Is Escitalopram compatible with breastfeeding? Do we have alternatives for Escitalopram?

Escitalopram

July 2, 2015 (Very Low Risk)

S-Enantiomer of Citalopram that shares similar pharmacokinetics and properties with Citalopram.

Excretion into breast milk is clinically non-significant. Serum levels of infants from breastfeeding mothers who were treated have been shown to be undetectable or very low.

Overall, short or long-term harmful effect has not been reported among breastfed infants. Isolated cases of irritability and neonatal necrotizing enterocolitis after intrauterine exposure have appeared in medical literature contrasting with harmlessness reported by others.

Galactorrhea associated or not to hyperprolactinemia, may appear.

Women who are on antidepressant treatment in pregnancy are in need of special and intensive support for breastfeeding because of a high risk of early weaning.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Escitalopram Oxalate

Writings

  • Эсциталопрама Оксалат (Cyrillic)
  • エスシタロプラムシュウ (Japanese)

Drug trade names

References

  1. Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015Abstract Full text (link to original source) Full text (in our servers)
  2. Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015Abstract
  3. Neuman G, Colantonio D, Delaney S, Szynkaruk M, Ito S. Bupropion and Escitalopram During Lactation. Ann Pharmacother. 2014Abstract
  4. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014Abstract
  5. Nebhinani N. Sertraline-induced galactorrhea: case report and review of cases reported with other SSRIs. Gen Hosp Psychiatry. 2013Abstract
  6. Kim S, Park YM. Serum prolactin and macroprolactin levels among outpatients with major depressive disorder following the administration of selective serotonin-reuptake inhibitors: a cross-sectional pilot study. PLoS One. 2013Abstract Full text (link to original source) Full text (in our servers)
  7. Bellantuono C, Orsolini L, Bozzi F. [The safety profile of escitalopram in pregnancy and breastfeeding]. Riv Psichiatr. 2013Abstract
  8. Bellantuono C, Bozzi F, Orsolini L. Safety of escitalopram in pregnancy: a case series. Neuropsychiatr Dis Treat. 2013Abstract Full text (link to original source) Full text (in our servers)
  9. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. 2013Abstract
  10. Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. 2012Abstract
  11. Bellantuono C, Bozzi F, Orsolini L, Catena-Dell'Osso M. The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review. Hum Psychopharmacol. 2012Abstract
  12. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011Abstract
  13. Patil AS, Kuller JA, Rhee EH. Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv. 2011Abstract
  14. Berle JO, Spigset O. Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011Abstract Full text (link to original source) Full text (in our servers)
  15. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011Abstract Full text (link to original source) Full text (in our servers)
  16. Hale TW, Kendall-Tackett K, Cong Z, Votta R, McCurdy F. Discontinuation syndrome in newborns whose mothers took antidepressants while pregnant or breastfeeding. Breastfeed Med. 2010Abstract
  17. Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009Abstract Full text (link to original source) Full text (in our servers)
  18. Shim SH, Lee YJ, Lee EC. A case of galactorrhea associated with excitalopram. Psychiatry Investig. 2009Abstract Full text (link to original source) Full text (in our servers)
  19. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #18: use of antidepressants in nursing mothers. Breastfeed Med. 2008Abstract Full text (link to original source) Full text (in our servers)
  20. Potts AL, Young KL, Carter BS, Shenai JP. Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram. J Perinatol. 2007Abstract Full text (link to original source) Full text (in our servers)
  21. Gulsun M, Algul A, Semiz UB, Ates MA, Doruk A, Ebrinc S, Basoglu C, Cetin M. A case with euprolactinemic galactorrhea induced by escitalopram. Int J Psychiatry Med. 2007Abstract
  22. Hackett LP, Ilett KF, Rampono J, Kristensen JH, Kohan R. Transfer of reboxetine into breastmilk, its plasma concentrations and lack of adverse effects in the breastfed infant. Eur J Clin Pharmacol. 2006Abstract
  23. Gentile S. Escitalopram late in pregnancy and while breast-feeding. Ann Pharmacother. 2006Abstract
  24. Rampono J, Hackett LP, Kristensen JH, Kohan R, Page-Sharp M, Ilett KF. Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk. Br J Clin Pharmacol. 2006Abstract Full text (link to original source) Full text (in our servers)
  25. Castberg I, Spigset O. Excretion of escitalopram in breast milk. J Clin Psychopharmacol. 2006Abstract
  26. Gentile S. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf. 2005Abstract