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Reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Breastfeeding can be a fantastic way to bond with your infant while giving them wonderful health benefits for years to come, but if you’re using antidepressants like Celexa®, you might have a reason to pause before breastfeeding. That’s because antidepressants are known in some cases to increase the risks of certain problems in infants if taken while breastfeeding. So what about Celexa and breastfeeding — is the story the same?
Whether you’ve taken Celexa all your life and through your pregnancy, or are looking at this antidepressant medication for the first time, it’s understandable that you want to eliminate all uncertainty about the potential danger before exposing your infant.
Some people, however, don’t always have the luxury of choosing. For some new moms, Celexa might provide the very necessary mental health support crucial to your ability to function and perform necessary daily tasks.
If it feels like being caught between a rock and a hard place, we can understand why. We’re here to help you feel a little more in the know about your risk and benefit potential.
The best way to help you is to start with the seemingly straightforward question of whether you can take Celexa while breastfeeding — let’s start there.
Celexa is a selective serotonin reuptake inhibitor, or SSRI — a medication designed to help people manage the symptoms of mood disorders, psychiatric disorders and other mental health issues through what scientists believe is the alteration of the brain’s serotonin supply.
These medications essentially work to reduce your depression symptoms by preventing the reuptake of serotonin. They keep your brain from reabsorbing your supply so you don’t run out.
Normally, Celexa and other SSRIs have relatively few serious side effects, which is why over the last couple of decades they’ve become the go-to class of antidepressant medication for many healthcare providers.
They’re among the safest options when compared with other antidepressant medications, and if you’re, say, a mom with postpartum depression, you might be a perfect candidate for this medication (talk to your healthcare provider to learn more). But there’s a caveat in all of this: the risk associated with breastfeeding.
So, now to the big question: can you take it while breastfeeding? You can, though you may not want to.
While Celexa is generally considered safe for adults when taken as directed, it can pose some serious health risks for infants and, well, it can be transmitted to them through breast milk.
Healthcare professionals typically warn of the dangers of allergic reaction and common side effects, but if you weren’t pregnant or planning to get pregnant when you started taking Celexa, you may not have heard about the risks of taking antidepressants during pregnancy or how a maternal dose of an antidepressant can cause adverse outcomes.
And then there’s the postpartum risk. What risks does a single dose of Celexa pose to an infant when delivered through breastmilk? Well, that depends on the infant, the dosage and some other factors.
As we mentioned, Celexa (and many other medications for that matter) can be passed through human breast milk.
The good news, in general, is that there’s not a blanket “drop this medication immediately” recommendation from the Food and Drug Administration (FDA). The bad news is that there are plenty of risks associated with breastfeeding while on Celexa.
Those risks may include physical and mental side effects for a newborn.
While antidepressants in pregnancy have been associated with low birth weights, studies have observed increased sleeping, decreased feeding, weight loss, poor feeding, fussiness and other issues in breastfed infant populations exposed to a substantial dosage of an SSRI.
Here’s some more good news: at least one study has shown that most infants immediately recover from these adverse effects when exposure stops.
There aren’t any long term studies examining the impact of infant exposure to SSRIs and problems later in life, unfortunately, but at least with regards to the short-term effects, we can tell you there’s evidence of recovery.
Ultimately, you may not want to take the risk that an infant might be more fussy, difficult to feed, sleepy or troubled with weight gain.
So, should you stop taking Celexa while breastfeeding? Should you stop breastfeeding while taking Celexa? Should you continue doing both?
The short answer is: talk to your healthcare provider. We can’t emphasize it enough. Celexa carries a Category C rating with the FDA, which means that while there are no definitive human trials that show Celexa may be harmful to an infant, there were adverse effects in fetuses in animal trials.
The choice to continue taking your medication or not is one you should make exclusively with the guidance of your primary healthcare provider.
The reality of antidepressant drugs and breastfeeding is not that there’s one right decision. As much as risks might matter, there’s context to be considered — and whether psychotropic medications in human milk or untreated depression present the greatest risks in the postpartum period.
One way or another, though, the answer is not just dumping your pills and going cold turkey — there are numerous risks associated with that. When you stop treatment for depression, those depression symptoms can return.
There’s a danger to taking too much medication: you increase your risk of serotonin syndrome, and the symptoms of serotonin syndrome can be pretty rough.
But Celexa, like many SSRIs, has the capacity to cause withdrawal symptoms if suddenly discontinued, and that alone could cause potentially serious side effects.
Generally, when you do go off of an antidepressant, a healthcare provider will want you to do so gradually to reduce your risk of withdrawal syndrome. and the associated symptoms of serotonin syndrome.
That might mean lowering your daily dose over time, or quitting with some supervision, to make sure that the side effects aren’t too severe.
Most experts don’t advise that you stop taking a medication that is necessary for your basic function while breastfeeding, and many caution against changing medications during this time.
The treatment of depression is important for not just your mental health, but your physical health as well. Healthcare providers will also point out that maternal depression can have repercussions on the physical and mental health of a baby, too.
But that’s the key — talking to your healthcare provider. They know you better than we could ever pretend to, and they’re the ones that can help you decide what’s best for you and your child.
The reality is that, even with the worrying data we’ve shared, your best course of action with regards to your mental health and your baby’s health isn’t so clear.
We can tell you what the studies say, we can tell you what the experts say, but ultimately we can’t tell you what’s best for your needs, because they are unique, and likely require a unique solution. It’s very important to not do this alone and talk with your healthcare provider. They can help determine what is best for you and your baby.
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