SERTRALINE AND DESMETHYLSERTRALINE IN HUMAN BREAST-MILK AND NURSING INFANTS

Objective: The purpose of this study was to determine the concentratio ns of sertraline and desmethylsertraline in both human breast milk and infant serum. Method: Breast milk samples from 12 women were collecte d at specific time intervals after oral doses of sertraline (25-200 th eir infants' serum levels 2-4 hours after nursing were ascertained by high-performance liquid chromatography. Results: Sertraline and desmet hylsertraline were present in all breast milk samples, with a gradient from ''fore'' milk to ''hind'' milk. The highest concentrations of se rtraline were observed in hind milk 7-10 hours after maternal dose. In creasing the maternal dose of sertraline resulted in increased breast milk concentrations of both sertraline and desmethylsertraline. Detect able concentrations of sertraline were found in three nursing infants and desmethylsertraline in six. No adverse effects of exposure were ob served in any infant. Conclusions: Sertraline and desmethylsertraline were present in the breast milk of nursing women treated with sertrali ne. Concentrations were affected by aliquot of milk sampled time after maternal nose, and maternal daily dose. The infants' serum concentrat ions detected were below the detection limit of most commercial labora tories. The presence of desmethylsertraline and desmethylsertraline co ncentrations from one full breast at maternal serum steady state. Futu re studies of breast milk and infant serum samples should address thes e issues.