Wellbutrin & Cymbalta

[bsruden]

Hello,

I have a very long history of anxiety/depression/OCD and have tried numerous medications to help manage my illness. Currently I'm on 80 mg Cymbalta and 75 mg of Wellbutrin. I suffered Post Partum OCD with unwanted obsessive thoughts after both of my pregnancies and have a decent handle on it with the second one but it's still lingering.

The Wellbutrin seems to be compounding my anxiety instead of relieving it and my milk production seems a bit lower since I started taking it. My psychiatrist and I are now working with a naturopath to see if herbal supplements can offer support to replace at least one of the medications I'm on. I have side effects from Wellbutrin/Cymbalta (constipation, disrupted sleep patterns, trouble with short term memory recall, increased anxiety, and reduced milk production) and I would love to get off of them altogether and go with herbal supplements but I'm not sure that they'll work. Because my PP OCD is a serious matter, we're being very careful about dosing/switching my meds.

Are there any prescription anti-anxiety / depression meds that are safe for breastfeeding and are known to have fewer side effects? I've heard Lexepro is good but according to Mother's Milk a fair bit passes through to the baby. My baby is 5 1/2 months old and I'd love to continue nursing him but I don't want to risk his health if what I'm taking orally is dangerous for him.

Thanks for any thoughts on all of this.

[Sandra]

Bsruden, thanks for posting,

If the medications you are taking are not working for you then you may need to talk to your Dr about changing. Many of the SSRI's, SNRI's, and other medications are considered compatible with breastfeeding.

Lexapro (escitalopram) is given an L2- safer rating. The amount transferred in breast milk is 5.2-7.9% of your dose. Recent and good data now show that levels in milk are low, and that plasma levels of escitalopram are low to undetectable in most infants. While the number of case reports in the literature are still low, it would appear this medication is suitable to use in breastfeeding mothers. Monitor the infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

Zoloft (sertraline) is given an L1-safest rating, it is the only one in this class of drugs with this low of rating. The amount transferred into breast milk is 0.4-2.2% of your dose. Sertraline 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. Monitor the infant for sedation or irritability, not waking to feed/poor feeding and weight gain.

There are several medications they could use to treat your conditions so we would recommend speaking with your Dr about alternative medications, as he would be the best qualified to recommend what would help most in your situation. Then you could call us at the InfantRisk Center at 806-352-2519 and we could discuss the safety of the medications he recommends.

I hope this helps, please call or post again after speaking with your Dr. Thanks.

Sandra Lovato R.N.
InfantRisk Center

[bsruden]

Hello, I'm tapering off Cymbalta and around the same time my son (7 1/2 month old) began to roll his eyes to the back of his head. It could be coincidence, but could it also be linked to tapering too fast? I was supposed to go from 40 mg to 30 mg but couldn't get to the pharmacy to pick up the 30 mg so just went from 40 mg to 20 mg instead. My psych said that cutting a dose in half could cause bad side effects, which I definitely noticed myself. I was having very strange sensations in my brain where it felt like a record skipping in my head. Many years ago I tried Cymbalta and went off cold-turkey (DO NOT DO THIS) and suffered severe brain zaps in my head for almost 2 weeks. It was terrifying and terrible. For this recent tapering, I felt like the "record skipping" was a precursor to the brain zaps so she had me increase to 30 mg/day to alleviate the symptoms. The plan is to stay at 30 mg for 3 weeks and then go down to 20 mg, etc.

My son's eye rolling started about a week after I cut my dosage from 40 to 20 mg. He's currently at the Children's Hospital getting an EEG done to confirm it's not seizures. Has anyone dealt with this before? I'm terrified that my Cymbalta taper has caused this and would love to hear from anyone with a similar story or information to share.

Thank you.