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Duloxetine transfer across the placenta during pregnancy and into milk during lactation.
MedLine Citation:
PMID:  21359876     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: Duloxetine is an efficacious antidepressant; however, its safety during the perinatal period is uncertain. The objective of this study was to assess the transfer across the placenta and provide data on infant exposure to duloxetine via breast milk. METHODS: A multiparous 31-year-old woman with recurrent melancholic depression had responded poorly to previous antidepressants, but had a full remission on duloxetine. She elected to remain on duloxetine for her third pregnancy and while breastfeeding. She gave birth to a healthy term infant and there were no adverse events noted for the infant exposed to duloxetine. Duloxetine concentration was measured chromatographically in maternal and infant serum collected at birth, and in maternal milk and plasma and infant plasma 18 days later, (C/M) concentration ratio was calculated. Absolute and relative infant doses via milk were estimated and the percent drug in infant versus mother's plasma was calculated. RESULTS: Cord/maternal serum concentration ratio for duloxetine was 0.12. Absolute infant dose via milk was 7.6 μg/L and relative infant dose was 0.81%. The ratio of drug in the infant's plasma to that in maternal plasma during lactation also gave a 0.82% infant exposure estimate. CONCLUSIONS: The low C/M ratio suggests a limited transfer across the placenta. The relative infant dose via milk was low by comparison to most other antidepressants, and this estimate confirmed the amount of drug in infant plasma during lactation. Our data suggest that duloxetine may be used in pregnancy and lactation for selected patients in whom other antidepressants have not been successful.
Authors:
Philip M Boyce; L Peter Hackett; Kenneth F Ilett
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-27
Journal Detail:
Title:  Archives of women's mental health     Volume:  -     ISSN:  1435-1102     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815663     Medline TA:  Arch Womens Ment Health     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Discipline of Psychiatry, Western Clinical School, Sydney Medical School, The University of Sydney, Westmead Hospital, PO Box 553, Wentworthville, NSW, Australia, philip.boyce@sydney.edu.au.
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