Celexa or Paxil?

[eleighhaynie]

I am now about to embark on my 3rd antidepressant since giving my birth to my daughter in January. I tried zoloft and had horrible side effects. Then I was reccommended to go back on Prozac. Well, the always does well with me however my daugther experienced severe colic and wouldn't sleep. Her symptoms improved as soon as I came off my medication. So, now I have been subscribed celexa. I have held off on going on it because of how my infant responded to the Prozac. I really want to go on something that will be best for her. I am scared of Paxil because of side effects and withdrawals if I ever have to got back off the antidepressant. And with Celexa I see that there are possible side effects with the baby like somnelence and decreased feeding. I've also heard that Lexapro is preferable over Celexa..is this true? My baby is three months old. I am willing to go on Paxil if it's my best possible choice for antidepressants.
What are your reccommendations? If I were to go on either what are their peak concentrations times?

Thank you.

[admin]

Eleighhaynie:

I do not prefer Celexa too much as I've had calls about somnolence in the infant. Its active metabolite, Lexapro, has been studied and the levels are modest to low, but the infants did just fine. I would suggest this as a suitable alternative but you'll have to talk with your physician. I would also suggest, a small dose to start with for the first few weeks, then taper up gently to the full dose as prescribed by your physician. Again, watch your infant for sedation and gut symptoms, although these are unlikely.

Tom Hale Ph.d

[eleighhaynie]

So, Lexapro is even a preferable option over Paxil?
When does it peak in your system? My 3 month infant is sensitive to most everything I put in my system. I'd like to take actions that would cause the least impact upon her.

[cpride]

Dear Eleighhaynie,

Both Lexapro and Paxil are compatible with breastfeeding. You should talk with your physician about which medication would be best for your particular symptoms. The time Lexapro is highest in your system is five hours after the dose and Paxil is 5 to 8 hours after the dose. Both of these medications have long half-lives so the amount of medication would be expected to be in your system about the same after a few doses (called steady state) so if you breastfeed during these peak times you would not likely increase risk to your infant with these two medications. If you have further questions, please call the InfantRisk Center at 806-352-2519. We are open Monday through Friday, 8 to 5, CDT.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center