John Libbey Eurotext

Journal de Pharmacie Clinique

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Clomipramine in breast milk: a case study Volume 28, issue 1, janvier-février-mars 2009

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Laboratoire de pharmacocinétique et toxicologie clinique, Hôpital Purpan, Institut Fédératif de Biologie, 330 avenue de Grande Bretagne, TSA 40031, 31059 Toulouse Cedex 09, Laboratoire de physiopathologie et toxicologie expérimentales, UMR 181 INRA, ENVT, 23 chemin des Capelles, BP 87614, 31076 Toulouse Cedex 03, Service de gynécologie-obstétrique, Hôpital Paule-de-Viguier, CHU de Toulouse, 330 avenue de Grande Bretagne, TSA 70034, 31059 Toulouse Cedex 09

Following chronic exposure to clomipramine taken by a mother during pregnancy at 25 mg/j, the infant showed neonatal inadaptation syndrome associated with hypotonicity and hypoventilation with no fatal consequences. Infant serum levels of clomipramine and its metabolite were undetectable by sensitive and specific liquid chromatography after 33 days of breastfeeding. However, a concentration of 55.1 μg/L of clomipramine was found in the breast milk. Breastfeeding can be continued but a clinical surveillance of the couple mother-infant is strongly recommended.