Has anyone bf while on mirtazapine?

[francesrivis]

I finally got up the courage to go to my GP today to ask for a change of ad because of the lack of libido caused by my current one (many thanks to those who posted on my previous thread about this, it really helped!). She is happy to switch me to mirtazapine. Only problem is I am still bfing dd2 who is 14 mths. She said that mirtazapine does pass into the breastmilk and manufacturer's advice is to avoid. This is also the case with my current ad, dothiepin, but as this has been around a lot longer I feel more reassured that there are unlikely to be problems. Just wondering if anyone is or has bf on mirtazapine, and what your experience was?

tia

Hi there!

Well the fact you have successfully bf your DD for 14 months is fantastic! She will have received all the benefits of breast milk for that whole time.

I personally would say, ok now is the time to do something for myself. I wouldn't b/feed on mirtazapine if it passes into breastmilk. Why would you? At 14 months she will be fine to have cows milk now surely? Would now be a good time to therefore give up breastfeeding, switch to mirtazapine, sort out your libido problem, improve your relationship?

I am on mirtazapine by the way and i have found it very useful. No problems in terms of libido on it either. Hope you get the right support and advice and are happy with the decision you take.

Take care x

I don't have personal experience but I am a mental health nurse.

Often in our area the GP will refer a client to the psychiatrist for a one-off appointment, solely to review medication. Obviously the psychiatrist will have far more knowledge/experience.

As you say, part of the issue is that the "older" medications are more likely to be prescribed. This doesn't mean that newer types are not as safe, just that ethically they cannot test effectively on bf mothers.

and following on from onepieceoflollipop there should be a psychiatrist who specialises in peri-natal issues in each NHS trust... i.e. expert in psychiatric medications in pregnancy and breast feeding.

Thanks,this is really helpful. I'm still very undecided - before I saw the doctor I thought that I would be quite happy to wait until I finished bfing dd2 just as long as I knew I could make the change then (I've waited for years to do something about this after all!). When I saw her, though, and she would have been quite happy to write out the prescription there and then, I must say I was very tempted. But on the other hand, I fed dd1 for two years and I always took it for granted that I would do the same for dd2 - it seems a bit selfish to stop just so I can get my libido back!

THe idea of a one off referral to a psychiatrist sounds good - I'm just not sure quite how to phrase the request with the GP -would she think I was not trusting her to give me the right advice?

A reasonable GP wouldn't think you didn't trust her imo. Perhaps plan ahead what you might say.

Perhaps something like you are aware there are a lot of different opinions regarding drugs/medications for pregnant or bf mothers, and you would appreciate the chance to see a specialist as a one off just so you could be fully aware of the options.

You could also have a look at the Nice Guidelines on perinatal mental heath.