Serum clomipramine and metabolite levels in four nursing mother-infant pairs.
BACKGROUND
Women with postpartum-onset obsessive compulsive disorder may elect treatment with clomipramine. There is minimal information to guide the clinician who must advise breastfeeding women about clomipramine therapy.


METHODS
Four clomipramine-treated breastfeeding mother-infant pairs were assessed for serum concentrations of clomipramine, N-desmethylclomipramine, and corresponding 8-hydroxymetabolites.


RESULTS
Although the mothers exhibited a wide range of serum concentrations, the parent drug and metabolites were either nondetectable or below the quantifiable limit in the sera of all infants. No adverse clinical effects were observed.


CONCLUSIONS
This report adds to the growing literature that suggests that tricyclic use during breastfeeding rarely results in measurable drug levels in infant sera.
Mood Disorders Program, Case Western Reserve University, Cleveland, Ohio 44106.
K L
KL
Wisner
J M
JM
Perel
J P
JP
Foglia
D000328:Adult; D001942:Breast Feeding; D002997:Clomipramine / Q000031:analogs & derivatives / Q000097:blood* / Q000378:metabolism / Q000627:therapeutic use; D005260:Female; D006207:Half-Life; D006801:Humans; D007223:Infant; D007231:Infant, Newborn / Q000097:blood*; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000097:blood* / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000188:drug therapy
C012273:desmethylclomipramine; C053390:8-hydroxyclomipramine; D002997:Clomipramine