breastfeeding and celexa...

[wiccan mom]

I posted this a couple days ago, over at the Breastfeeding site...I see it more as a bf issue and not a depression issue...but nevertheless, any advice here would be most appreciated.

I am clinically depressed...have been for years, since just after my ds1 was born 10 yrs ago...took Paxil(grrrr - badstuff but it worked!) for years and recently had trouble with 2 pregnancies - lost at 3 months...gp switched me to Celexa20mg...happydance-we had our ds2 at the beginning of Feb this year...my gp and I agree: I must stay on the Celexa and it doesn't seem to affect my ds.

So...here's the question...had my postpartum checkup...doc says 20mgs seems to be working - of course sleep deprivation was an issue in my mood: weepy, nervous, impatient and crabby when overwhelmed. Ds is now almost 3 months...i'm feeling panicky at times (old resurface of PanicDisorder)...i often dwell on "what ifs": what if i dropped the baby, what if i got in a car accident, what if i get sick...these feelings are not overwhelming me - just concerning. I know my gp will say: up the meds to a higher dose...i don't wanna do that because there'll be more in my bm...and i WILL NOT stop bfing.

Anybody know anything about bfing and Celexa...have any ideas about my recent moodswings?...i don't wanna put all my concerns at my gp's feet...he's pro bf but also pro meds. HELP!

[ibex67]

First, I would definitely see a psychiatrist if at all possible. They are usually more informed on the most recent studies on the psychotropic meds. And they probably have more experience finding just the right med for your symptoms.

Second, I am currently on 60 mg of Celexa and I am 6 mo pregnant. Both my Psych. and my midwife and her supervising OB have said that while it is okay to stay on the Celexa post-partum and for nursing, I *might* want to consider Zoloft. Evidently infants immediately post-partum experience some withdrawal from these kinds of meds in utero and Zoloft is supposed to be a little easier to withdraw from. Though no one has said I *have* to switch. I haven't decided yet. I was on Zoloft for years and years [nursed ds #1 for 4 years while taking it] and I kind of hit a plateau with it and it doesn't work as well for me as the Celexa does.

Finally, this is the premiere website to learn about some of these drugs: http://neonatal.ttuhsc.edu/lact/

Good luck.

[wiccan mom]

Thanks...where i live there are no psychiatrists and even if i travelled to see one, none of them are taking new patients....(softsigh)...so i make due with my family doc, who's also my gyno and ped. I have an appt with him in 2 weeks...i plan to ask about increasing my celexa and how it will affect my ds. So far, my babe seems unaffected by 20mg of the stuff.

Good luck with your pregnancy!

PS...i had no trouble on 20mg celexa with my ds pp...he had no withdrawal.

[littld62]

Here is a good link to read...

http://www.perinatology.com/exposure...Citalopram.htm

[ibex67]

Originally Posted by littld62

Here is a good link to read...

http://www.perinatology.com/exposure...Citalopram.htm

Thank you for this link. It was excellent.

[Gale Force]

If you are going to up your dose (and even if you aren't) you might want to read more about when the peak concentration of the medication occurs in your blood. Your blood levels determine your breastmilk levels, so if you can avoid having baby nurse in that time, baby will be exposed to less.

It's probably too much to hope that this baby already sleeps through the night (because it seems like nobody with PPD has babies who sleept through the night ) but if by chance, baby is sleeping through the night, you would take your meds so that the peak happened at night.

I don't know about celexa but I did a quick search and found this. It says that celexa peaks four hours after you take it. You could take it a couple hours before the night feeding.

Just a strategy for you in case it works.
My son began to sleep through the night at two years old.

[katterpiller]

breastfeeding and celexa

I have been on Celexa for almost 5 years. I started at 30 mg, then moved to 40mgs. I did a ton of research on my own about using celexa during pregnancy and lactation well before getting pregnant with my now 2.5 week old. I did choose to continue taking the celexa during my pregnancy, and I am choosing to continue now while bfg. I spoke frankly with my docs before and during my pregnancy. I was lucky to have found a NP who was up to speed on anti depressants & bfg. Baby has not had any side effects or withdrawals, and I feel confident in my decision to continue with my medication.
I found Dr Hale's website very helpful.
Just thought I would share for what it's worth, hope it helps a little.

[Still_Snarky]

I'm another mama who has been on Celexa for the past 5 years or so, through (almost) 2 pregnancies and 2.5+ years of breastfeeding. My psychiatrist, ob (last pregnancy), midwife (this time), and I feel it is best for me to be a sane/stable mama... I have been on doses from 20-60mg, with 60 being right after the birth of my dd (bad PPD). My daughter has never been noticeably affected by my medication. Feel free to pm me with questions or anything.

[wiccan mom]

wow...thank you all so much for your information and expertise. It is very comforting to hear about other mommas who have success with this drug, depression, and their babes.

Btw, I have been managing my anxiety with a homeopathic/flower remedy: Bach's Rescue Remedy. I dunno if it's psychosomatic, but if I really feel jittery, anxious, and overwhelmed, I dose myself with the drops and feel much better in minutes. I used this years ago, forgot about it, and just dragged it out again. As far as I know, there are no sideeffects for my ds. It's available in most health/natural foods shops and I really recommend it. It is also safe for babies, children, and pets.

Thanks again for everyone's support.

[ChristineCC]

breastfeeding, celexa & sleep

This isn't really a direct reply to the original question about increasing dosage of celexa, but since I found it while doing my own research re: my current pregnancy I thought I'd share my own experience as a *possible* warning about baby's sleep to others breastfeeding while taking celexa. I breastfed my first son for 13 months on a 20-30 mg dosage of celexa, and thought I had no problems at all--he developed normally and is very bright. It was only long after I had weaned him that I stumbled across some surprising information about celexa. I had always been told to take the celexa in the morning and had for years without thinking about it--apparently this is because about 85% of people who take it have a bit of a stimulant effect from it. Personally, I had such low energy levels that I even frequently had to come home at lunchtime for a nap before ever getting pregnant, so it never dawned on me that celexa could act as a stimulant.

Now I wonder whether my son's horrible sleep problems his first year can be attributed in part to the celexa in the breastmilk. He was difficult to get to sleep, and slept for short periods (for the first 8 months I don't think he ever napped longer than 20 minutes unless he was being rocked or pushed in the stroller, and woke about every 1 1/2 hours at night). Although I nursed on demand until 13 months when I was with him, I had gone back to work part time and he was getting formula as well. Looking back, I think his sleep improved as the proportion of formula increased, and his sleep improved dramatically once he was weaned completely. I know that breastfed babies in general have shorter, lighter sleep cycles, and I know that once the comfort of nursing was no longer available in the middle of the night his incentive to call for me was lessened, but I can't help wondering if part of the problem was that my breastmilk was actually stimulating him and making long, deep periods of sleep more difficult.

I'm 7 months pregnant with #2 and taking 30 mg of celexa, and plan to breastfeed again. But this time I've been reading up on all the techniques for encouraging good sleep, and if this baby is having as many sleep problems as his brother, I'll be experimenting to see if there is a correlation between the celexa and his sleep.

Has anyone else noticed a possible correlation with their babies?

[Still_Snarky]

Interesting post Christine!

I haven't noticed any sleep changes in dd related to dosage changes or anything else as far as my Celexa is concerned. (She's always been a great sleeper though and actually slept through the night at about 6 weeks.) I take my Celexa at bedtime and don't notice any stimulating effect in myself though either...

[wiccan mom]

Greetings all!
thot I'd check in and update for anyone interested...I was at the doc's a while back and he increased my Celexa to 30mg. He does not think it will affect my ds in my bm. Nevertheless, I've changed to taking the dose at nite, instead of the morn. My ds sleeps thru the nite and I'm hoping the meds will have evened out and give him a more restful day than he's been having.

Overall, I have not noticed any real change in my mood. I still have to avoid caffeine, get a LOT of sleep, and take my Bach's Rescue Remedy when I feel a "meltdown" coming on...but hey, it's springtime and life is good. Right?

btw...doc has never heard of 5-htp and I decided I'd not tinker with anything just yet.

[Still_Snarky]

Glad to hear you got into your doctor. FWIW, dose changes always take me about 2 weeks to a month to notice. Hope things continue to improve.

[wiccan mom]

Thanks Still Snarky...i figured it'd take some time.

[BabyBumblebee]

Hi mama, and to you too.

I just wanted to let you know that I bfed dd for 17 months whilst taking 120mg of Celexa daily - it did not seem to affect her at all, thankfully. Yup, that is a crazy high dose - seems that I don't really respond very well to most of the meds :

dd is now a happy, healthy 23 mo and I treasure the memories of our nursing relationship!

[wiccan mom]

BabyBumblebee - thanks for the hugs and encouragement. I do think everything's better overall with celexa than without...hugs right back atcha!

[ibex67]

Originally Posted by BabyBumblebee

I just wanted to let you know that I bfed dd for 17 months whilst taking 120mg of Celexa daily - it did not seem to affect her at all, thankfully. Yup, that is a crazy high dose - seems that I don't really respond very well to most of the meds

Thanks for posting this. I am on 60mgs per day and am due in August and was starting to get a little nervous because everyone else seemed to be on such lower doses...

[tireesix]

Phew, relief, just been prescribed 20mg a day and was worried, feeling better now.

[BabyBumblebee]

well, 20-40mg is considered the 'normal' therapeutic dose...the amount of *active* meds present in your blood serum/breastmilk is somewhere around 1 - 4% of that doseage.

(I had my BM tested as part of a safety study...what fun!)

Oh, and I'm expecting another blessing in November, and will absolutely bf this one too...