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首页> 外文期刊>The journal of clinical psychiatry >Breastfeeding During Maternal Antidepressant Treatment With Serotonin Reuptake Inhibitors: Infant Exposure, Clinical Symptoms, and Cytochrome P450 Genotypes.
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Breastfeeding During Maternal Antidepressant Treatment With Serotonin Reuptake Inhibitors: Infant Exposure, Clinical Symptoms, and Cytochrome P450 Genotypes.

机译：用5-羟色胺再摄取抑制剂进行母体抗抑郁治疗期间的母乳喂养：婴儿暴露，临床症状和细胞色素P450基因型。

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BACKGROUND: The aims of the study were to quantify the drug exposure in breastfed infants of antidepressant-treated mothers, to identify possible adverse events, and to correlate these variables to maternal and infant drug metabolism-relevant genotypes and milk triglyceride content. METHOD: The study included 25 lactating women treated with citalopram (N = 9), sertraline (N = 6), paroxetine (N = 6), fluoxetine (N = 1), or venlafaxine (N = 3) and their 26 breastfed infants. Drug concentrations in maternal and infant serum and milk were analyzed using liquid chromotography mass spectrometry methods; milk triglyceride levels were measured with a commercial kit. Cytochrome P450 (CYP) 2D6 and CYP2C19 activity was determined by polymerase chain reaction-based genotyping of the mothers and infants. An infant adverse event questionnaire was completed by the medication-treated mothers as well as by a control group of medication-free breastfeeding mothers of 68 infants. RESULTS: Sertraline and paroxetine were not detected in any of the drug-exposed infants. The infant serum level of citalopram was either undetectable (N = 4) or low (N = 6). All venlafaxine-exposed infants had measurable drug concentrations. We identified a paroxetine-treated mother and her infant who were both CYP2D6 poor metabolizers, as well as a citalopram-treated mother with CYP2C19 poor metabolizer status, but the serum drug levels of their infants were still either undetectable (paroxetine) or low (citalopram). There was no evidence of adverse events in the drug-exposed infants. CONCLUSION: Serum drug levels in breastfed infants of antidepressant-treated mothers were undetectable or low. This study adds further evidence to previously published data indicating that breastfeeding should not be generally discouraged in women using serotonin reuptake inhibitor anti-depressants.
机译：背景：这项研究的目的是量化抗抑郁药物治疗的母亲的母乳喂养婴儿的药物暴露，确定可能的不良事件，并将这些变量与母婴药物代谢相关的基因型和甘油三酸酯含量相关联。方法：该研究包括接受西酞普兰（N = 9），舍曲林（N = 6），帕罗西汀（N = 6），氟西汀（N = 1）或文拉法辛（N = 3）治疗的25名泌乳妇女及其26名母乳喂养婴儿。 。使用液相色谱质谱法分析母婴血清和乳汁中的药物浓度;用商业试剂盒测量牛奶中甘油三酸酯的水平。细胞色素P450（CYP）2D6和CYP2C19活性是通过基于聚合酶链反应的母亲和婴儿的基因分型来确定的。接受药物治疗的母亲以及对照组的68名无药物母乳喂养母亲均完成了婴儿不良事件调查表。结果：在任何接触药物的婴儿中均未检出舍曲林和帕罗西汀。婴儿西酞普兰的血清水平不可检测（N = 4）或较低（N = 6）。所有文拉法辛接触的婴儿均具有可测量的药物浓度。我们确定了一名帕罗西汀治疗的母亲和她的婴儿都是CYP2D6弱代谢者，以及一个经西酞普兰治疗的母亲具有CYP2C19弱代谢者状态，但是他们婴儿的血清药物水平仍然无法检测到（帕罗西汀）或低（西酞普兰） ）。没有证据表明接触药物的婴儿有不良事件。结论：接受抗抑郁药治疗的母亲的母乳喂养婴儿的血清药物水平无法检测或较低。这项研究为以前发表的数据提供了进一步的证据，表明使用5-羟色胺再摄取抑制剂抗抑郁药的妇女一般不建议母乳喂养。

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