Perinatal psychiatry: antidepressants in lactation: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Perinatal psychiatry: antidepressants in lactation

Sample item

A breastfeeding mother needs an antidepressant for postpartum depression. Which drug is generally preferred because of low infant exposure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Sertraline

Sertraline passes into milk in very small amounts and is usually the first choice during lactation, with paroxetine also acceptable. Fluoxetine accumulates because of its long half-life, doxepin has been linked to infant sedation, and lithium needs careful infant monitoring.

Option by option

  • A. Doxepin

    Doxepin is associated with infant sedation and respiratory depression.

  • B. Sertraline (correct)

    Correct. Sertraline has low infant exposure.

  • C. Lithium

    Lithium is excreted in significant amounts in milk and needs monitoring.

  • D. Fluoxetine

    Fluoxetine has higher infant levels due to a long half-life.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Sertraline. Sertraline passes into milk in very small amounts and is usually the first choice during lactation, with paroxetine also acceptable.

Why is "Doxepin" not the answer?

Doxepin is associated with infant sedation and respiratory depression.

Why is "Lithium" not the answer?

Lithium is excreted in significant amounts in milk and needs monitoring.

Why is "Fluoxetine" not the answer?

Fluoxetine has higher infant levels due to a long half-life.

What concept does this question test?

It tests Perinatal psychiatry: antidepressants in lactation in Psychiatry. Fluoxetine accumulates because of its long half-life, doxepin has been linked to infant sedation, and lithium needs careful infant monitoring.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perinatal psychiatry: antidepressants in lactation?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.