Can You Take Celexa While Breastfeeding?

For some new moms, Celexa® (citalopram) can provide mental health support crucial to the ability to function and perform necessary daily tasks — baby-feeding included. But if you’re using the antidepressant, you may wonder how Celexa and breastfeeding mix and whether you have cause for any concerns.

In general, the use of antidepressants while breastfeeding may increase the risks of certain problems in your baby. Celexa is not necessarily different, as there’s evidence that babies exposed to the medication through breastmilk can experience symptoms ranging from restlessness to weight loss. That said, your healthcare provider still may recommend taking Celexa if the benefits outweigh the risks.

Keep reading for a closer look at the research on Celexa and breastfeeding, along with guidance on making the right choice for both you and your baby.

Celexa (and its generic form, citalopram) can treat a variety of anxiety disorders and several depressive disorders.

It is a selective serotonin reuptake inhibitor (SSRI), a class of medications that works by preventing the reuptake of serotonin. How do they do this? Scientists believe SSRIs alter the brain’s serotonin activity, preventing it from reabsorbing serotonin, so it remains active longer.

Examples of other SSRIs include:

• Escitalopram (Lexapro®)

• Fluoxetine (Prozac®)

• Paroxetine (Paxil®)

• Sertraline (Zoloft®)

Normally, Celexa and other SSRIs have relatively few serious side effects. That’s why, over the last couple of decades, they’ve become the go-to class of antidepressant medication for many healthcare providers.

SSRIs are among the safest options when compared with other antidepressant medications. They tend to have fewer side effects than tricyclic antidepressants (TCAs).

Though Celexa is generally considered safe for adults when taken as directed, it can pose some risks for infants, and it may be transmitted to them through breast milk.

That said, Celexa may greatly help you if you have an anxiety disorder or depressive disorder. 

If you’re pregnant or breastfeeding, a healthcare provider can go over the safety profile of the medication with you and help weigh up the risks and benefits.

What risks does Celexa pose to an infant when delivered through breast milk? Well, that depends on the infant as well as the dosage of the antidepressant you’re taking, alongside some other factors.

Celexa Excretion in Breast Milk

As mentioned, Celexa — and many other medications, for that matter — can be passed (excreted) into human breast milk, albeit at low levels. In some situations, it may also be passed to a breastfeeding infant.

A 2024 study looked at the excretion of three different SSRIs (citalopram, paroxetine, and sertraline) into the breast milk of 37 women. It found detectable levels of the SSRIs in all breast milk samples.

The researchers also explored something called the milk-to-plasma (M/P) ratio, which measures how much SSRI is in the blood versus in breast milk. For citalopram and sertraline, they found that the M/P ratio was above one, meaning the concentration of the antidepressant was higher in the breast milk than in the blood.

However, the researchers also noted that most of the breastfed infants didn’t have detectable levels of any of the SSRIs in their blood. This included nine out of 13 infants whose mothers were taking citalopram.

Other Potential Risks of Breastfeeding While on Celexa

The good news, in general, is that there’s not a blanket “drop this medication immediately” recommendation from the FDA (U.S. Food and Drug Administration). The bad news is that there are risks associated with breastfeeding while on Celexa.

Those risks may include physical and mental side effects for your newborn. The potential side effects for nursing infants exposed to Celexa include:

• Restlessness

• Irritability 

• Excessive sleepiness or drowsiness 

• Decreased feeding

• Weight loss 

LactMed (a database focused on drug safety during breastfeeding) notes additional side effects associated with using citalopram during breastfeeding, like uneasy sleep in your baby. However, it also highlights studies where no side effects were found. 

Case Studies and Research on Celexa and Breastfeeding

Case studies have also documented additional side effects associated with citalopram use during breastfeeding. For example, one of these case reports mentioned teeth grinding during sleep in an infant that resolved after the nursing mother stopped taking citalopram.

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 regard to the short-term effects, we can tell you there’s evidence of recovery.

LactMed also cites older studies that found that nursing infants exposed to citalopram gained weight normally. The database references another study finding in which uneasy sleep was reversible with a reduction in the maternal dose of citalopram.

Overall, few serious side effects in breastfeeding infants exposed to Celexa have been reported. Still, you may not want to take the chance of your infant potentially being more fussy or sleepy, having difficulty feeding, or struggling with weight gain.

Maybe, but we don’t have much data. One small older study found that nursing mothers taking an SSRI were more likely to experience delays in breast milk production after giving birth.

Additionally, a 2022 study found that pregnant women using an antidepressant in the third trimester were less likely to start breastfeeding compared to pregnant women who were not taking an antidepressant for a mental health disorder.

This doesn’t mean the medication affected lactation — it could just be that the women wanted to stay on their medication and didn’t want to risk transferring some of the drug to their babies.

The same study found that breastfeeding mothers who started or restarted antidepressants after delivery, perhaps due to postpartum depression, were less likely to still be breastfeeding after six months and were also more likely to abruptly stop breastfeeding.

The short answer is: Seek medical advice from your healthcare provider. We can’t emphasize that enough. The choice of whether to stop taking Celexa while breastfeeding or to stop breastfeeding while taking Celexa is personal.

With that in mind, here’s some info to guide you. 

Weighing the Benefits With Potential Risks of Celexa and Breastfeeding

When it comes to antidepressant drugs and breastfeeding, there’s no one right answer for what to do. As much as risks might matter, context should be considered. In this case, the context is whether psychotropic medications in human milk or untreated depression present greater risks to you and your baby.

Switching to a different SSRI might be an option. A 2022 review noted that there’s more data supporting the safety of paroxetine and sertraline during lactation.

Not all breastfeeding women may be able to switch to a different antidepressant, but it’s certainly a conversation worth having with your healthcare provider if you’re concerned.

Safely Tapering Off Celexa While Breastfeeding

If you decide to stop taking Celexa while breastfeeding, dumping your pills and going cold turkey isn’t recommended — there are numerous risks associated with that. And when you stop treatment for depression, those depression symptoms can return.

What’s more, Celexa (like many SSRIs) can cause withdrawal symptoms if suddenly discontinued — and that alone could cause potentially serious side effects.

When you go off of an antidepressant, a healthcare provider will usually want you to do so gradually to reduce your risk of discontinuation syndrome. That might mean lowering your daily dose over time or quitting with some supervision to make sure the side effects aren’t too severe.

Most psychiatry experts don’t advise stopping a medication that’s necessary for your basic function while breastfeeding. Many also caution against changing medications during this time. But again, ask your provider.

If you’ve just found out you’re pregnant, know that Celexa carries a category C rating with the FDA. This means that while there are no definitive human trials showing that Celexa may be harmful to an infant, there were adverse effects in fetuses in animal trials.

However, untreated depression can also lead to problems in a developing fetus. Because of this, most doctors now recommend that if a woman is doing well on an antidepressant, she should continue taking it while pregnant, possibly stopping it temporarily during the third trimester.

The FDA prescribing information for Celexa notes that SSRI use — especially in the third trimester — can lead to an increased risk of:

• Pulmonary hypertension

• Respiratory distress

• Feeding difficulty in an infant

The decision of whether or not to continue taking your medication is one you should make exclusively with the guidance of your primary healthcare provider. They can help you weigh up the benefits and risks.

Check out our guide to Celexa and pregnancy to learn more.

Taking citalopram (or any medication) while breastfeeding can feel like a big decision. Here’s what to keep in mind about Celexa and breastfeeding:

• There are some risks to citalopram breastfeeding. Your baby might be more restless, irritable, and drowsy, and have trouble with feeding and weight gain. 

• But treating depression and anxiety is important. Treatment of depression and anxiety is essential not just for your mental health, but for your physical health as well. Healthcare providers will also point out that maternal depression and anxiety can have repercussions on the physical and mental health of your baby, too.

• Talk to a healthcare provider. You don’t have to (and shouldn’t) make this decision alone. A healthcare provider can go over your medical history and current health needs and help you decide what’s best for you and your child.

To see what anxiety medications or antidepressants may fit your needs and unique situation, start a free mental health assessment.

If you and your provider decide citalopram is vital for your mental health, Hers can offer you affordable, discrete access to this medication.