Breastfeeding and Psychotropics: What You Need to Know

When you're breastfeeding and need medication for depression, anxiety, or psychosis, the question isn't just can I take it—it's which one and how. Psychotropic medications, a category of drugs that affect brain function, mood, or behavior. Also known as mental health medications, these include SSRIs, SNRIs, antipsychotics, and mood stabilizers. Many mothers worry these drugs will harm their baby, but the truth is more nuanced. Most psychotropics do pass into breast milk, but often in tiny amounts that don’t cause harm. The real risk comes from stopping your meds, not from taking them.

Antidepressants, like sertraline and paroxetine, are the most studied in breastfeeding. Also known as SSRIs, they’re often the first choice because they show up in milk at low levels and rarely cause side effects in infants. Studies show babies exposed to sertraline through breast milk usually have no detectable levels in their blood. On the other hand, antipsychotics, such as risperidone or quetiapine, require more caution. Also known as neuroleptics, they can cause drowsiness or feeding issues in newborns, especially at high doses. The key isn’t avoiding all meds—it’s picking the safest one for your situation. Your doctor can match your condition with a drug that’s low-risk for your baby.

What about mood stabilizers like lithium or valproate? Lithium can build up in breast milk and affect baby’s thyroid or kidneys, so it’s usually avoided unless no other option exists. Valproate carries a higher risk of liver damage in infants and is generally not recommended. But here’s the thing: untreated depression or bipolar disorder can be just as dangerous for you and your baby as any medication. A mother who’s too sick to bond, feed, or care for her child isn’t helping anyone.

Some moms wonder if pumping and dumping helps. It rarely does. Most psychotropics have long half-lives, meaning they stay in your system for hours. Dumping won’t remove them faster. Timing your dose right after nursing can lower the baby’s exposure, but the best move is always working with your doctor to choose a drug with the best safety profile.

You’ll find real-world examples below—how moms managed depression with sertraline, what happened when someone switched from fluoxetine to escitalopram, and why some antipsychotics are safer than others during nursing. These aren’t theory pieces. They’re stories from real people who made choices, tracked outcomes, and lived to tell the tale. Whether you’re just starting meds or adjusting your current plan, this collection gives you the facts you need to feel confident—not scared—about taking care of yourself while caring for your baby.