Quetiapine and breast feeding

Ann Pharmacother. 2007 Apr;41(4):711-4. doi: 10.1345/aph.1H555. Epub 2007 Mar 20.


Objective: To quantify the relative infant dose of quetiapine during breast feeding, describe the milk:plasma (M:P) ratio, and determine the well-being of the exposed infant.

Case summary: A 26-year-old mother and her 3-month-old son were studied over a 24 hour quetiapine dose interval at steady-state. Quetiapine concentrations were quantified by high-performance liquid chromatography. Infant exposure was calculated as the concentration in milk multiplied by an estimated milk production of 0.15 L/kg/day and normalized to the weight-adjusted maternal dose. The average concentration in milk was 41 microg/L, the M:P ratio (measured using average concentrations in the elimination phase) was 0.29, and the relative infant dose was 0.09% of the maternal weight-adjusted dose (7273 microg/kg/day). The infant plasma concentration of 1.4 microg/L was some 6% of the corresponding maternal plasma concentration. No adverse effects were noted in the infant.

Discussion: Our findings of an infant exposure to quetiapine of less than 0.1% of the maternal dose and a lack of adverse effects confirm and extend the findings of 2 previous studies.

Conclusions: Although limited, the data shown here support the prescription of quetiapine to a breast-feeding mother following a careful individual risk/benefit analysis. We suggest regular monitoring of infant progress and occasional measurement of quetiapine in the infant's plasma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / analysis
  • Antipsychotic Agents / blood*
  • Breast Feeding*
  • Chromatography, High Pressure Liquid
  • Dibenzothiazepines / adverse effects
  • Dibenzothiazepines / analysis
  • Dibenzothiazepines / blood*
  • Female
  • Humans
  • Infant
  • Male
  • Milk, Human / chemistry
  • Quetiapine Fumarate


  • Antipsychotic Agents
  • Dibenzothiazepines
  • Quetiapine Fumarate