Last update: June 17, 2019

Sertraline Hydrochloride

Very Low Risk for breastfeeding


Safe. Compatible.
Not risky for breastfeeding or infant.

Excreted in nil or tiny amounts into breast milk (Weissman 2004, Berle 2004, Stowe 2003). Serum levels of breastfed infants whose mothers are on Sertraline are usually undetectable or very low. No harm effect has been observed on health and short or long term development of infants.

Transient troubles in the early neonatal period like drug withdrawal syndrome among newborn or premature infants with high serum levels as a result of treatment with Sertraline to the mother during pregnancy have been observed.

Sertraline causes fewer problems related to galactorrhea than other antidepressant drugs.

It is probably the safest antidepressant medication while breastfeeding (McAllister 2017).
Several medical societies, experts and expert consensus, consider the use of this medication safe or probably safe during breastfeeding (Hale 2019, Molenaar 2018, Mcallister 2017, Pinheiro 2015, Sriraman 2015, Orsolini 2015, Berle 2011, ABM 2008, Weissman 2004).

Mothers who are treated with antidepressant medicaction are in need of stronger support for a higher risk of early breastfeeding failure.

Alternatives

We do not have alternatives for Sertraline Hydrochloride since it is relatively safe.

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

Sertraline Hydrochloride in other languages or writings:

Group

Sertraline Hydrochloride belongs to this group or family:

Tradenames

Main tradenames from several countries containing Sertraline Hydrochloride in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 100 %
Molecular weight 343 daltons
Protein Binding 98 %
VD 20 l/Kg
Tmax 4,5 - 8,4 hours
T1/2 24 - 26 hours
M/P ratio 0,9 -
Theoretical Dose 0,00002 mg/Kg/d
Relative Dose 0,003 %

References

  1. Leggett C, Costi L, Morrison JL, Clifton VL, Grzeskowiak LE. Antidepressant Use in Late Gestation and Breastfeeding Rates at Discharge from Hospital. J Hum Lact. 2017 Nov;33(4):701-709. Abstract
  2. Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015 Abstract
  3. 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)
  4. Davanzo R, Bua J, Paloni G, Facchina G. Breastfeeding and migraine drugs. Eur J Clin Pharmacol. 2014 Abstract
  5. Nebhinani N. Sertraline-induced galactorrhea: case report and review of cases reported with other SSRIs. Gen Hosp Psychiatry. 2013 Abstract
  6. Müller MJ, Preuß C, Paul T, Streit F, Brandhorst G, Seeliger S. Serotonergic overstimulation in a preterm infant after sertraline intake via breastmilk. Breastfeed Med. 2013 Abstract
  7. 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. 2013 Abstract Full text (link to original source) Full text (in our servers)
  8. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  9. Kelly LE, Poon S, Madadi P, Koren G. Neonatal benzodiazepines exposure during breastfeeding. J Pediatr. 2012 Sep;161(3):448-51. Abstract
  10. Nielsen RE, Damkier P. Pharmacological treatment of unipolar depression during pregnancy and breast-feeding--a clinical overview. Nord J Psychiatry. 2012 Abstract
  11. Gorman JR, Kao K, Chambers CD. Breastfeeding among women exposed to antidepressants during pregnancy. J Hum Lact. 2012 Abstract
  12. 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)
  13. 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
  14. 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)
  15. Patil AS, Kuller JA, Rhee EH. Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv. 2011 Abstract
  16. Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A. Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2011 Abstract
  17. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Abstract Full text (link to original source) Full text (in our servers)
  18. 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
  19. 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)
  20. Field T. Breastfeeding and antidepressants. Infant Behav Dev. 2008 Abstract Full text (link to original source) Full text (in our servers)
  21. 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)
  22. Wisner KL, Hanusa BH, Perel JM, Peindl KS, Piontek CM, Sit DK, Findling RL, Moses-Kolko EL. Postpartum depression: a randomized trial of sertraline versus nortriptyline. J Clin Psychopharmacol. 2006 Abstract
  23. Oberlander TF, Grunau RE, Fitzgerald C, Papsdorf M, Rurak D, Riggs W. Pain reactivity in 2-month-old infants after prenatal and postnatal serotonin reuptake inhibitor medication exposure. Pediatrics. 2005 Abstract
  24. Gentile S. The safety of newer antidepressants in pregnancy and breastfeeding. Drug Saf. 2005 Abstract
  25. 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)
  26. 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
  27. 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
  28. 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
  29. Hostetter AL, Stowe ZN, Cox M, Ritchie JC. A novel system for the determination of antidepressant concentrations in human breast milk. Ther Drug Monit. 2004 Abstract
  30. 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
  31. Epperson CN, Jatlow PI, Czarkowski K, Anderson GM. Maternal fluoxetine treatment in the postpartum period: effects on platelet serotonin and plasma drug levels in breastfeeding mother-infant pairs. Pediatrics. 2003 Abstract Full text (in our servers)
  32. Stowe ZN, Hostetter AL, Owens MJ, Ritchie JC, Sternberg K, Cohen LS, Nemeroff CB. The pharmacokinetics of sertraline excretion into human breast milk: determinants of infant serum concentrations. J Clin Psychiatry. 2003 Abstract
  33. Petit A, Piednoir D, Germain ML, Trenque T. [Drug-induced hyperprolactinemia: a case-non-case study from the national pharmacovigilance database]. Therapie. 2003 Abstract
  34. 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)
  35. Sagud M, Pivac N, Mück-Seler D, Jakovljević M, Mihaljević-Peles A, Korsić M. Effects of sertraline treatment on plasma cortisol, prolactin and thyroid hormones in female depressed patients. Neuropsychobiology. 2002 Abstract
  36. DeVane CL, Liston HL, Markowitz JS. Clinical pharmacokinetics of sertraline. Clin Pharmacokinet. 2002 Abstract
  37. Wisner KL, Parry BL, Piontek CM. Clinical practice. Postpartum depression. N Engl J Med. 2002 Abstract
  38. 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)
  39. Hendrick V, Fukuchi A, Altshuler L, Widawski M, Wertheimer A, Brunhuber MV. Use of sertraline, paroxetine and fluvoxamine by nursing women. Br J Psychiatry. 2001 Abstract Full text (link to original source) Full text (in our servers)
  40. Dodd S, Stocky A, Buist A, Burrows GD, Norman TR. Sertraline analysis in the plasma of breast-fed infants. Aust N Z J Psychiatry. 2001 Abstract
  41. Epperson N, Czarkowski KA, Ward-O'Brien D, Weiss E, Gueorguieva R, Jatlow P, Anderson GM. Maternal sertraline treatment and serotonin transport in breast-feeding mother-infant pairs. Am J Psychiatry. 2001 Abstract Full text (in our servers)
  42. Nordeng H, Bergsholm YK, Bøhler E, Spigset O. [The transfer of selective serotonin reuptake inhibitors to human milk]. Tidsskr Nor Laegeforen. 2001 Abstract
  43. Holland D. An observation of the effect of sertraline on breast milk supply. Aust N Z J Psychiatry. 2000 Abstract
  44. Dodd S, Stocky A, Buist A, Burrows GD, Maguire K, Norman TR. Sertraline in paired blood plasma and breast-milk samples from nursing mothers. Hum Psychopharmacol. 2000 Abstract
  45. Ohman R, Hägg S, Carleborg L, Spigset O. Excretion of paroxetine into breast milk. J Clin Psychiatry. 1999 Abstract
  46. Wisner KL, Perel JM, Blumer J. Serum sertraline and N-desmethylsertraline levels in breast-feeding mother-infant pairs. Am J Psychiatry. 1998 Abstract Full text (in our servers)
  47. Gordon C, Whale R, Cowen PJ. Sertraline treatment does not increase plasma prolactin levels in healthy subjects. Psychopharmacology (Berl). 1998 Abstract
  48. Kristensen JH, Ilett KF, Dusci LJ, Hackett LP, Yapp P, Wojnar-Horton RE, Roberts MJ, Paech M. Distribution and excretion of sertraline and N-desmethylsertraline in human milk. Br J Clin Pharmacol. 1998 Abstract Full text (in our servers)
  49. Mammen OK, Perel JM, Rudolph G, Foglia JP, Wheeler SB. Sertraline and norsertraline levels in three breastfed infants. J Clin Psychiatry. 1997 Abstract
  50. Epperson CN, Anderson GM, McDougle CJ. Sertraline and breast-feeding. N Engl J Med. 1997 Abstract Full text (in our servers)
  51. Stowe ZN, Owens MJ, Landry JC, Kilts CD, Ely T, Llewellyn A, Nemeroff CB. Sertraline and desmethylsertraline in human breast milk and nursing infants. Am J Psychiatry. 1997 Abstract Full text (in our servers)
  52. 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)
  53. Håberg M, Matheson I. [Antidepressive agents and breast feeding]. Tidsskr Nor Laegeforen. 1997 Abstract
  54. Wisner KL, Perel JM, Findling RL. Antidepressant treatment during breast-feeding. Am J Psychiatry. 1996 Sep;153(9):1132-7. Review. Abstract
  55. Lesaca TG. Sertraline and galactorrhea. J Clin Psychopharmacol. 1996 Abstract
  56. Altshuler LL, Burt VK, McMullen M, Hendrick V. Breastfeeding and sertraline: a 24-hour analysis. J Clin Psychiatry. 1995 Abstract

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