citalopram and breastfeeding

[Mimmit]

hi.wonder if anyone can help.was prescribed these ads today but forgot to tell dr i am still bf my 2yr old.normally only in morning so was thinking i may be ok to take tablet straight after?has anyone taken them while bf?
Also feel bit wobbly about taking them at all.i know i need some help but never had anything like this before.

There is very little research on what is and isn't safe to take when bf because it is not ethical to do research on babies.

Practically speaking if I had a 2 yr old taking some milk in the morning I would not worry about it and take the citalopram. The dose they will get is so minute as very little gets in your milk, your tot drinks very little milk and that milk is a small part of their diet.

Citalopram has a half life of 36 hours so it will make some difference if you take your tablet after the feed but not a lot, because you will still have 75% or so of a dose in your system after 24 hours. More important to take it at the time that makes you feel best, especially regarding side effects in the early days.

I'd ring your doctor

thank you both.gumby think you are right.
Madmouse thanks for all the info especially about the half life.dr told me no side effects?! Oh well suppose if it helps it will be worth it.

Don't be shocked if the doctor tells you to stop bf. Most GPs are pig ignorant in these matters.

And no side effects?? Most will disappear when you get used to them in a few weeks, but you may experience increased anxiety, nausea, light headedness, headaches and others until then.

i was prescribed citalopram in late pregnancy .gp knew i was intending to breastfeed

i took them.she was ok.

thank you loopy.i will call tomorrow.
Liveinazoo that is reassuring to know.hope it helped you and that you are ok now.i do want to take it if i can.i think this has been going on for at least two years.would just like to feel normal again.
Madmouse my gp has already raised eyebrows when i said i was feeding a few months ago so yes i am prepared for that response.guess it makes life easier for them if they don't have to factor it in!

DD is 16 months and I have been on Citalopram for over 2 months. I said specifically to my GP I was still breastfeeding 2 to 3 times day and she said it was fine. I have not noticed any changes in my DD's behaviour. Taking the ADwas the best thing I did in the situation, my daughter would suffer unresponsive, easily irritable, snappy and sometimes devoid of feelings mother.

Your doc is taking crap. yes, there are side effects to taking citalopram, they just differ from person to person. I had very dry mouth, tense jaw and would become very tired and had to go to bed around lunchtime. I take the med in the morning. I did not suffer sleeplessness, although some people do. That lasted for about 2 weeks.

The issue is the drug concentration level in breast milk which will vary according to the actual drug rather than the half life and also drug 'trial' results - see nice guidance below:

(For example Venlafaxine has an incredibly short half life but is no no.)

www.nice.org.uk/nicemedia/live/11004/30433/30433.pdf

See page 20, section 1.4.3.2.

i took citalopram in pregnancy and when bfeeding it was also fine, my cpn and mh team did some research for me and decided that at the dosage i was on, 20mg it was fine :)

but call the bfn and check with them :)

Loopy all drug administration should be administered based on the patient's risk medical profile exposure and the user informed of the various increasing or decreasing level of risk exposure through both non administration and administration which is why I provided the Nice link.

Happy to accept your comment but it depends on your personel medical risk profile, not that it is without risk - Venlafaxine is one of the high risks ADs for BF, not least because it is still considered 'new' and therefore statistically unproven through 'live' multiple meta analyses.

Either way the advice about half life from Madmouse is misleading as it ignores the biochemical way different chemical compounds may present within breast milk, rather than it solely being about half life.

This I was actually meaning to convey in that Venlafaxine has
a very short life (I also take this, but was changed during BF) but is considered higher risk. Whereas Prozac has a very long half life but is considered very low risk in BF.

Similarly, the level of risk you present is determined by your doctor, and also in consideration of other personal medical factors, medical health and other meds that you might be taking.

BfN provide generic advice (as does Nice) which is why it's good for info, but we still 'need' those doctors!

Whitand A please read posts carefully. All I said was that there was limited benefit in taking the drug straight after bf. I believe that to be correct. I also believe that when a drug is taken regularly the level in bm will remain more or less constant especially as milk is not made 'on the spot' when feeding.

Oh and BfN provides far less generic advice than most GPs who are likely to say stop bf - seeing that as the most straightforward risk assessment of all. You may not realise how shockingly uninformed GPs are about bf and bf+ADs. I've seen mums of 4 month old EBM fed infants told by GPs yes you are depressed but you cannot have ADs until you stop bf. Imagine what this firced stop does to the woman's MH and well being, especially if bf is one of the few things that goes well.

So to say that your doctor will determine risk factors is naieve and belies the somewhat technical language you use.

Loopy you are right I explained myself badly, getting stuck in between your breasts never being empty and the 'ingredients' for the milk being constantly on tap.