Which antidepressant can cause seizures in breastfeeding neonates?

Bupropion is known to potentially cause seizures in breastfeeding neonates due to its mechanism of action and pharmacokinetic properties. This medication is a norepinephrine-dopamine reuptake inhibitor (NDRI) that has a lower seizure threshold compared to many other antidepressants. In rare cases, when the mother is breastfeeding, bupropion can be passed to the infant through breast milk. Although the occurrence of seizures in neonates from bupropion exposure is not common, it is a recognized risk, which makes it necessary for healthcare providers to caution against its use in breastfeeding mothers when considering the safety profile for the infant.

In contrast, the other options listed—citalopram, escitalopram, and sertraline—are selective serotonin reuptake inhibitors (SSRIs) that have a different side effect profile and are generally considered safer for use during breastfeeding. While these drugs do pass into breast milk, they do not have the same association with seizures in neonates as bupropion does.