{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:55:50Z","timestamp":1771563350693,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p><jats:bold>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT<\/jats:bold><\/jats:p><jats:p>\u2022\u2003Antidepressants are associated with withdrawal symptoms after <jats:italic>in utero<\/jats:italic> exposure.<\/jats:p><jats:p>\u2022\u2003Half\u2010life of clomipramine in neonates is prolonged compared with that in adults.<\/jats:p><jats:p><jats:bold>WHAT THIS STUDY ADDS<\/jats:bold><\/jats:p><jats:p>\u2022\u2003We present 10 cases of neonates exposed <jats:italic>in utero<\/jats:italic> to clomipramine, with detailed information about withdrawal symptoms and pharmacokinetics.<\/jats:p><jats:p>\u2022\u2003There is a high and severe complication rate in our cohort regarding the mother and the neonate.<\/jats:p><jats:p><jats:bold>AIM<\/jats:bold> After <jats:italic>in utero<\/jats:italic> exposure to tricyclic antidepressants, neonatal withdrawal symptoms have been reported with an estimated incidence between 20 and 50%; however, few data are available for clomipramine. This could also be the case for neonatal pharmacokinetic clomipramine parameters and so this study was set up.<\/jats:p><jats:p><jats:bold>METHODS<\/jats:bold> Babies exposed to clomipramine <jats:italic>in utero<\/jats:italic> were included in an observational study, approved by the local ethics committee, after written informed consent. Withdrawal symptoms were scored at 12, 24 and 48\u2003h after birth using the Finnegan score. Plasma concentrations were determined using an in\u2010house\u2010developed, validated liquid chromatography with mass detection (LC\u2010MSMS) method at 0, 12, 24 and 48\u2003h after birth.<\/jats:p><jats:p><jats:bold>RESULTS<\/jats:bold> We found that three of 11 pregnancies were complicated with pre\u2010eclampsia. Ten neonates were observed for clomipramine withdrawal symptoms. The observed withdrawal symptoms were too short a period of sleep after feeding (6), poor feeding (3), mild to severe tremors (6), hyperactive Moro reflex (3) and respiratory rate &gt;60 breaths min<jats:sup>\u22121<\/jats:sup>. Serious withdrawal reactions, such as tachycardia and cyanosis, were seen. We calculated a half\u2010life value of 42 \u00b1 16\u2003h for clomipramine in neonates. Only a weak correlation was found between withdrawal reactions and clomipramine plasma concentration or desmethylclomipramine plasma concentration.<\/jats:p><jats:p><jats:bold>CONCLUSIONS<\/jats:bold> In neonates, clomipramine is eliminated with a half\u2010life value of 42\u2003h, compared with 20\u2003h in adults. In two of 10 neonates, tachycardia and cyanosis were seen as serious withdrawal symptoms after maternal use of clomipramine.<\/jats:p>","DOI":"10.1111\/j.1365-2125.2011.04072.x","type":"journal-article","created":{"date-parts":[[2011,7,29]],"date-time":"2011-07-29T14:47:32Z","timestamp":1311950852000},"page":"295-302","source":"Crossref","is-referenced-by-count":25,"title":["Clomipramine concentration and withdrawal symptoms in 10 neonates"],"prefix":"10.1111","volume":"73","author":[{"given":"Peter G. 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