Sertraline and Breast-Feeding

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Abstract
Postpartum depression occurs in approximately 10 percent of women who give birth and is associated with substantial morbidity in mothers and their children. For some women, treatment with an antidepressant drug may be necessary but complicated by their desire to continue to breast-feed. Unfortunately, there is a dearth of information on the safety of treatment with various antidepressant drugs, including the selective serotonin-reuptake inhibitors, during breast-feeding. During gestation, serotonin (5-hydroxytryptamine) influences neurogenesis and morphogenesis, and in the neonatal period it modulates synaptogenesis.1 The effects of 5-hydroxytryptamine on early neurodevelopment arouse special concern about the use of selective serotonin-reuptake inhibitors by nursing mothers. Although plasma drug levels in infants exposed to serotonin-reuptake inhibitors in breast milk are reported to be generally quite low,2 it is not known whether 5-hydroxytryptamine transport in infants is affected.