cymbalta vs zoloft

[desdes]

Hi. I would like to ask to Dr Hale, which is more safe for breastfeding? Cymbalta or zoloft? My baby is 6 months and I have to choose between these medications. Thank you.
P.s. where can I see the level of medications?

[admin]

Dear Desdes,

It is probably safe to use Sertraline (Zoloft), the breastfed infant receives approximately 0.4- 2.2% of the mother's dose. Zoloft has been extensively studied in many breastfeeding mothers. The data is consistent that levels in milk are quite low and do not normally affect an infant. Studies of platelet function further suggest that sertraline is poorly absorbed by the infant and at levels too low to affect platelet function. Sertraline is a preferred antidepressant.

That being said, if the Zoloft does not work for you the Duloxetine (Cymbalta) is still probably ok to use especially since your infant is already 6 months old. Cymbalta is an L3, infant receives approximately 0.1-1.1% of the mother's dose. New data suggest that the milk/plasma ratio is low, and the amount the infant receives is low as well, too low to have clinical effects on an infant.

Hope this is helpful. If you have any more questions please call the Infant Risk Center at 806-352-2519.

Thanks, Sandra Lovato R.N.
InfantRisk Center

[desdes]

to admin

Iam confused! You wrote that baby receives 0,4-2,2% of the mother's dose of zoloft and 0,1-1,1% of the mother's dose of cymbalta. Why then zoloft is preffered and is level 1 but cymbalta is level 3? Thank you!

ps. Please I don't speak good english and is very difficult to me to speak by the phone! Thank you!

[admin]

Dear Desdes,

Dr. Hale does not rate drugs only on the RID (the amount the infant receives from the mother). This rating depends on many other things, such as the amount of research we have on the drug, the safety profile, the pharmacokinetic properties, and the side effects.

Tassneem Abdel Karim, MD
InfantRisk Center