Is Desipramine Safe in Breastfeeding

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

Milk levels of desipramine and its metabolite are low and have not been detected in the serum of breastfed infants. Immediate side effects have not been reported and a limited amount of follow-up has found no adverse effects on infant growth and development. Desipramine use during breastfeeding would usually not be expected to cause any adverse effects in breastfed infants, especially if the infant is older than 2 months.

One infant whose mother took desipramine 100 mg daily for 8 weeks starting at 16 weeks postpartum was followed up at 36 months of age. No adverse effects on growth and development were found.[4]

Desipramine has caused increased serum prolactin levels in some patients.[5] The clinical relevance of these findings in nursing mothers is not known. The 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.[6] 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.[7] None of the mothers were taking desipramine.