Sertraline and desmethylsertraline in human breast milk and nursing infants.
Sertraline and desmethylsertraline in human breast milk and nursing infants.
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人母乳和哺乳婴儿中的舍曲林和去甲基舍曲林。
DOI：
10.1176/ajp.154.9.1255
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
Nemeroff,CB
中科院分区：
文献类型：
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作者：
Stowe,ZN;Owens,MJ;Landry,JC;Kilts,CD;Ely,T;Llewellyn,A;Nemeroff,CB
目的测定人母乳和婴儿血清中舍曲林和去甲基舍曲林的浓度。方法对12例妇女口服舍曲林（25 ~ 200 mg，每日1次）后，按一定时间间隔采集母乳样本。采用高效液相色谱法测定了11对母婴在给药后24小时的血清水平和母乳喂养后2-4小时的血清水平。结果所有母乳样品中均含有舍曲林和去甲基舍曲林，且呈由“前”乳到“后”乳的梯度。舍曲林的最高浓度出现在母体给药后7-10小时的后乳中。增加母亲服用舍曲林的剂量导致母乳中舍曲林和去甲基舍曲林浓度增加。在三名哺乳婴儿中发现可检测浓度的舍曲林，在六名婴儿中发现去甲基舍曲林。在任何婴儿中未观察到暴露的不良反应。结论服用舍曲林的哺乳期妇女母乳中存在舍曲林和去甲基舍曲林。浓度受母乳取样的比例、母体给药后的时间和母体每日给药剂量的影响。检测到的婴儿血清浓度低于大多数商业实验室的检测限。六个婴儿样本中去甲基舍曲林的存在强调了代谢物监测在确定婴儿暴露中的重要性。在母体血清稳定状态下，对一个完整乳房的舍曲林和去甲基舍曲林浓度进行分析后，可以确定婴儿每日暴露量的估计。未来对母乳和婴儿血清样本的研究应该解决这些问题。
ObjectiveThe purpose of this study was to determine the concentrations of sertraline and desmethylsertraline in both human breast milk and infant serum.MethodBreast milk samples from 12 women were collected at specific time intervals after oral doses of sertraline (25–200 mg once daily). For 11 mother-infant pairs, maternal serum levels 24 hours after a dose and their infants’ serum levels 2–4 hours after nursing were ascertained by high-performance liquid chromatography.ResultsSertraline and desmethylsertraline were present in all breast milk samples, with a gradient from “fore” milk to “hind” milk. The highest concentrations of sertraline were observed in hind milk 7–10 hours after maternal dose. Increasing the maternal dose of sertraline resulted in increased breast milk concentrations of both sertraline and desmethylsertraline. Detectable concentrations of sertraline were found in three nursing infants and desmethylsertraline in six. No adverse effects of exposure were observed in any infant.ConclusionsSertraline and desmethylsertraline were present in the breast milk of nursing women treated with sertraline. Concentrations were affected by aliquot of milk sampled, time after maternal dose, and maternal daily dose. The infants’ serum concentrations detected were below the detection limit of most commercial laboratories. The presence of desmethylsertraline in six infants’ samples underscores the importance of metabolite monitoring in determining infant exposure. Estimates of daily infant exposure can be determined after analysis of sertraline and desmethylsertraline concentrations from one full breast at maternal serum steady state. Future studies of breast milk and infant serum samples should address these issues.