Citalopram serum and milk levels in mother and infant during lactation.
We present a case of intensified therapeutic drug monitoring (TDM) of citalopram in mother and newborn infant after clinically observed selective serotonin reuptake inhibitor (SSRI)-associated symptoms 2 weeks until 2 months after delivery. The SSRI-associated symptoms observed in the infant (up to 3 weeks after delivery) were irregular breathing, sleep disorders, hypotonia, and hypertonia. We conclude that the SSRI-associated symptoms in the infant represent citalopram withdrawal effects rather than side effects caused by breastfeeding. This case illustrates the importance of a flexible TDM program and a multidisciplinary approach in a hospital setting to deal with cases of drug-associated adverse effects, such as SSRI withdrawal effects.
Franssen
E J F
EJ
Department of Clinical Pharmacy, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. e.j.f.franssen@olvg.nl
Meijs
V
V
Ettaher
F
F
Valerio
P G
PG
Keessen
M
M
Lameijer
W
W
D000328:Adult; D015283:Citalopram / Q000009:adverse effects* / Q000097:blood / Q000378:metabolism; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007774:Lactation / Q000378:metabolism*; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000097:blood / Q000378:metabolism
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors