Can You Take Celexa While Breastfeeding?

Breastfeeding can be a fantastic way to bond with your infant while giving them wonderful health benefits for years to come. But if you’re using antidepressants like Celexa® (citalopram), you might have reason to pause before breastfeeding.

That’s because use of antidepressants by breastfeeding mothers may increase the risks of certain problems in infants. So what about Celexa and breastfeeding — is the story the same?

Maybe you’ve taken Celexa all your life and through pregnancy, or perhaps looking at this antidepressant medication for the first time. In any case, it’s understandable to want to eliminate all uncertainty about any potential risks before exposing your infant.

Keep reading for a closer look at the data on Celexa and breastfeeding, along with guidance on making the right choice for both you and your baby.

For some new moms, Celexa might provide mental health support crucial to the ability to function and perform necessary daily tasks — baby-feeding included.

If it feels like being caught between a rock and a hard place, we can understand why. We’re here to help you feel a little more in the know about your risk and benefit potential of nursing while taking citalopram.

The best way to help you is to start with the seemingly straightforward question of whether you can take Celexa while breastfeeding — let’s start there.

Celexa is a selective serotonin reuptake inhibitor (or SSRI). This type of medication is designed to help manage the symptoms of mood disorders, psychiatric disorders, and other mental health issues.

How do they do this? Scientists believe SSRIs alter the brain’s serotonin activity.

These medications essentially work to reduce depression symptoms by preventing the reuptake of serotonin. They keep your brain from reabsorbing serotonin, so it remains active longer.

Celexa (and generic citalopram) can treat a variety of anxiety disorders and several depressive disorders.

Examples of other SSRIs include:

• Escitalopram (Lexapro®)

• Fluoxetine (Prozac®)

• Paroxetine (Paxil®)

• Sertraline (Zoloft®)

Normally, Celexa and other SSRIs have relatively few serious side effects. That’s why, over the last couple of decades, they’ve become the go-to class of antidepressant medication for many healthcare providers.

SSRIs are among the safest options when compared with other antidepressant medications. They tend to have fewer side effects than tricyclic antidepressants (TCAs).

If you’re, say, a mom with postpartum depression, you might be a perfect candidate for this medication. Talk to your healthcare provider to learn more.

But there’s a caveat in all of this: the risk associated with citalopram and breastfeeding.

Though Celexa is generally considered safe for adults when taken as directed, it can pose some risks for infants. And there’s some concern that it can be transmitted to them through breast milk.

When healthcare providers first prescribe antidepressants to patients, they typically warn of the potential for an allergic reaction and common side effects. If you’re pregnant or breastfeeding, your provider can go over the safety profile of your medication with you.

Of course, if you’ve been on the medication for years, you may not have been pregnant or even planning to get pregnant when you started taking Celexa. In that case, your provider might not have gone over the risks of taking antidepressants during pregnancy — or how a maternal dose of an antidepressant may cause adverse outcomes.

The U.S. Food and Drug Administration (FDA) prescribing information for Celexa notes that SSRI use — especially in the third trimester — can lead to an increased risk of pulmonary hypertension, respiratory distress, and feeding difficulty in an infant.

That’s why it’s important for pregnant people to discuss the risks associated with SSRI use during pregnancy with their healthcare provider.

And then there’s the postpartum risk. What risks does Celexa pose to an infant when delivered through breast milk? Well, that depends on the infant, the dosage, and some other factors.

Celexa Excretion in Breast Milk

As mentioned, Celexa — and many other medications, for that matter — can be passed (excreted) into human breast milk, albeit at low levels. In some situations, it may also be passed to a breastfeeding infant.

For instance, a 2024 study looked at the excretion of three different SSRIs (citalopram, paroxetine, and sertraline) into the breast milk of 37 women. It found detectable levels of the SSRIs in all breast milk samples.

The researchers also explored something called the milk-to-plasma (M/P) ratio, which measures how much SSRI is in the blood versus in breast milk. For citalopram and sertraline, they found that the M/P ratio was above one, meaning the concentration of the antidepressant was higher in the breast milk than in the blood.

However, the researchers also noted that most of the breastfed infants didn’t have detectable levels of any of the SSRIs in their blood. This included nine out of 13 infants whose mothers were taking citalopram.

Other Potential Risks of Breastfeeding While on Celexa

The good news, in general, is that there’s not a blanket “drop this medication immediately” recommendation from the FDA. The bad news is that there are risks associated with breastfeeding while on Celexa.

Those risks may include physical and mental side effects for a newborn. The potential side effects for nursing infants exposed to Celexa include:

• Poor feeding

• Colic

• Drowsiness

• Irritability

• Restlessness

LactMed (a database focused on drug safety during breastfeeding) notes additional side effects associated with citalopram during breastfeeding. These include an increased risk of weight loss or uneasy sleep.

Case Studies and Research on Celexa and Breastfeeding

Case studies have also documented additional side effects associated with citalopram use during breastfeeding. For example, one of these case reports mentioned teeth grinding during sleep in an infant that resolved after the nursing mother stopped taking citalopram.

There aren’t any long-term studies examining the impact of infant exposure to SSRIs and problems later in life, unfortunately. But at least with regard to the short-term effects, we can tell you there’s evidence of recovery.

LactMed also cites older studies that found that nursing infants exposed to citalopram gained weight normally. The database references another study finding in which uneasy sleep was reversible with a reduction in citalopram dose.

Overall, few serious side effects in breastfeeding infants exposed to Celexa have been reported. On the other hand, you may not want to risk that your infant might be more fussy, difficult to feed, sleepy, or struggling with weight gain.

Maybe, but we don’t have much data. One small older study found that nursing mothers taking an SSRI were more likely to experience delays in breast milk production after giving birth.

Additionally, a 2022 study found that pregnant women using an antidepressant in the third trimester were less likely to start breastfeeding compared to pregnant women not taking an antidepressant for a mental health disorder.

This doesn’t mean the medication affected lactation — it could just be that the women wanted to stay on their medication and didn’t want to risk transferring some of the drug to their babies.

The same study found that nursing mothers who started or restarted antidepressants after delivery were less likely to still be breastfeeding after six months and were also more likely to abruptly stop breastfeeding.

The short answer is: Seek medical advice from your healthcare provider. We can’t emphasize it enough. The choice of whether to stop taking Celexa while breastfeeding or (stop breastfeeding while taking Celexa) is personal.

If you’ve just found out you’re pregnant, know that Celexa carries a category C rating with the FDA. This means that while there are no definitive human trials showing that Celexa may be harmful to an infant, there were adverse effects in fetuses in animal trials. Untreated depression can also lead to problems in a developing fetus, so most doctors now recommend that if a woman is doing well on an antidepressant, she should continue taking it while pregnant, possibly stopping it temporarily during the third trimester.

The decision to continue taking your medication or not is one you should make exclusively with the guidance of your primary healthcare provider.

Weighing the Benefits With Potential Risks of Celexa and Breastfeeding

When it comes to antidepressant drugs and breastfeeding, there’s no one right answer. As much as risks might matter, context should be considered. In this case, the context is whether psychotropic medications in human milk or untreated depression present greater risks in the postpartum period.

Switching to a different SSRI might be an option. A 2022 review noted that there’s more data supporting the safety of paroxetine and sertraline during lactation.

Not all breastfeeding women may be able to switch to a different antidepressant, but it’s certainly a conversation worth having with your healthcare provider.

Safely Tapering Off Celexa While Breastfeeding

If you decide to stop taking Celexa while breastfeeding, dumping your pills and going cold turkey isn’t recommended — there are numerous risks associated with that. When you stop treatment for depression, those depression symptoms can return.

What’s more, Celexa (like many SSRIs) can cause withdrawal symptoms if suddenly discontinued — and that alone could cause potentially serious side effects.

When you go off of an antidepressant, a healthcare provider will usually want you to do so gradually to reduce your risk of discontinuation syndrome.

That might mean lowering your daily dose over time or quitting with some supervision to make sure the side effects aren’t too severe.

Most psychiatry experts don’t advise stopping a medication that’s necessary for your basic function while breastfeeding. And many caution against changing medications during this time. But again, ask your provider.

Here’s what to keep in mind about Celexa and breastfeeding:

• If you have a depressive disorder, treatment of depression is essential not just for your mental health but also for your physical health as well.

• Healthcare providers will also point out that maternal depression can have repercussions on the physical and mental health of a baby too.

• But that’s the key — talking to your healthcare provider about Celexa and breastfeeding (or any other medication). They know your medical history and current health needs and can help you decide what’s best for you and your child.

• The reality is, even with the data we’ve shared, your best course of action for your mental health and your baby’s health isn’t so clear. Rather than navigating this alone, talk with your medical provider about Celexa and breastfeeding.

To see what anxiety medications or antidepressants may fit your needs and unique situation, start a free mental health assessment.

If you and your provider decide citalopram is vital for your mental health, Hers can offer you affordable, discrete access to this medication.