ArticleBritish journal of clinical pharmacology2012
Clomipramine concentration and withdrawal symptoms in 10 neonates.
Article in British journal of clinical pharmacology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 29 citations in OpenAlex.
- Severity of neonatal opioid withdrawal syndrome with prenatal exposure to serotonin reuptake inhibitors.Pediatric research · 2022Article
- Novel Pharmacological Approaches to the Treatment of Depression.Life (Basel, Switzerland) · 2022Review
- Liver-Heart on chip models for drug safety.APL bioengineering · 2021Review
- Review
- Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development.Brain communications · 2019Review
- Neonatal Adaptation Issues After Maternal Exposure to Prescription Drugs: Withdrawal Syndromes and Residual Pharmacological Effects.Drug safety · 2016Review
- A neonatal prolonged QT syndrome due to maternal use of oral tricyclic antidepressants.European journal of pediatrics · 2016Article
- Pharmacokinetics of clomipramine during pregnancy.European journal of clinical pharmacology · 2015Article
- The use of psychotropic medication during pregnancy: how about the newborn?Neuropsychiatric disease and treatment · 2013Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimAfter in utero exposure to tricyclic antidepressants, neonatal withdrawal symptoms have been reported with an estimated incidence between 20 and 50%; however, few data are available for clomipramine. This could also be the case for neonatal pharmacokinetic clomipramine parameters and so this study was set up.
methodsBabies exposed to clomipramine in utero were included in an observational study, approved by the local ethics committee, after written informed consent. Withdrawal symptoms were scored at 12, 24 and 48 h after birth using the Finnegan score. Plasma concentrations were determined using an in-house-developed, validated liquid chromatography with mass detection (LC-MSMS) method at 0, 12, 24 and 48 h after birth.
resultsWe found that three of 11 pregnancies were complicated with pre-eclampsia. Ten neonates were observed for clomipramine withdrawal symptoms. The observed withdrawal symptoms were too short a period of sleep after feeding (6), poor feeding (3), mild to severe tremors (6), hyperactive Moro reflex (3) and respiratory rate >60 breaths min(-1). Serious withdrawal reactions, such as tachycardia and cyanosis, were seen. We calculated a half-life value of 42 ± 16 h for clomipramine in neonates. Only a weak correlation was found between withdrawal reactions and clomipramine plasma concentration or desmethylclomipramine plasma concentration.
conclusionsIn neonates, clomipramine is eliminated with a half-life value of 42 h, compared with 20 h in adults. In two of 10 neonates, tachycardia and cyanosis were seen as serious withdrawal symptoms after maternal use of clomipramine.
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