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Xanax until Lexapro starts working

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  • Xanax until Lexapro starts working

    My OB prescribed me 10mg Lexapro and .5 mg Xanax PRN for severe panic/anxiety until it starts working. I am currently nursing a one month old little girl who has no health problems. My dr encouraged pumping and dumping for 12 hrs after each dose of Xanax which I have been doing. However, it has been quite traumatic for my daughter as she is so used to nursing for comfort, which is in turn increasing my anxiety even further! From what I can find in these forums I may be able to continue nursing as long as I maybe avoid the first few hours after a dose, and of course watch for drowsiness in my baby?? I only plan on using the Xanax when absolutely necessary, but have had to have 1-2 doses daily as I have to care for 2 other children and need to be sane. I absolutely don't want to harm my child and will wean if necessary, this has just been so stressful for me. I also read that Ativan may be a better option than Xanax as less gets into the milk? I don't think my dr will be open to switching my meds as he has not been very supportive.

  • #2
    Hi, thanks for your post.

    I don't thing pumping and dumping is necessary with this medication. Xanax (alprazolam) is one of the shorter acting benzodiazepines and is probably the best choice in that drug class for breastfeeding women. 1-2 mg per day is a level of exposure that is a good compromise between benefit to you and breastfeeding risk. Try to use as little as you can while still getting good control of your anxiety.

    Watch your baby for sedation. This means that she should be waking up for regular feeding times and nursing well. If she appears overly drowsy or unable to feed several times in a row, there is a problem. You know your baby's normal patterns better than anyone. In the absence of these symptoms, you can consider the medication to be safe for your situation; there are no "hidden" dangers of benzodiazepines that we know of. Continue to practice standard SIDS precautions.

    If she is a little sedated, the first step to addressing the problem is to delay feeding for 4 hours after taking the pill. It is not necessary to discard your milk during this time because the drug is reabsorbed back into your bloodstream from the milk. You should also make an effort to feed just before you take a dose. This is the point when your milk has the lowest level of the drug in it.

    Lexapro (escitalopram) has been used extensively in breastfeeding women. I do not anticipate you having any BF issues while on this drug.

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

    -James Abbey, MD

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