Hostetter Amy L, Stowe Zachary N, Cox Mary, Ritchie James C
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Ther Drug Monit. 2004 Feb;26(1):47-52. doi: 10.1097/00007691-200402000-00011.
The high incidence of psychiatric illness in the postpartum period and the increasing percentage of women who breastfeed has focused attention on the treatment of breastfeeding women with psychotropic medications and, additionally, the exposure of nursing infants to these medications. Consequently, there has been an increased effort to develop standardized methods for quantifying psychotropic medications in breast milk. This paper details a novel method for quantifying the concentrations of multiple selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) in breast milk. The method consists of a common liquid/liquid and solid-phase extraction followed by HPLC separation on a common column and UV detection. Assay system 1 measures fluoxetine, norfluoxetine, fluvoxamine, and paroxetine; assay 2 measures sertraline and desmethylsertraline; and assay 3 measures the TCAs including doxepin, nordoxepin, desipramine, imipramine, nortriptyline, and amitriptyline. The method is shown to be a highly accurate and precise technique for measuring 12 different antidepressants in human breast milk and to be free of the matrix effects often encountered in breast milk drug analyses.
产后精神疾病的高发病率以及母乳喂养女性比例的不断增加，使得人们将注意力集中在使用精神药物治疗母乳喂养的女性以及哺乳婴儿接触这些药物的问题上。因此，人们加大了力度来开发用于定量母乳中精神药物的标准化方法。本文详细介绍了一种用于定量母乳中多种选择性5-羟色胺再摄取抑制剂（SSRI）和三环类抗抑郁药（TCA）浓度的新方法。该方法包括常见的液/液和固相萃取，然后在普通柱上进行高效液相色谱分离并采用紫外检测。分析系统1测定氟西汀、去甲氟西汀、氟伏沙明和帕罗西汀；分析方法2测定舍曲林和去甲基舍曲林；分析方法3测定包括多塞平、去甲多塞平、地昔帕明、丙咪嗪、去甲替林和阿米替林在内的三环类抗抑郁药。该方法被证明是一种用于测量人母乳中12种不同抗抑郁药的高度准确和精确的技术，并且不存在母乳药物分析中经常遇到的基质效应。
