Last update: July 2, 2015

Citalopram

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Excretion into breast milk is low. Serum levels of infants from treated nursing mothers have been shown to be very low.

Overall, short or long-term harmful effect has not been reported among breastfed infants. Neither negative effect on growth nor psychomotor development has been observed in breastfed infants.

Galactorrhea associated or not to hyperprolactinemia, may appear.

Although it is considered to be safe while breastfeeding, an alternative with lesser excretion into breast milk should be preferred.

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

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.
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Other names

Citalopram is also known as


Citalopram in other languages or writings:

Group

Citalopram belongs to this group or family:

Tradenames

Main tradenames from several countries containing Citalopram in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 80 %
Molecular weight 405 daltons
Protein Binding 80 %
VD 12 l/Kg
Tmax 2 - 4 hours
T1/2 35 hours
M/P ratio 1 - 3 -
Theoretical Dose 0.024 - 0,048 mg/Kg/d
Relative Dose 3,6 - 9,4 %

References

  1. Sriraman NK, Melvin K, Meltzer-Brody S. ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  2. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  3. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  4. Nielsen RE, Damkier P. Pharmacological treatment of unipolar depression during pregnancy and breast-feeding--a clinical overview. Nord J Psychiatry. 2012 Abstract
  5. Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. 2012 Abstract
  6. Hübner-Liebermann B, Hausner H, Wittmann M. Recognizing and treating peripartum depression. Dtsch Arztebl Int. 2012 Abstract Full text (link to original source) Full text (in our servers)
  7. Trenque T, Herlem E, Auriche P, Dramé M. Serotonin reuptake inhibitors and hyperprolactinaemia: a case/non-case study in the French pharmacovigilance database. Drug Saf. 2011 Abstract
  8. Berle JO, Spigset O. Antidepressant Use During Breastfeeding. Curr Womens Health Rev. 2011 Abstract Full text (link to original source) Full text (in our servers)
  9. Patil AS, Kuller JA, Rhee EH. Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv. 2011 Abstract
  10. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011 Abstract
  11. Koch HJ, Zellmer H. Marked mydriasis and neuritis nervi optici associated with galactorrhea following citalopram treatment: a case report and discussion. Case Rep Med. 2011 Abstract Full text (link to original source) Full text (in our servers)
  12. 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. 2010 Abstract
  13. Lanza di Scalea T, Wisner KL. Antidepressant medication use during breastfeeding. Clin Obstet Gynecol. 2009 Abstract Full text (link to original source) Full text (in our servers)
  14. Werremeyer A. Ziprasidone and citalopram use in pregnancy and lactation in a woman with psychotic depression. Am J Psychiatry. 2009 Abstract Full text (link to original source) Full text (in our servers)
  15. Field T. Breastfeeding and antidepressants. Infant Behav Dev. 2008 Abstract Full text (link to original source) Full text (in our servers)
  16. Academy of Breastfeeding Medicine Protocol Committee. ABM clinical protocol #18: use of antidepressants in nursing mothers. Breastfeed Med. 2008 Abstract Full text (link to original source) Full text (in our servers)
  17. Franssen EJ, Meijs V, Ettaher F, Valerio PG, Keessen M, Lameijer W. Citalopram serum and milk levels in mother and infant during lactation. Ther Drug Monit. 2006 Abstract
  18. Wessels-van Middendorp AM, Timmerman L. Galactorroe en het gebruik van selectieve serotonineheropnameremmers. [Galactorrhoea and the use of selective serotonin reuptake inhibitors]. Tijdschr Psychiatr. 2006 Abstract Full text (link to original source) Full text (in our servers)
  19. Wessels-van Middendorp AM, Timmerman L. [Galactorrhoea and the use of selective serotonin reuptake inhibitors]. Tijdschr Psychiatr. 2006 Abstract
  20. Gentile S. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf. 2005 Abstract
  21. Weissman AM, Levy BT, Hartz AJ, Bentler S, Donohue M, Ellingrod VL, Wisner KL. Pooled analysis of antidepressant levels in lactating mothers, breast milk, and nursing infants. Am J Psychiatry. 2004 Abstract Full text (link to original source) Full text (in our servers)
  22. Berle JØ, Steen VM, Aamo TO, Breilid H, Zahlsen K, Spigset O. Breastfeeding during maternal antidepressant treatment with serotonin reuptake inhibitors: infant exposure, clinical symptoms, and cytochrome p450 genotypes. J Clin Psychiatry. 2004 Abstract
  23. Lee A, Woo J, Ito S. Frequency of infant adverse events that are associated with citalopram use during breast-feeding. Am J Obstet Gynecol. 2004 Abstract
  24. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Abstract
  25. Hendrick V, Smith LM, Hwang S, Altshuler LL, Haynes D. Weight gain in breastfed infants of mothers taking antidepressant medications. J Clin Psychiatry. 2003 Abstract
  26. Gjerdingen D. The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J Am Board Fam Pract. 2003 Abstract Full text (link to original source) Full text (in our servers)
  27. Heikkinen T, Ekblad U, Kero P, Ekblad S, Laine K. Citalopram in pregnancy and lactation. Clin Pharmacol Ther. 2002 Abstract
  28. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002 Abstract
  29. Nordeng H, Bergsholm YK, Bøhler E, Spigset O. Overgang av selektive serotoninreopptakshemmere til morsmelk \ [The transfer of selective serotonin reuptake inhibitors to human milk]. Tidsskr Nor Laegeforen. 2001 Abstract Full text (link to original source) Full text (in our servers)
  30. Nordeng H, Lindemann R, Perminov KV, Reikvam A. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001 Abstract
  31. González Pablos E, Mínguez Martín L, Hernández Fernández M, Sanguina Andrés RM. [A clinical case of galactorrhoea after citalopram treatment]. Actas Esp Psiquiatr. 2001 Abstract
  32. Nordeng H, Bergsholm YK, Bøhler E, Spigset O. [The transfer of selective serotonin reuptake inhibitors to human milk]. Tidsskr Nor Laegeforen. 2001 Abstract
  33. Schmidt K, Olesen OV, Jensen PN. Citalopram and breast-feeding: serum concentration and side effects in the infant. Biol Psychiatry. 2000 Abstract
  34. Rampono J, Kristensen JH, Hackett LP, Paech M, Kohan R, Ilett KF. Citalopram and demethylcitalopram in human milk; distribution, excretion and effects in breast fed infants. Br J Clin Pharmacol. 2000 Abstract Full text (link to original source) Full text (in our servers)
  35. Ohman R, Hägg S, Carleborg L, Spigset O. Excretion of paroxetine into breast milk. J Clin Psychiatry. 1999 Abstract
  36. Spigset O, Carieborg L, Ohman R, Norström A. Excretion of citalopram in breast milk. Br J Clin Pharmacol. 1997 Abstract Full text (link to original source) Full text (in our servers)
  37. Jensen PN, Olesen OV, Bertelsen A, Linnet K. Citalopram and desmethylcitalopram concentrations in breast milk and in serum of mother and infant. Ther Drug Monit. 1997 Abstract

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