Nursing moms face meds dilemma

A woman who develops major depression or any other mental disorder after giving birth faces a tough decision. If she takes psychoactive medication while continuing to breast-feed, she stands a good chance of feeling better, but she also exposes her baby to potentially harmful amounts of the drug.

Unfortunately, there is a dearth of data to help guide her decision. To date, studies of nursing women who used psychoactive drugs have yielded no clear treatment guidelines, according to a report in the July American Journal of Psychiatry.

Psychiatrist Vivien K. Burt of the University of California, Los Angeles Medical School and her colleagues analyzed 95 individual and multiple case reports covering 32 psychoactive medications used by nursing mothers. The researchers found no study in which exposed infants were compared to similar babies not exposed to the drugs.

The scientists, however, culled some trends from the analysis. For example, fluoxetine (Prozac) and related antidepressants appear to be largely safe for nursing infants. However, babies exposed to lithium–a treatment for manic depression–or to antipsychotic drugs require monitoring for potentially serious physical responses, Burt’s team says. Anxiety in nursing mothers should first be treated with psychological methods, such as relaxation training, the group recommends.

The lack of treatment guidelines in these cases demands that parents, pediatricians, and psychiatrists work together to care for each nursing mother’s mental maladies, says Burt.