Announcement

Collapse
No announcement yet.

Celexa 40mg, Buspirone 5 mg (3xday) 8 weeks Pregnant

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Celexa 40mg, Buspirone 5 mg (3xday) 8 weeks Pregnant

    I hope you can help me. I had severe PPA and PPD after my daughter's birth. Unfortunately I did not seek help for almost 2 years, and ended up in real bad condition. I have been taking Celexa 40mg and Clonazepam (2mg) for 8 months, tried to wean before this pregnancy, but it did not go well at all.

    I am currently 8 weeks pregnant and take Celexa 40mg and Buspirone 5mg (3xday) and I'm doing well. I am worried about this dosage of Celexa during breastfeeding. I only read that Zoloft is the number one choice SSRI for breastfeeding, but I am very worried about switching medication not knowing if Zoloft will work for me and transitioning from one SSRI to another during breastfeeding, which can cause major issues for me.

    Is it okay to exclusively breastfeeding while on Celexa 40mg? Also, if my panic attacks come back postpartum, can I use smaller doses of Clonazepam (up to what amount is safe)? Thank you so very much for your help!

  • #2
    Hi, thanks for your post.

    40mg of citalopram (Celexa) per day is certainly compatible with breastfeeding. We consider Zoloft to be a better choice because it is better studied and its safety profile is better established. However, if Celexa is controlling your depression and anxiety, you SHOULD NOT switch to another medication just because of concerns about breastfeeding safety. The risks of poorly treated depression are far greater than the potential risk of Celexa.

    About 3% of your daily clonazepam dose will transfer to the baby via the breastmilk. There have been rare reports of infants being sedated while breastfeeding, but all of those cases had confounding factors that make it hard to blame the clonazepam for those symptoms. No "safe" level of this medication has been established. While breastfeeding, you should start with a small dose and watch your baby for changes in behavior or mental status. If you don't see any symptoms, you can consider the medication to be safe for your situation. There are no "hidden" dangers of this drug that we know of.

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

    -James Abbey, MD

    Comment


    • #3
      Thank you so much for your quick reply. I'm so grateful for this thread and resource.
      I only plan to take Clonazepam if my panic attacks return, otherwise I will try to get by on SSRI alone until baby is older. IF my panic attacks return, are there more studies on Ativan vs. Clonazepam? My Clonazepam tablets are 0.50 mg each and Ativan tablets are 1.0 mg. I'm hesitant about Xanax since it short life (only 4 hours) and kicks in really quickly which is difficult to manage with breastfeeding on demand.

      PS I'm guessing Buspirone 15mg is safe since it GABA agent vs benzo, am I correct? Is it safe for breastfeeding? Thank you again for your help!

      Comment


      • #4
        Buspirone is probably safe, but we do not have any specific data on how much transfers into breastmilk. It has similar anti-anxiety properties as Valium, but without the sedation or the potential for addiction. It is a good choice for your situation, but you should still watch out for changes in your baby's behavior while you are taking the medication.

        The safety profiles of Ativan (lorazepam) and Klonopin (clonazepam) are very similar. Clonazepam is a "low and slow" drug that does a good job in most people of preventing panic attacks from starting. Lorazepam is sometimes used for maintenance in the same way, but is more often prescribed "as needed" to stop an attack already in progress. Which drug you use will depend more on what works for you than on breastfeeding safety. If lorazepam turns out to be the best choice, we should talk about how to plan your feedings to avoid the times when you have the most drug in your milk.

        You should not take lorazepam or clonazepam while you are pregnant, if possible.

        -James Abbey, MD

        Comment


        • #5
          Thank you so much for your reply.

          Do you know of any studies or publications that site Clonazepam peak? I'll use this info during breastfeeding to know when to avoid nursing (maybe prepare for it but using pumped milk and doing pump & dump during Clonazepam peak)

          Comment

          Working...
          X