You often get good response at very low doses. Please comment on the role of SSRIs in seasonal affective disorder. That's what I pick as first-line and try to treat the disorder with that. You often find that patients are depressed in the fall and winter months, and get a little hypomanic during the summer months. Some people have used mood stabilizers in seasonal affective disorder because it sometimes looks like a cycling disorder.
Light therapy is also a good alternative.
There's not a lot of treatment trials with seasonal affective disorder. Right now, the best information I have about breastfeeding and medications is that all of the drugs get to the breast milk and will get to the infant. If you do a literature search, you'll see conflicting reports that nortriptyline isn't found at all, or clomipramine was not found at all. And then you'll see another study where they found a lot of nortriptyline or whatever. The problem with doing studies with breastfeeding is that most of the drug is found in the hind milk, which means it's the milk that comes down from the breast behind in the fat cells.