Buist A, Janson H
Mercy Hospital for Women, Melbourne, Australia.
Br J Psychiatry. 1995 Sep;167(3):370-3. doi: 10.1192/bjp.167.3.370.
This study looks at the outcome of infants exposed to dothiepin in breast milk in an attempt to guide clinicians on the risk-benefit ratio of breast-feeding when on antidepressants.
Thirty women, who had had HDRS scores > 15 within the first five years postpartum from the same women's hospital, were assessed with their children 3-5 years postpartum; half had breast-fed while on dothiepin (study group). Thirty-six non-depressed women were also assessed. Rating scales assessed depression, anxiety, self-esteem, personality, social support, marital relationship, child behaviour and temperament. The children were assessed by the McCarthy Scale.
Comparisons of the two depressed groups showed no significant differences on any measures except marital conflict and child behaviour, which were the most disturbed in the study group (P < 0.001). Overall cognitive scores for the children did not differ between the groups. Higher levels of dothiepin and northiaden were associated with higher cognitive scores on subscales (P = 0.02).
We are cautiously optimistic about the lack of any negative associations between cognitive development and exposure to dothiepin via breast milk.
本研究观察了暴露于母乳中多塞平的婴儿的结局，旨在为临床医生在服用抗抑郁药时母乳喂养的风险效益比提供指导。
对来自同一家妇产医院、产后头五年内汉密尔顿抑郁量表（HDRS）评分>15的30名女性及其产后3至5岁的孩子进行评估；其中一半女性在服用多塞平时进行了母乳喂养（研究组）。还对36名未患抑郁症的女性进行了评估。使用评定量表评估抑郁、焦虑、自尊、性格、社会支持、婚姻关系、儿童行为和气质。通过麦卡锡量表对儿童进行评估。
两组抑郁症患者的比较显示，除婚姻冲突和儿童行为外，其他各项指标均无显著差异，研究组在这两项指标上受干扰最大（P<0.001）。两组儿童的总体认知得分无差异。多塞平和去甲替林水平较高与分量表上较高的认知得分相关（P = 0.02）。
对于认知发育与通过母乳接触多塞平之间缺乏任何负面关联，我们持谨慎乐观态度。
