Безопасно. Совместимый. Минимальный риск для грудного вскармливания и ребёнка.
Это дибензотиазепиновый атипичный антипсихотик (нейролептики второго поколения и антагонисты серотонина-дофамина). Он используется при лечении шизофрении, биполярных и других психотических расстройств, а также пограничных расстройств личности.
Выделяется в грудное молоко в клинически незначимых количествах. (Yazdani 2018, Aydin 2015, Van Boekholt 2015, Rampono 2007, Misri 2006, Lee 2004, Seppala 2004)
Клинические проблемы или проблемы развития у младенцев, матери которых лечились, не наблюдались ни в краткосрочной, ни в долгосрочной перспективе.(Levesque 2016, Sharma 2016, Aydin 2015, Van Boekholt 2015, Newport 2009, Rampono 2007, Misri 2006, Ritz 2005, Gentile 2005, Seppala 2004, Lee 2004)
У этих детей были обнаружены очень низкие уровни кветиапина в плазме. (Rumpono 2007)
Галакторея может возникать как с повышением пролактина, так и без него. (Glocker 2021, Suttajit 2013, Mushtaq 2012, Sethi 2010, Gupta 2007, Atmaca 2002)
Авторы-эксперты считают использование кветиапина безопасным или, скорее всего, безопасным во время грудного вскармливания. (Hale, Lactmed, Uguz 2021, Teodorescu 2020, Rybakowski 2019, Pacchiarotti 2016, Schaefer 2015, Grover 2005, Larsen 2015, Parikh 2014, Rowe 2013)
| Наименование | Значение | Ед.изм. |
|---|---|---|
| pKa | 15.12 | моль/л |
| Tmax | 1.5 | час |
| T½ | 7 | час |
| БПП | 10 | % |
| Молекулярная масса | 883 | Да |
| ОР | 10 | л/кг |
| Относительная доза | 0.1 - 0.43 | % |
| Связывание с белками | 83 | % |
| Соотношение М/П | 0.3 | - |
| Теоретическая доза | 0.01 - 0.1 | мг/кг/сут |
Автор: Atmaca M, Kuloglu M, Tezcan E, Canatan H, Gecici O.
Quetiapine is not associated with increase in prolactin secretion in contrast to haloperidol.
Arch Med Res. 2002 Nov-Dec;33(6):562-5.
Автор: Gentile S.
Quetiapine-fluvoxamine combination during pregnancy and while breastfeeding.
Arch Womens Ment Health.
Автор: Ritz S.
Quetiapine monotherapy in post-partum onset bipolar disorder with a mixed affective state.
Eur Neuropsychopharmacol 2005;15 (Suppl 3):S407. Abstract P2.036.
Автор: Seppala J.
Quetiapine (Seroquel) is effective and well tolerated in the treatment of psychotic depression during breast-feeding. XXIVth CINP Congress Paris, France, 20–24 June 2004.
Int J Neuropsychopharmacol 2004;7 (Suppl 2):S245. Abstract P01.431.
Автор: Lee A, Giesbrecht E, Dunn E, Ito S.
Excretion of quetiapine in breast milk.
Am J Psychiatry.
Автор: Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A.
Antidepressant drugs and breastfeeding: a review of the literature.
Breastfeed Med.
Автор: Sethi S, Sharma M, Malik A.
Dose-dependent galactorrhea with quetiapine.
Indian J Psychiatry.
Автор: Yazdani-Brojeni P, Taguchi N, Garcia-Bournissen F, Moretti M, Verjee Z, Koren G, Ito S.
Quetiapine in human milk and simulation-based assessment of infant exposure. American Society for Clinical Pharmacology and Therapeutics. Abstracts of papers 2010 Annual Meeting Atlanta, Georgia, March 17–20, 2010.
Clin Pharmacol Ther 2010;87 (Suppl. 1):S3-4. Abstract PT 08.
Автор: Newport DJ, Ritchie JC, Knight BT, Glover BA, Zach EB, Stowe ZN.
Venlafaxine in human breast milk and nursing infant plasma: determination of exposure.
J Clin Psychiatry.
Автор: Rampono J, Kristensen JH, Ilett KF, Hackett LP, Kohan R.
Quetiapine and breast feeding.
Ann Pharmacother.
Автор: Klier CM, Mossaheb N, Saria A, Schloegelhofer M, Zernig G.
Pharmacokinetics and elimination of quetiapine, venlafaxine, and trazodone during pregnancy and postpartum.
J Clin Psychopharmacol.
Автор: Gupta M.
Low dose quetiapine induced galactorrhoea: a case report.
Clin Pract Epidemiol Ment Health.
Автор: Gentile S.
Prophylactic treatment of bipolar disorder in pregnancy and breastfeeding: focus on emerging mood stabilizers.
Bipolar Disord.
Автор: Misri S, Corral M, Wardrop AA, Kendrick K.
Quetiapine augmentation in lactation: a series of case reports.
J Clin Psychopharmacol. 2006 Oct;26(5):508-11.
Автор: LactMed.
Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/
2006 -
Автор: Hale TW.
Medications & Mothers' Milk.
1991- . Springer Publishing Company. Available from https://www.halesmeds.com
Автор: Glocker C, Grohmann R, Engel R, Seifert J, Bleich S, Stübner S, Toto S, Schüle C.
Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015.
Eur Arch Psychiatry Clin Neurosci. 2021 Dec;271(8):1425-1435.
Автор: Uguz F.
A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation.
Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126.
Автор: Teodorescu A, Dima L, Popa MA, Moga MA, Bîgiu NF, Ifteni P.
Antipsychotics in Postpartum Psychosis.
Am J Ther. 2020 Jun 22;28(3):e341-e348.
Автор: Rybakowski J, Cuba?a WJ, Ga?ecki P, Rymaszewska J, Samochowiec J, Szulc A, Dudek D.
Recommendations of the Polish Psychiatric Association regarding the treatment of affective disorders in women of childbearing age. Part II: Bipolar disorder.
Psychiatr Pol. 2019 Apr 30;53(2):263-276.
Автор: Yazdani-Brojeni P, Tanoshima R, Taguchi N, Garcia-Bournissen F, Wallach I, Moretti ME, Verjee Z, Ito S.
Quetiapine Excretion Into Human Breast Milk.
J Clin Psychopharmacol. 2018 Aug;38(4):362-364.
Автор: Levesque S, Riley C.
Fetal exposure to lamotrigine and quetiapine in two consecutive pregnancies.
Arch Womens Ment Health. 2017 Feb;20(1):237-239.
Автор: Sharma V, Sommerdyk C.
Lamotrigine in the Prevention of Bipolar II Postpartum Depression.
Prim Care Companion CNS Disord. 2016 Nov 3;18(6).
Автор: Pacchiarotti I, León-Caballero J, Murru A, Verdolini N, Furio MA, Pancheri C, Valentí M, Samalin L, Roigé ES, González-Pinto A, Montes JM, Benabarre A, Crespo JM, de Dios Perrino C, Goikolea JM, Gutiérrez-Rojas L, Carvalho AF, Vieta E.
Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder.
Eur Neuropsychopharmacol. 2016 Oct;26(10):1562-78.
Автор: Aydin B, Nayir T, Sahin S, Yildiz A.
Olanzapine and quetiapine use during breastfeeding: excretion into breast milk and safe breastfeeding strategy.
J Clin Psychopharmacol. 2015 Apr;35(2):206-8.
Автор: Grover S, Avasthi A.
Mood stabilizers in pregnancy and lactation.
Indian J Psychiatry.
Автор: Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, Linde VJ, Knudsen HE, Skaarup L, Videbech P.
Use of psychotropic drugs during pregnancy and breast-feeding.
Acta Psychiatr Scand Suppl.
Автор: Van Boekholt AA, Hartong EG, Huntjens-Fleuren H, Grootens KP, Semmekrot BA.
Quetiapine concentrations during exclusive breastfeeding and maternal quetiapine use.
Ann Pharmacother.
Автор: Sriraman NK, Melvin K, Meltzer-Brody S.
ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers.
Breastfeed Med.
Автор: Schaefer C, Peters P, Miller RK.
Drugs During Pregnancy and Lactation. Treatment options and risk assessment.
Elsevier, Third Edition.
Автор: Parikh T, Goyal D, Scarff JR, Lippmann S.
Antipsychotic drugs and safety concerns for breast-feeding infants.
South Med J.
Автор: Rowe H, Baker T, Hale TW.
Maternal medication, drug use, and breastfeeding.
Pediatr Clin North Am. 2013 Feb;60(1):275-94.
Автор: Klinger G, Stahl B, Fusar-Poli P, Merlob P.
Antipsychotic drugs and breastfeeding.
Pediatr Endocrinol Rev. 2013 Mar-Apr;10(3):308-17. Review.
Автор: Suttajit S, Srisurapanont M, Xia J, Suttajit S, Maneeton B, Maneeton N.
Quetiapine versus typical antipsychotic medications for schizophrenia.
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Автор: Mushtaq S, Khan S, Patel H.
Quetiapine-induced galactorrhea with normal prolactin level in an adult female patient.
Prim Care Companion CNS Disord.
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