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Sertraline and lorazepam

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  • Sertraline and lorazepam

    Hi, I am writing from Europe for your help.
    I am fully breastfeeding a 3,5-month old daughter (second child). She is 5,6kg now and she does not take the bottle att all (my milk or formula). I had no problems until my first birth after which I had suffered from postpartum depression, but I was ok for the past 4 years and off the meds for 2,5 years. Now my postpartum reoccured after second birth. It always starts with insomnia (not sleeping at all) and warm flashes in the entire body. With the last postpartum depression I found that lorazepam helps me a bit, I was taking is in crisis only, but I was not breastfeeding the child then.
    Now that I breastfeed I was perscribed 50mg of sertraline (Zoloft) by my psychiatrist (2 days ago). I was also perscribed lorazepam up to 1mg to take when necessary by my physician, but my psychiatrist was not very happy about it (she did not prohibit me to take it though). I also asked my daughter's pediatrician what she thinks and she advised not to breastfeed for about 12 hours after I take lorazepam, but this is impossible because baby rejects the bottle.
    I took lorazepam twice (0,5mg and 0,25mg) which helped a bit with sleeping (4hours on 0,5mg and 2 hours in 0,25mg) but I am really worried taking it. Can you please reassure me if I am doing a right thing by taking lorazepam until the Zoloft kicks in? I am scarred of going crazy if I will not sleep, but I am also scared to damage my baby. Are there any other negative effect on babyies except for sedation and weight loss? What does it mean that lorazepam is rated L3- limited data-probably compatibleAlso I want to add that my baby still breastfeeds very frequently during day and night so it is difficult for me to time the best moment to take lorazepam and not breastfeed for a certain period of time...
    Thank you so much for your help!
    Last edited by Zhiva; 12-20-2018, 07:11 AM.

  • #2

    Only about 2.9% of the Lorazepam enters milk, which is considered quite low. Thus far, we've not had any problems with infants. Lorazepam is the preferred benzodiazepine for breastfeeding mothers.

    I think your infant will do fine. You might wait 2-4 hours after dosing to breastfeed IF you can wait that long.

    Just watch your infant for sedation, and difficulty to arouse. If you see these symptoms, then caution is recommended.
    Lastly, remember, some of this "fear" you are experiencing about this drug is your anxiety/depression speaking to you, and is probably not real.

    Good luck.

    Tom Hale Ph.D.

    InfantRisk Center