Sertraline is used to manage several mental health conditions, and it is frequently prescribed during pregnancy and breastfeeding. The ConcePTION project has developed a population pharmacokinetic (popPK) model to describe how the body interacts with the drug during pregnancy and breastfeeding.
Sertraline is used to treat depression, panic attacks, obsessive-compulsive disorder, post-traumatic stress and other mental health disorders. According to the available literature, only small amounts of sertraline are transferred into breast milk and cord blood. However, the existing data is not sufficient to explain significant interindividual variability. Researchers from the ConcePTION project developed a population pharmacokinetic model that is able to characterise sertraline pharmacokinetics in cord blood and breast milk. The model is also designed to assess interindividual variability, and identify covariates responsible for variations between different individuals.
According to Anaëlle Monfort, PhD student at the Université de Montréal’s Faculty of Pharmacy, the model allowed the team to identify two covariates that can influence how much sertraline the infant is exposed to during breastfeeding: the mother’s ability to metabolise the drug (related to a specific enzyme called CYP2C19) and individual variations in the fat content in breast milk.
The model-based simulations suggested that the median daily infant dosage while a mother is being treated with 50 mg sertraline per day is 6.9 μg per kg of the infants body weight, representing 0.95% of the maternal dose adjusted to her weight. The median concentration of sertraline in umbilical cord blood could range from 3.29 to 33.23 ng/mL after maternal daily doses between 25 and 150 mg.
Women who suffer from mental health conditions need treatment during both pregnancy and breastfeeding. “Our results are in line with previous studies, and show that infant exposure is low, which is reassuring, as sertraline is widely used during pregnancy and breastfeeding”, says Anaëlle Monfort.
Want to read the paper? Monfort, A., Cardoso, E., Eap, C.B., Ansermot, N., Crettol, S., Fischer Fumeaux, C.J., Bickle Graz, M., Morisod Harari, M., Weisskopf, E., Gandia, P., Allegaert, K., Annaert, P., Nordeng, H., Hascoët, J-M., Claris, O., Epiney, M., Ferreira, E., Leclair, G., Csajka, C., Panchaud, A., Guidi, M., collaborators of the SSRI Breast Milk study, A population pharmacokinetic model for sertraline in women during the perinatal period—A contribution from the ConcePTION project. Br J Clin Pharmacol, 2024, 1-12. DOI: https://doi.org/10.1111/bcp.16177
By Josepine Fernow
