Citalopram and Desmethylcitalopram Concentrations in Breast Milk and in Serum of Mother and Infant

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Abstract
A case is presented with measurements of the selective serotonin reuptake inhibitor (SSRI)-antidepressant citalopram in serum of mother and breast-fed infant and in breast milk. We found a milk-to-serum concentration ratio of ∼3 for both citalopram and the main metabolite desmethylcitalopram. Peak milk concentrations of citalopram occurred 3-9 h after drug intake by the mother. The infant received ∼5% of the mother's dose, adjusted for weight. Accordingly, the serum level in the infant of ∼7 nM corresponded to ∼1/15 of the trough serum concentration of the mother (104 nM). No signs of drug effects in the infant were observed.