Drugs online research references
J Clin Psychiatry. 2003 Jan;64(1):73-80.
The pharmacokinetics of sertraline excretion into human breast milk: determinants of infant serum concentrations.
Stowe ZN, Hostetter AL, Owens MJ, Ritchie JC, Sternberg K, Cohen LS, Nemeroff CB.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta GA, USA.
BACKGROUND: The purpose of this study was to attain a new landmark in the area of selective serotonin reuptake inhibitor therapy during lactation by establishing a basis for interpreting infant serum concentrations and for minimizing infant exposure in the absence of treatment-emergent side effects. METHOD: Breast milk and paired maternal and infant sera were collected following maternal treatment with sertraline monotherapy (25-200 mg/day) administered once daily. Sertraline and its major metabolite were measured in breast milk and serum samples using high-performance liquid chromatography with UV detection (limit of detection = 2 ng/mL). RESULTS: Twenty-six nursing women with DSM-IV major depressive disorder participated in the study; the mean (SD) daily sertraline dose was 123.9 (62.8) mg/day. Fifteen women submitted 182 breast milk samples for analysis of gradient (foremilk to hindmilk) and time course of medication excretion. The milk/plasma ratio was highly variable (range, 0.42-4.81). A significant gradient and time course of excretion for both sertraline (p <.001 for both) and desmethylsertraline (p <.001 for gradient and p <.046 for time course) were observed, with the highest concentrations observed in the hindmilk 8 to 9 hours after maternal ingestion. Mathematical modeling of sertraline and desmethylsertraline excretion revealed that discarding breast milk 9 hours after maternal dose decreased the infant daily dose of sertraline by a mean of 17.1% (1.8%). Twenty-two mother/infant sera pairs were obtained. Sertraline was detectable in 4 infants (18% of sample), and desmethylsertraline was found in 11 infants (50% of sample). The mean (SD) maximum calculated nursing infant dose of sertraline, 0.67 (0.61) mg/day, and desmethylsertraline, 1.44 (1.36) mg/day, represented 0.54% (0.49%) of the maternal daily dose. The maximum infant dose of desmethylsertraline (p <.002) significantly correlated with infant serum desmethylsertraline concentrations (ng/mL). In contrast, maternal daily dose, duration of medication exposure, and infant age and weight at sampling did not correlate with either detectability (< 2 ng/mL vs. > or = 2 ng/mL) or absolute concentrations (ng/mL) in infant serum. No adverse events were reported or documented in any infant. CONCLUSION: These results extend previous studies by demonstrating the utility of breast milk analysis in interpreting infant serum concentrations and minimizing infant exposure.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12590627&dopt=Abstract
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Psychiatr Pol. 2002 Nov-Dec;36(6 Suppl):289-95.
[The effect of sertraline on cognitive functions in patients with obsessive-compulsive disorder]
[Article in Polish]
Borkowska A, Pilaczynska E, Araszkiewicz A, Rybakowski J.
Katedra i Klinika Psychiatrii AM w Bydgoszczy.
The aim of this study was to assess the effect of sertraline on psychopathological symptoms and cognitive functions and in patients with obsessive compulsive disorder (OCD). The investigated group consisted of 25 patients with OCD (12 male, 13 female) aged 17-47 (mean 29 +/- 9) years, duration of illness was 1-15 (mean 4 +/- 2) years. After treatment with sertraline, a significant improvement in OCD symptoms measured by YBOCS and in neuropsychological "frontal" tests were observed. Little correlation was found between the effect of sertraline on OCD symptoms and on cognitive dysfunctions. This may suggest that these two effects may be connected with different pharmacological properties of the drug. The effect of sertraline on OCD symptoms, similarly like other drugs inhibiting serotonin transporter (clomipramine, other SSRI) is associated with its influence on serotonergic system. On the other hand, the effect of sertraline on dopaminergic neurotransmission may be related to its favorable action on cognitive functions connected with the activity of frontal lobe.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12647451&dopt=Abstract
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Adm Policy Ment Health. 2002 Nov;30(2):121-39.
Selective serotonin reuptake inhibitor usage patterns as risk factors for hospitalization.
Sheffield RE, Lo Sasso AT, Young CH, Way K.
PCS Health Systems, Scottsdale, AZ, USA.
The authors examined how differences in SSRI utilization affect the risk of hospitalization among persons with depression. In particular, they decompose how different types of drug therapy affect hospitalization and how that effect varies with the usage pattern of the drug. Using retrospective medical and pharmacy claims from a Midwestern health maintenance organization, they employed multiple logistic regression analyses of patients newly treated for depression. Their findings were that (a) paroxetine may be a significant risk factor for early discontinuation compared with fluoxetine; and (b) sertraline initiation among stable-use patients may lower the risk of hospitalization. However, initiation on paroxetine or sertraline rather than fluoxetine may increase the risk of hospitalization among patients not exhibiting a stable usage pattern.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12680617&dopt=Abstract
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