lacental Passage of Tricyclic Antidepressants

ackground: The use of antidepressants during pregnancy continues to garner considerable attention, though there are limited nvestigations that have sought to quantify fetal exposure. ethods: Maternal and umbilical cord sera were collected at delivery from ten women taking nortriptyline and seven taking lomipramine. Placental passage was calculated as the ratio of umbilical cord to maternal serum concentration. Obstetrical outcome ata were gathered from subjects at delivery. esults: The placental passage ratio of nortriptyline and its active metabolite, cis-10-hydroxynortriptyline, were .68 .40, 1.40 .40, respectively. Clomipramine and desmethylclomipramine ratios were .60 .50, .80 .60. Obstetrical complications, such as re-term delivery and pregnancy induced hypertension, were increased compared to the national average. onclusions: The in vivo ratios of umbilical cord to maternal serum drug concentrations demonstrate considerable fetal exposure nd differ greatly from previous results utilizing ex vivo perfusion.