Is Surmontil Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Surmontil? Is Surmontil safe for nursing mother and child? Does Surmontil extracts into breast milk? Does Surmontil has any long term or short term side effects on infants? Can Surmontil influence milk supply or can Surmontil decrease milk supply in lactating mothers?

We are working on a comment for this product.

If Surmontil is required by the mother, it is not a reason to discontinue breastfeeding. Because of the lack of data on use during breastfeeding, other antidepressants are preferred during breastfeeding, especially while nursing a newborn or preterm infant.

Published information on Surmontil was not found as of the revision date. Follow-up for 1 to 3 years in a group of 20 breastfed infants whose mothers were taking a tricyclic antidepressant found no adverse effects on growth and development.[1] Two small controlled studies indicate that other tricyclic antidepressants have no adverse effect on infant development.[2][3] In another study, 25 infants whose mothers took a tricyclic antidepressant during pregnancy and lactation were tested formally between 15 to 71 months and found to have normal growth and development.[4] However, none of the mothers in any of these studies took Surmontil.

Surmontil increases serum prolactin levels[5] and has caused at least one case of galactorrhea.[6] The maternal prolactin level in a mother with established lactation may not affect her ability to breastfeed. An observational study looked at outcomes of 2859 women who took an antidepressant during the 2 years prior to pregnancy. Compared to women who did not take an antidepressant during pregnancy, mothers who took an antidepressant during all 3 trimesters of pregnancy were 37% less likely to be breastfeeding upon hospital discharge. Mothers who took an antidepressant only during the third trimester were 75% less likely to be breastfeeding at discharge. Those who took an antidepressant only during the first and second trimesters did not have a reduced likelihood of breastfeeding at discharge.[7] The antidepressants used by the mothers were not specified. A retrospective cohort study of hospital electronic medical records from 2001 to 2008 compared women who had been dispensed an antidepressant during late gestation (n = 575) to those who had a psychiatric illness but did not receive an antidepressant (n = 1552) and mothers who did not have a psychiatric diagnosis (n = 30,535). Women who received an antidepressant were 37% less likely to be breastfeeding at discharge than women without a psychiatric diagnosis, but no less likely to be breastfeeding than untreated mothers with a psychiatric diagnosis.[8] None of the mothers were taking Surmontil.