Clomipramine concentration and withdrawal symptoms in 10 neonates

British Journal of Clinical Pharmacology

Volumn 73, Issue 2, 2012, Pages 295-302

  ter Horst, Peter G J ^a,b   van der Linde, Susanne ^a   Smit, Jan Pieter ^b   den Boon, Jan ^b   van Lingen, Richard A ^b   Jansman, Frank G A ^c   de Jong van den Berg, Lolkje T W ^a   Wilffert, Bob ^a  

^a UNIVERSITY OF GRONINGEN   (Netherlands)

^b ISALA HOSPITAL   (Netherlands)

^c DEVENTER HOSPITAL   (Netherlands)

Author keywords

Clomipramine; Neonatal abstinence syndrome; Newborn; Pharmacokinetics

Indexed keywords

CLOMIPRAMINE; NORCLOMIPRAMINE;

ARTICLE; BODY TEMPERATURE DISORDER; BREATHING RATE; CESAREAN SECTION; CLINICAL ARTICLE; CYANOSIS; DRUG BLOOD LEVEL; DRUG ELIMINATION; DRUG HALF LIFE; FEEDING DISORDER; FEMALE; HUMAN; HUMAN TISSUE; HYPERREFLEXIA; LIMIT OF QUANTITATION; MALE; MUSCLE HYPERTONIA; NEWBORN; OBSERVATIONAL STUDY; PREECLAMPSIA; PREGNANCY COMPLICATION; PREGNANCY DIABETES MELLITUS; PRENATAL DRUG EXPOSURE; PRIORITY JOURNAL; PUERPERIUM; RESTLESSNESS; SLEEP DISORDER; SLEEP TIME; SNEEZING; TACHYCARDIA; TREMOR; WITHDRAWAL SYNDROME;

ADULT; ANTIDEPRESSIVE AGENTS, TRICYCLIC; CLOMIPRAMINE; DEPRESSIVE DISORDER; FEMALE; HALF-LIFE; HUMANS; INFANT, NEWBORN; MALE; MATERNAL-FETAL EXCHANGE; NETHERLANDS; PREGNANCY; PREGNANCY COMPLICATIONS; SUBSTANCE WITHDRAWAL SYNDROME;

EID: 84855490614     PISSN: 03065251     EISSN: 13652125     Source Type: Journal    
DOI: 10.1111/j.1365-2125.2011.04072.x     Document Type: Article

References (46)

1. Weinstock M. The potential influence of maternal stress hormones on development and mental health of the offspring. Brain Behav Immun 2005; 19: 296-308.
2. Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Depression during pregnancy: overview of clinical factors. Clin Drug Investig 2004; 24: 157-79.
3. Eberhard-Gran M, Eskild A, Opjordsmoen S. Use of psychotropic medications in treating mood disorders during lactation: practical recommendations. CNS Drugs 2006; 20: 187-98.
4. Boyd RC, Zayas LH, McKee MD. Mother-infant interaction, life events and prenatal and postpartum depressive symptoms among urban minority women in primary care. Matern Child Health J 2006; 10: 139-48.
5. Mian AI. Depression in pregnancy and the postpartum period: balancing adverse effects of untreated illness with treatment risks. J Psychiatr Pract 2005; 11: 389-96.
6. Altshuler LL, Cohen L, Szuba MP, Burt VK, Gitlin M, Mintz J. Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. Am J Psychiatry 1996; 153: 592-606.
7. Grover S, Avasthi A, Sharma Y. Psychotropics in pregnancy: weighing the risks. Indian J Med Res 2006; 123: 497-512.
8. Marcus SM, Barry KL, Flynn HA, Tandon R, Greden JF. Treatment guidelines for depression in pregnancy. Int J Gynaecol Obstet 2001; 72: 61-70.
9. National collaborating centre for mental health. NICE Clinical Guideline 45: Antenatal and Postnatal Mental Health. Midplace, UK: National Institute for Health and Clinical excellence, 2007; 1-48.
10. Koren G, Pastuszak A, Ito S. Drugs in pregnancy. N Engl J Med 1998; 338: 1128-37.
11. Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5: e45.
12. Teratology of paroxetine: evidence for cardiovascular malformations. 2005. Available at: (last accessed 17 August 2011).
13. Sanz EJ, las-Cuevas C, Kiuru A, Bate A, Edwards R. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005; 365: 482-7.
14. Chambers CD, Hernandez-Diaz S, Van Marter LJ, Werler MM, Louik C, Jones KL, Mitchell AA. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 2006; 354: 579-87.
15. Unadkat JD, Dahlin A, Vijay S. Placental drug transporters. Curr Drug Metab 2004; 5: 125-31.
16. Garner EM, Kelly MW, Thompson DF. Tricyclic antidepressant withdrawal syndrome. Ann Pharmacother 1993; 27: 1068-72.
17. Withdrawing patients from antidepressants. Drug Ther Bull 1999; 37: 49-52.
18. Diamond BI, Borison RL, Katz R, DeVeaugh-Geiss J. Rebound withdrawal reactions due to clomipramine. Psychopharmacol Bull 1989; 25: 209-12.
19. Ter Horst PG, Jansman FG, van Lingen RA, Smit JP, de Jong-van den Berg LT, Brouwers JR. Pharmacological aspects of neonatal antidepressant withdrawal. Obstet Gynecol Surv 2008; 63: 267-79.
20. Cowe L, Lloyd DJ, Dawling S. Neonatal convulsions caused by withdrawal from maternal clomipramine. Br Med J (Clin Res Ed) 1982; 284: 1837-8.
21. Musa AB, Smith CS. Neonatal effects of maternal clomipramine therapy. Arch Dis Child 1979; 54: 405.
22. Boringa JB, de Jong GM, Touw DJ. [Neonatal withdrawal symptoms following the use of clomipramine during pregnancy]. Ned Tijdschr Geneeskd 1992; 136: 1473-5.
23. Myllynen P, Immonen E, Kummu M, Vahakangas K. Developmental expression of drug metabolizing enzymes and transporter proteins in human placenta and fetal tissues. Expert Opin Drug Metab Toxicol 2009; 5: 1483-99.
24. Ward RM. Drug disposition in the late preterm ('near-term') newborn. Semin Perinatol 2006; 30: 48-51.
25. Alcorn J, McNamara PJ. Pharmacokinetics in the newborn. Adv Drug Deliv Rev 2003; 55: 667-86.
26. Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology - drug disposition, action, and therapy in infants and children. N Engl J Med 2003; 349: 1157-67.
27. Koren G. A new indication for therapeutic drug monitoring in the neonate. Ther Drug Monit 2006; 28: 1.
28. Goldstein DJ. Effects of third trimester fluoxetine exposure on the newborn. J Clin Psychopharmacol 1995; 15: 417-20.
29. Laine K, Heikkinen T, Ekblad U, Kero P. Effects of exposure to selective serotonin reuptake inhibitors during pregnancy on serotonergic symptoms in newborns and cord blood monoamine and prolactin concentrations. Arch Gen Psychiatry 2003; 60: 720-6.
30. Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2: 141-58.
31. Moses-Kolko EL, Bogen D, Perel J, Bregar A, Uhl K, Levin B, Wisner KL. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 2005; 293: 2372-83.
32. Dilsaver SC, Greden JF. Antidepressant withdrawal phenomena. Biol Psychiatry 1984; 19: 237-56.
33. Balant-Gorgia AE, Gex-Fabry M, Balant LP. Clinical pharmacokinetics of clomipramine. Clin Pharmacokinet 1991; 20: 447-62.
34. Gelman CR, Rumack BH. MICROMEDEX® Healthcare Series. Greenwood Village, CO: MICROMEDEX, 2000; 93(3).
35. Schimmell MS, Katz EZ, Shaag Y, Pastuszak A, Koren G. Toxic neonatal effects following maternal clomipramine therapy. J Toxicol Clin Toxicol 1991; 29: 479-84.
36. Loughhead AM, Stowe ZN, Newport DJ, Ritchie JC, DeVane CL, Owens MJ. Placental Passage of Tricyclic Antidepressants. Biol Psychiatry 2005; 59: 287-90.
37. Oberlander TF, Misri S, Fitzgerald CE, Kostaras X, Rurak D, Riggs W. Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry 2004; 65: 230-7.
38. Oberlander TF, Warburton W, Misri S, Aghajanian J, Hertzman C. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiatry 2006; 63: 898-906.
39. Wisner KL, Perel JM, Findling RL. Antidepressant treatment during breast-feeding. Am J Psychiatry 1996; 153: 1132-7.
40. Newport DJ, Wilcox MM, Stowe ZN. Antidepressants during pregnancy and lactation: defining exposure and treatment issues. Semin Perinatol 2001; 25: 177-90.
41. Koren G, Matsui D, Einarson A, Knoppert D, Steiner M. Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates? CMAJ 2005; 172: 1457-9.
42. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 2008; 111: 1001-20.
43. Leeuwenburgh-Pronk WG, de Vries MC, Clement-de BA. A multidisciplinary approach is necessary in the neonatal withdrawal syndrome. Ned Tijdschr Geneeskd 2006; 150: 761-5.
44. Baumann P, Hiemke C, Ulrich S, Eckermann G, Gaertner I, Gerlach M, Kuss HJ, Laux G, Muller-Oerlinghausen B, Rao ML, Riederer P, Zernig G. The AGNP-TDM expert group consensus guidelines: therapeutic drug monitoring in psychiatry. Pharmacopsychiatry 2004; 37: 243-65.
45. Edginton AN, Schmitt W, Willmann S. Development and evaluation of a generic physiologically based pharmacokinetic model for children. Clin Pharmacokinet 2006; 45: 1013-34.
46. Vlaminck JJ, van Vliet IM, Zitman FG. [Withdrawal symptoms of antidepressants]. Ned Tijdschr Geneeskd 2005; 149: 698-701.