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Zoloft and breastfeeding

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  • #1

    Zoloft and breastfeeding

    Dear Dr. Hale,
    What studies have been done on Zoloft and is it indeed safe while breastfeeding?
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  • #2
    Italian2018,

    Here are the references you requested:

    1.##Altshuler LL, Burt VK, McMullen M, Hendrick V. Breastfeeding and sertraline: a 24-hour analysis. J Clin Psychiatry 1995; 56(6):243-245.
    2.##Mammen OK, Perel JM, Rudolph G, Foglia JP, Wheeler SB. Sertraline and norsertraline levels in three breastfed infants. J Clin Psychiatry 1997; 58(3):100-103.
    3.##Epperson CN. et.al. Sertraine and Breastfeeding. NEJM 1997; 336(16):1189-1190.
    4.##Stowe ZN, Owens MJ, Landry JC, Kilts CD, Ely T, Llewellyn A, Nemeroff CB. Sertraline and desmethylsertraline in human breast milk and nursing infants. Am J Psychiatry 1997; 154(9):1255-1260.
    5.##Kristensen JH, Ilett KF, Dusci LJ, Hackett LP, Yapp P, Wojnar-Horton RE, Roberts MJ, Paech M. Distribution and excretion of sertraline and N-desmethylsertraline in human milk. Br J Clin Pharmacol 1998; 45(5):453-457.
    6.##Epperson N, Czarkowski KA, Ward-O'Brien D, Weiss E, Gueorguieva R, Jatlow P, Anderson GM. Maternal sertraline treatment and serotonin transport in breast-feeding mother-infant pairs. Am J Psychiatry 2001; 158(10):1631-1637.
    7.##Wisner KL, Perel JM, Findling RL. Antidepressant treatment during breast-feeding. Am J Psychiatry 1996; 153(9):1132-1137.
    8.##Stowe ZN, Hostetter AL, Owens MJ, Ritchie JC, Sternberg K, Cohen LS, Nemeroff CB. The pharmacokinetics of sertraline excretion into human brest milk: determinants of infant serum concentrations. J Clin Psychiatry 2003; 64(1):73-80.
    9.##Weissman AM, Levy BT, Hartz AJ, et.al. Pooled Analysis of Antidepressant Levels in Lactating Mothers, Breast Milk, and Nursing Infants. Am J Psychiatry 2004 June; 161(6):1066-1078.
    10.##Pinheiro W, Bogen DL, Hoxha D et al. Sertraline and breastfeeding: review and meta-analysis. Arch Womens Ment Health 2015;18:139-46.
    11.##Rohan A. Drug distribution in human milk. Aust Prescriber 1997;20:84.

    Zoloft (sertraline) is rated and L2-probably compatible. Zoloft has been extensively studied and the data is consistent that the levels found in breast milk are very low. The amount that transfers into breast milk is only 0.4-2.2% of moms dose. We think as long as the infant is not symptomatic that she can breastfeed while taking Zoloft. Monitor the infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

    Sandra Lovato R.N.
    InfantRisk Center
    806-352-2519

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