Sertraline lactation

Serotonin pathways are involved in the regulation of prolactin secretion. Galactorrhea has also been reported in a patient taking sertraline, in whom lactation ceased after withdrawal (SEDA-18, 20) and in another case... 

A 71-year-old woman took sertraline 50 mg/day for depression and 2 months later was found to have markedly increased creatine kinase, lactate dehydrogenase, and aspartate aminotransferase activities and serum myoglobin concentration. These abnormalities resolved within 1 week of sertraline withdrawal, but recurred dramatically 2 weeks after re-introduc-tion of sertraline. Once again, everything resolved after withdrawal of sertraline. She was successfully treated with escitalopram without recurrence of the biochemical disturbances. 

In this preterm infant, the initial clinical impairment was the result of neonatal abstinence syndrome consequent upon sertraline exposure in utero not being maintained at the same level after delivery. As sertraline is not contraindicated diuing lactation, breastfeeding was continued, ultimately resulting in serotonergic overstimulation in this preterm infant. On day 9, the breast milk was substituted with formula due to further clinical impairment. As serum levels of sertraline and desmethylserfraline decreased, the infant s condition improved. 

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