Plasma and breast milk concentrations of dothiepin and northiaden in lactating women

✍ Scribed by Anne Buist; Trevor R. Norman; Lorraine Dennerstein

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 393 KB
• Volume: 8
• Category: Article
• ISSN: 0885-6222
• DOI: 10.1002/hup.470080106

✦ Synopsis

Plasma and breast-milk concentrations of dothiepin and its metabolite northiaden were measured in 20 lactating women receiving the drug for post-partum depression. Samples were collected at steady-state and both compounds quantitated by HPLC. Doses of dothiepin varied from 75 mgfday to 225 mdday. Accordingly a wide range of plasma and breast-milk concentrations of dothiepin and northiaden were determined. Most determinations were made for women receiving 150 mg/day. At this dose mean (f SD) plasma concentrations of dothiepin and northiaden were 56(f27)pg/l and 72(f79)pg/I respectively while breast-milk concentrations were 95(f71)pgll and 40(f29)pg/I for dothiepin and northiaden respectively. The data reflect the well recognised inter-individual variability in plasma concentrations for subjects receiving the same oral dose. Similar variability was noted in breast-milk concentrations at all doses of dothiepin. Dothiepin passes into the breast-milk of lactating women receiving the drug for post-partum depression. In this respect the drug is similar to other tricyclic antidepressants. The inter-individual variability of results recorded here suggest the need to determine drug concentrations on an individual basis before reaching a decision about breastfeeding. Perceived side effects in the infant are clear criteria for cessation of breastfeeding; high levels of drug in breastmilk where the infant is unaffected, warrant monitoring in view of our inadequate knowledge regarding long term effects of these drugs.