Quetiapine and breast feeding.
OBJECTIVE
To quantify the relative infant dose of quetiapine during breast feeding, describe the milk:plasma (M:P) ratio, and determine the well-being of the exposed infant.


METHODS
A 26-year-old mother and her 3-month-old son were studied over a 24 hour quetiapine dose interval at steady-state. Quetiapine concentrations were quantified by high-performance liquid chromatography. Infant exposure was calculated as the concentration in milk multiplied by an estimated milk production of 0.15 L/kg/day and normalized to the weight-adjusted maternal dose. The average concentration in milk was 41 microg/L, the M:P ratio (measured using average concentrations in the elimination phase) was 0.29, and the relative infant dose was 0.09% of the maternal weight-adjusted dose (7273 microg/kg/day). The infant plasma concentration of 1.4 microg/L was some 6% of the corresponding maternal plasma concentration. No adverse effects were noted in the infant.


CONCLUSIONS
Our findings of an infant exposure to quetiapine of less than 0.1% of the maternal dose and a lack of adverse effects confirm and extend the findings of 2 previous studies.


CONCLUSIONS
Although limited, the data shown here support the prescription of quetiapine to a breast-feeding mother following a careful individual risk/benefit analysis. We suggest regular monitoring of infant progress and occasional measurement of quetiapine in the infant's plasma.
Rampono
Jonathan
J
Department of Psychological Medicine, King Edward Memorial Hospital for Women, Subiaco, Western Australia.
Kristensen
Judith H
JH
Ilett
Kenneth F
KF
Hackett
L Peter
LP
Kohan
Rolland
R
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000032:analysis / Q000097:blood*; D001942:Breast Feeding; D002851:Chromatography, High Pressure Liquid; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000032:analysis / Q000097:blood*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008895:Milk, Human / Q000737:chemistry; D000069348:Quetiapine Fumarate
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate