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Safest anti anxiety/panic attack medication while breastfeeding?

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  • Safest anti anxiety/panic attack medication while breastfeeding?

    I am really needing professional advice on this topic. I have been suffering anxiety/panic attacks for a week due to extreme stress. I need to know the safest anti anxiety medication I can take while breastfeeding. My bub is 4 m.o. I am only needing something until this horrible time passes as i do not reguarly suffer from the attacks. It is really important that i can still function and think clearly whilst taking whatever is recommended. Please help!

  • #2
    Dear Danielle,

    Lorazepam (Ativan) is a typical benzodiazepine from the Valium family of drugs and has a half-life (time it takes for one-half of the drug to be excreted from the body) of 12 hours. The amount that is transferred into breastmilk is 2.9% (RID) . The time the drug is most concentrated is 2 hours after your dose (Tmax) so avoid that feeding time and that will decrease the amount available to the baby via breastmilk. Lorazepam may cause sedation. Because each person reacts differently to medications, you should not engage in activities such as driving until you know how lorazepam affects you. Your infant should also be observed for sedation. Another medication that is used for anxiety is sertraline (Zoloft). Sertraline has a RID of 0.4 % to 2.2 %. The Tmax is 7 to 8 hours. Observe your infant for vomiting and diarrhea although not likely since the RID is low. These two medications have the lowest RID, but there are others that are compatible with breastfeeding. You can talk with your physician to see if either one of these medications would be helpful for your condition. Let me know if you have further questions after consulting your physician.

    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center


    • #3

      At present, I do not know of any data that suggests that clonazepam reduces milk supply. Nor is this normal for this family of drugs.

      The only way to know would be to drop off the clonazepam for a day or so and MEASURE your milk production by weighing the infant before and after each breastfeeding. But don't do this without discussing it with your physician.

      Tom Hale PhD.


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