I tried to do a link but it didn't work so I've copied and pasted it, sorry! What do you think? I love to breastfeed dd and she loves it too and is forever pestering me now I've cut down
I am 35 and have suffered from bouts of depression for many years. During both pregnancies I was very depressed and took no medication. The depression lifted away after each baby was born. Since my periods started again last year I have had several low points each month but in no obvious pattern. Last month I felt really bad and started taking Sertraline as I am still breast feeding my 20 month old. I had an unusually long cycle and then an unusually short cycle leading me to believe that my depression is hormone related and if so, are anti depressants the best treatment? I very much dislike taking them). We have avoided doing anything to regulate my periods such as having a coil or taking the pill since I seem to be sensitive to the pregnancy hormones.
I am keen to continue breastfeeding but am worried that it would be better not to even though they are supposed to be safe. Is there such a thing as hormone related intermittant depression and if so is there an alternative treatment? Would it be best to stop breastfeeding since it isn?t really necessary now she is older? Does reducing her feeds and delaying feeds help at all other than making me feel better? Name and address withheld
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The antidepressant Sertraline, a 5HT reuptake inhibitor, was originally marketed under the brand name Lustral by Pfizer. It has a profile very similar to that of Prozac, and is a well tried and trusted drug. Sertraline has proved especially useful in treating depression that is associated with such conditions as pre-menstrual tension. It is also useful when the anxiety component of the depressive illness is predominant, as in obsessive compulsive disorders, post traumatic stress disorder and social phobias. In all cases of clinical depression the patient has some degree of anxiety, as well as the other depressive symptoms. The amount that anxiety contributes to the overall picture varies from case to case. In general SSRIs (5HT re-uptake inhibitors) are better tolerated than the older antidepressants, but it is important to make certain that liver and kidney function is, and remains, normal.
Whereas it is known that some 5HT re-uptake inhibitors can be found in the blood of babies being breast fed and in breast milk sertraline was undetectable in breast fed infants, even if it was present in a high concentration in the mother. Sertaline is therefore often considered one of the antidepressants of choice for nursing mothers who are depressed. It is always possible that the normal assessment methods for antidepressants might fail to detect tiny traces of the drug, and it is perhaps for this reason that the American Academy of Paediatrics recommends against the long term use of any of these antidepressants by nursing mothers. This advice wasn't based on any evidence of damage or adverse reaction to sertraline in babies, or even of its presence in babies who are breast fed.
Even before antidepressants were available I used to recommend that any patient who had been recently delivered and was suffering from depression should wean their baby early. Breast feeding if mother and child are enjoying it gives a baby a wonderful start, just as you have. Even so as any dairy farmer will tell you being regularly milked is very tiring, and nothing is worse for depression than becoming tired.
An excellent method for contraception for woman around 35 and more, who are in a stable relationship, is the Mirena coil. It is not without all risk of causing minor mood changes but from the experience of my practice I don't remember one patient who has had trouble from them, and in many cases the mood swings were much less once one was inserted.
Treating depression after a pregnancy is of the upmost importance, and as the reader implies keeping breast feeding going for twenty months has given the baby a head start.