Celexa in breastmilk - I am so frustrated!! - Mothering Forums

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#1 of 6 Old 01-25-2008, 08:53 PM - Thread Starter
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I need some help and at this point I have NO idea who to get some decent advice from.

I've dealt with depression since I was about 18 years old. It sucked, bad. I did therapy, I was put on Celexa. I have felt NORMAL for the past 6 years. Celexa works well for me, no side-effects. I have tried multiple times (about every 6 months, lol) to wean myself off of it (I'm at 20mg/day), and every time I drop below 20mg we really notice it. I am sad that my body is unable to handle it without this drug, I HATE taking drugs, but this is one of those cases where on the medication is most definitely better than off of it.

So before I got pregnant I talked with my old OB. He looked up research and we had a lengthy discussion about SSRIs and Celexa and he said in his opinion I should stay on the Celexa during pregnancy, that the studies are not showing any harm to the baby and that it is certainly better for me to be on this medication and mentally and emotionally stable than being off it. All is good. I've stayed on the Celexa, my mood is still stable as ever, even with pregancy hormones thrown in the mix, all is well.

The PROBLEM is breastfeeding. I of course always do my research on everything, and found that Celexa is passed into breastmilk in higher quantities than other SSRIs. At this point I have switched practices to an all-midwife practice that encourages and supports natural childbirth. So I bring up the medication issue with them.

And this is where I get frustrated. I have seen multiple midwives at this practice and I have asked every one about the celexa. I get a, "Well, they're all SSRIs, they're all going to be in breastmilk, celexa is fine to stay on" offhand response (so they obviously have not read up on it) and/or a "we'll check into it." and then next visit? The midwife is as clueless as ever and there seems to be no note in my chart of them saying they'll check into it. They are really very dismissive of this issue and I am BEYOND frustrated trying to get any kind of direction from them. They say, "Ask the baby's pediatrician." ARRGGGG.

The one midwife who DID seem to take it seriously expressed concern over me switching medications at a time when I am at a high risk for post-partum depression anyways. Her concern was valid, and it's a concern of mine too - celexa works WELL for me. Some women have to try three or four different drugs to find what actually works for them. I do not want to be messing around with my medication after the baby is born. And I am nervous about switching things up now, too. I am stable on the celexa... do I REALLY want to mess with that?

What the heck should I do? I know the facts in that celexa is higher in BM than, say, zoloft, and zoloft is the first drug recommended. But the midwives did point out that many women do BF while on celexa. Plus the whole do-I-really-want-to-mess-with-this thing. I do NOT want to be having a mental breakdown right before or after my beautiful baby is born.

I really feel like I need some professional advice, and my midwives are simply not providing it in this case - I just don't think they are educated enough in anti-depressants and breastmilk to be able to. So who should I ask about this?? The baby's ped? An LC? An OB? Which OB?? (My original OB, by the way, whom I liked so much, has since left that old practice. So I can't even schedule a second opinion with him.)


Natalie, mama to Katherine (5/22/10), missing Devin (stillborn 3/6/08)
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#2 of 6 Old 01-26-2008, 12:11 PM
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Go to a psychiatrist, and a therpist who specializes in PPD. They will be able to help you the best.

If you can't do the above, your OB will have current data, or SHOULD have, on this. Some OB's are more UTD on things than others.

Mom to two beautiful boys, now in school to be a therapist and help other women with PPD.  

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#3 of 6 Old 01-27-2008, 12:56 AM
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I had PPD with my daughter Hope and was put on effexor. I was TERRIFIED that taking effexor would somehow damage Hope in the long run. My doctor and nurse suggested I call the Motherisk hotline http://www.motherisk.org/ for more information on anti-depressants and breastfeeding. So I did.

Motherisk is a program run by the Hospital For Sick Children in Toronto, Ontario, Canada. They studied mothers on effexor and their babies up to one year old and noted no side effects on the babies and that their livers processed the anti-depressant out of their systems.

My sister was on celexa with three of her children and was able to breastfeed too. We called Motherisk for her too and they said the same thing.

According to Dr Jack Newman, Canada's breastfeeding expert, it is almost always safer to breastfeed than to not breastfeed.

Here is his site: Breastfeeding Online

Also, here are some articles on Breastfeeding and Medications

Keep breastfeeding!

P.S. Hope is now 5 years old and very happy and very healthy!
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#4 of 6 Old 01-27-2008, 02:12 AM
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According to "Medications and Mother's Milk"

in a study in which the mother was taking 20mg of Celexa the milk only contained 0.4% of the mother's dose. The amount was higher in other studies but only as high as 5.9%

The only concerns in the infant were two cases of decreased feeding and weight loss.

Sounds to me that these small risks outweigh the problems associated with not taking the medication.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#5 of 6 Old 01-27-2008, 02:18 AM
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Here is a wonderful site for you. Thomas Hale himself answers questions on all drugs and breastfeeding and there is a whole section on antidepressants:

:SaHM to 3 *DD* DD2 * DS
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#6 of 6 Old 01-27-2008, 03:06 AM - Thread Starter
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Thank you girls!!

I do not have an OB, currently, though I am considering finding one to get a "second opinion" from, since the midwives are clueless.

I've been reading everything I can online... I found some good info at Toxnet on celexa in breastmilk. Like Megan noted, there were only two cases where there was an issue, and it was pretty minor. This has made hubby and I feel a lot better about the option of staying on Celexa.

amydawnsmommy, thanks for sharing the info you got from Motherisk!

Now I just hope the pediatrician doesn't argue with me about breastfeeding, because that's just not an option for me. I'll switch meds if that's what is best, but I know it's possible to BF while on antidepressants and I am not going to give that up.

Natalie, mama to Katherine (5/22/10), missing Devin (stillborn 3/6/08)
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