Imaz M Luisa, Oriolo Giovanni, Torra Mercè, Soy Dolors, García-Esteve Lluïsa, Martin-Santos Rocio
Perinatal Psychiatry Program, Department of Psychiatry and Psychology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Department of Medicine, University of Barcelona, Barcelona, Spain.
Front Pharmacol. 2018 Mar 27;9:264. doi: 10.3389/fphar.2018.00264. eCollection 2018.
The current prescription of clozapine in psychotic women of reproductive age makes it crucial to understand its pharmacokinetics during pregnancy and lactation as well as its risk profile for neonatal outcome. The aim of this case series was to provide new evidence on the pharmacokinetic features of clozapine that determine its passage through the placenta and amniotic fluid, as well as the neonatal clozapine elimination half-life (t1/2). This case series demonstrates for the first time that clozapine might show partial placental passage similar to other atypical antipsychotics. Clozapine levels decreased during the first few days in nursing infants. The half-life of clozapine in neonates was slightly higher than previously estimated. Clozapine use in pregnancy may be associated with diabetes mellitus, especially if there is a family history of this disease. Although no acute toxicological effects were observed in the intrauterine exposed newborn, close follow-up of pregnancy is recommended. However, these results must be taken with caution being a case series with small sample size.
对于处于育龄期的患有精神病的女性，当前氯氮平的处方使得了解其在妊娠和哺乳期的药代动力学以及其对新生儿结局的风险状况变得至关重要。本病例系列的目的是提供有关氯氮平药代动力学特征的新证据，这些特征决定了其通过胎盘和羊水的情况，以及新生儿氯氮平的消除半衰期（t1/2）。本病例系列首次证明氯氮平可能表现出与其他非典型抗精神病药物相似的部分胎盘转运。在哺乳婴儿的最初几天里，氯氮平水平下降。氯氮平在新生儿中的半衰期略高于先前估计。孕期使用氯氮平可能与糖尿病有关，尤其是如果有该疾病的家族史。尽管在宫内暴露的新生儿中未观察到急性毒理学效应，但建议对妊娠进行密切随访。然而，由于本病例系列样本量较小，这些结果必须谨慎看待。
