding for anxiety but it doesn't really help. I was told by the paediatrician that it's the only safe antidepressant to take. Recently I was prescribed Escitalopram. I only take 5 mg daily and not the 10 mg prescribed to me because I don't want to expose my baby to unnecessary medication. For this reason I am still depressed and anxious.

    Everybody keeps telling me that I should stop breastfeeding her as I need to take antidepressants now and she is old enough to stop breastfeeding. However it's not so easy to stop as she is allergic to dairy and she derives so much comfort from me breastfeeding her.

    Are there health advantages to breastfeeding an older infant? Is it better for me to stop breastfeeding and take the medication or to continue feeding and take it?

    Is it safer to take Escitalopram or Eglonyl ( Sulpiride)? Is it safe for me to go up to 10 mg Escitalopram daily and still breastfeed? Or better for me to just give up the breastfeeding altogether? How long do you have to wait after taking Escitalopram to breastfeed?

    Thanks so much

    Nikita

  • #2
    Nikita:

    First, escitalopram is considered safe for use during lactation. Particularly in your case with an older infant. Please understand that antidepressants take at least 3-6 weeks to work. So don't abandon this good antidepressant until you've given it a thorough try. Also, you might want to increase the dose to 20 mg if its not working. IF after a month or so at increased dose, youlr anxiety has not subsided, then a change to another antidepressant is warranted. Sertraline would be a good choice if the escitalopram is not working. This, by the way, is standard procedure as no one knows which antidepressant will work in a particular patient.

    Tom Hale Ph.D.

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    • #3
      Thank you.

      ​​​​​​How many hours should I wait to breastfeed after taking the escitalopram?

      Would you say at 18 months it's preferable for me to stop breastfeeding her and take the meds? Or are there still health advantages to breastfeeding at this age?

      Thanks so much

      Comment


      • #4
        Nikita:

        Escitalopram has a long half-life of approximately 30 hours. It would not be useful to try and avoid a small peak. This technique doesn't really work with long half-life drugs so I wouldn't waste your time doing it.

        At 18 months, your infant may still gain some benefit from breastfeeding, but the volume of milk and hence the amount of drug transferred is low. So I'd suggest you take your med and continue to breastfeed and enjoy your infant.

        Tom Hale PH.d.
        ]

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        • #5
          Thanks so much.

          Is Eglonyl also safe to take with the Escitalopram? Or is it more preferable to just increase the Escitalopram and leave the Eglonyl? I'm looking for the safest option for my infant.

          If I do take the Eglonyl how many hours should I wait to breastfeed after?

          Thanks

          Comment


          • #6
            Nikita: As to whether you used these together is really something you need to talk up with your doctor. I doubt these will affect a 15 month-old infant because your milk volume has probably decreased and thus the dose transferred is lower.

            Ask you doctor about using these two together.

            Tom Hale Ph.D;

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            • #7
              Great post. Advices given here are really helpful.

              Comment

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