Pharmacopsychiatry 2018; 51(03): 112-113
DOI: 10.1055/s-0038-1649539
Abstracts
Georg Thieme Verlag KG Stuttgart · New York

Comprehensive measurements of intrauterine and postnatal exposure to lamotrigine

M Paulzen
1   Alexianer Hospital Aachen, Aachen, Germany
2   Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany, and JARA – Translational Brain Medicine
,
JC Stingl
3   Research Division, Federal Institute for Drugs and Medical Devices, Bonn, Germany
4   Centre for Translational Medicine, University Bonn Medical Faculty, Bonn, Germany
,
M Augustin
2   Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany, and JARA – Translational Brain Medicine
,
H Saßmannshausen
5   Department of Gynecology and Obstetrics, RWTH Aachen University, Germany
,
C Franz
5   Department of Gynecology and Obstetrics, RWTH Aachen University, Germany
,
G Gründer
6   Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
,
G Schoretsanitis
2   Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany, and JARA – Translational Brain Medicine
7   University Hospital of Psychiatry, Bern, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
09 May 2018 (online)

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    Objective:

    Aim of the study was to measure and investigate correlations of lamotrigine concentrations in maternal as well as umbilical cord blood, amniotic fluid, and mother milk to account for the distribution of the drug.

    Methods:

    Concentrations of lamotrigine were measured in nineteen mother infant pairs at the time of delivery. To account for the penetration ratio into amniotic fluid, cord blood and mother milk, the concentration of lamotrigine in the particular environment was divided by the concentration in maternal serum. Correlations between daily dosage, maternal serum concentrations and umbilical cord blood concentrations were computed for nineteen patients. As amniotic fluid and mother milk samples were available for sixteen and nine mother infant pairs respectively, appropriate calculations are provided for these mother-infant pairs.

    Results:

    The mean daily dosage of lamotrigine was 351.32 mg (range 50 – 650 mg). Significant correlations were found between the daily dosage and concentrations in cord blood (rs= 0.503, p = 0.028) as well as in mother milk (rs= 0.750, p = 0.02). Maternal serum concentrations correlated strongly with concentrations in amniotic fluid (rs= 0.737, p = 0.001) and cord blood concentrations (rs= 0.661, p = 0.002). The penetration ratio into amniotic fluid, cord blood and mother milk was 0.82, 0.88 and 0.77, respectively.

    Conclusions:

    Lamotrigine concentrations in amniotic fluid, cord blood and mother milk give evidence that the fetus/newborn is constantly exposed to lamotrigine. Maternal serum concentrations can be applied as a measure of this exposure via amniotic fluid. Data suggest that therapeutic drug monitoring can be recommended as part of the clinical routine in psychopharmacotherapy for pregnant or breastfeeding women.


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