NEONATAL RECURRENT PROLONGED HYPOTHERMIA ASSOCIATED WITH MATERNAL MIRTAZAPINE TREATMENT DURING PREGNANCY

Main Article Content

Nir Sokolover
Paul Merlob Merlob
Gil Klinger

Keywords

Mirtazapine, hypothermia, newborn

Abstract

We present  a case of recurrent  hypothermia  in concordant  monozygotic  twins  born to a mirtazapine treated mother. The twins were born at 35 weeks gestation at birth weights of 2426 g and 2355 g. Both twins presented with recurrent hypothermia continuing until day 10 of life. Possible etiologies of hypothermia were excluded. The degree of prematurity and the weight of the twins were not consistent with prolonged  thermal  instability.  The twins' mother  was treated  with mirtazapine  during the entire pregnancy.  Due to its serotonin  and alpha 2 receptors  antagonism  mirtazapine  is known to influence thermoregulation in adult humans and other mammals. We suggest that maternal mirtazapine treatment during pregnancy was associated with recurrent hypothermia in both identical twins.

Abstract 224 | PDF Downloads 127

References

1. Djulus J, Koren G, Einarson TR, et al. Exposure to mirtazapine during pregnancy: a prospective, comparative study of birth outcomes. J Clin Psychiatry 2006;67:1280-1284.
2. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 7th, Ed. 2005, pp:1090-1091. Lippincot Williams & Wilkins, Philadelphia, USA
3. Retz W, Maier S, Maris F, Rosler M. Non -fatal mirtazapine overdose. Int Clin Psychopharmacol 1998;13:277 -9.
4. Pawlyk AC, Cosmi S, Alfinito PD, Maswood N, Deecher DC. Effects of the 5 -HT2A antagonist mirtazapine in rat models of thermoregulation. Brain Res 2006;1123:135 -44.
5. Sipe K, Leventhal L, Burroughs K, Cosmi S, Johnston GH, Deecher DC. Serotonin 2A receptors modulate tail -skin temperature in two rodent models of estrogen deficienc y- related thermoregulatory dysfunction. Brain Res 2004;1028:191- 202.
6. Buecking A, Vandeleur CL, Khazaal Y, Zullino DF. Mirtazapine in drug-induced excessive sweating. Eur J Clin Pharmacol 2005;61:543-4.
7. Perez DG, Loprinzi CL, Barton DL, et al. Pilot evaluat ion of mirtazapine for the treatment of hot flushes. J Support Oncol 2004;2:50-6.
8. Waldinger MD, Berendsen HH, Schweitzer DH. Treatment of hot flushes with mirtazapine: four case reports. Maturitas 2000;36:165 -8.
9. Thermal protection of the newborn: a practi cal guide. The World Health Organization publications, 1997.
10. Smith LS. Temperature monitoring in newborns: A comparison of thermometry and measurement sites. J Neonat Nurs 2004;10:157 -165.
11. Bailey J, Rose P. Temperature measurement in the preterm infant: A literature review. J Neonat Nurs 2000;6:28-32.
12. Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30(2):239 - 45.