From the Guidelines
Yes, Lexapro (escitalopram) is present in breast milk, but it is generally considered compatible with breastfeeding. The amount that passes into breast milk is relatively small, with infants typically receiving less than 10% of the maternal weight-adjusted dose 1. Most experts and clinical guidelines consider Lexapro one of the preferred antidepressants for nursing mothers when treatment is necessary.
Key Points to Consider
- Mothers taking Lexapro can continue to breastfeed, though they should monitor their infants for unusual sleepiness, feeding difficulties, or irritability.
- The benefits of treating maternal depression often outweigh the minimal risks to the breastfed infant.
- Lexapro works by increasing serotonin levels in the brain, and its relatively short half-life and low protein binding contribute to its favorable safety profile during lactation.
- If you're breastfeeding and need antidepressant treatment, discuss with your healthcare provider as individual circumstances may vary.
Comparison with Other Antidepressants
- Other antidepressants, such as fluoxetine (Prozac) and venlafaxine, produce higher infant plasma concentrations compared to Lexapro 1.
- Potential adverse effects in infants exposed to SSRIs via breast milk have been documented only in case reports and are recorded more often after exposure to fluoxetine and citalopram (Celexa) than other drugs.
- There is little evidence to support any causal link between antidepressant use in breastfeeding mothers and adverse effects in infants 1.
From the FDA Drug Label
Escitalopram is excreted in human breast milk. Limited data from women taking 10-20 mg escitalopram showed that exclusively breast-fed infants receive approximately 3.9% of the maternal weight-adjusted dose of escitalopram and 1. 7% of the maternal weight-adjusted dose of desmethylcitalopram Data from the published literature report the presence of escitalopram and desmethylescitalopram in human milk
Yes, escitalopram (Lexapro) is present in breast milk.
- The amount of escitalopram in breast milk is approximately 3.9% of the maternal weight-adjusted dose.
- Infants exposed to escitalopram through breast milk should be monitored for excess sedation, restlessness, agitation, poor feeding, and poor weight gain 2.
From the Research
Presence of Escitalopram in Breast Milk
- There are no direct studies provided that investigate the presence of escitalopram in breast milk.
- However, the pharmacokinetic properties of escitalopram, such as its low protein binding (56%) and wide distribution throughout tissues 3, may suggest that it could be present in breast milk.
- The study on antidepressant-induced hyperprolactinaemia mentions that prolactin is responsible for milk production during lactation, but it does not specifically address the presence of escitalopram in breast milk 4.
- Further research would be needed to determine the presence and levels of escitalopram in breast milk, as the provided studies focus on its pharmacokinetics, efficacy, and safety in treating depression and anxiety disorders 5, 3, 6, 7.