Document Detail


Pharmacokinetics of sertraline across pregnancy and postpartum.
MedLine Citation:
PMID:  19011433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Insufficient data inform dosing of antidepressants and clinical monitoring for major depressive disorder (MDD) during the perinatal period. The objectives were to assess the pharmacokinetics of sertraline (SER) across pregnancy and postpartum. Participants treated with SER for MDD underwent serial sampling to measure steady-state concentrations of SER and norsertraline during the second and third trimesters and postpartum (total of 3 assessments). Blood was drawn before observed SER administration and 0.5, 1, 2, 4, 6, 8, 10, 12, and 24 hours after administration. A sensitive high-performance liquid chromatography/mass spectrometric method for simultaneous determination of serum concentrations of SER and norsertraline was developed and validated. For each sampling period for SER, area under the serum concentration versus time curve, maximal serum concentration (Cmax), and the time at which Cmax occurred (Tmax) were determined. Of 11 women initially enrolled, 6 completed second- and third-trimester assessments, and 3 completed all 3 assessments (including the postpartum assessment). Mean changes on all pharmacokinetic parameters were nonsignificant between assessments, although there was a marked heterogeneity among individuals. Results were not significantly altered by incorporation of body weights into the analyses. The range of pharmacokinetic changes between individuals was broad, indicating heterogeneity regarding the impact of pregnancy on SER metabolism. Overall, lowest observed SER area under the curve and Cmax occurred in the third trimester (observed in 5 of 6 participants). Despite nonsignificant mean pharmacokinetic changes, the range of pharmacokinetic changes across pregnancy warrants careful monitoring of depressive symptoms in women with MDD in late pregnancy and further study.
Authors:
Marlene P Freeman; Paul E Nolan; Melinda F Davis; Marietta Anthony; Karen Fried; Martha Fankhauser; Raymond L Woosley; Francisco Moreno
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of clinical psychopharmacology     Volume:  28     ISSN:  1533-712X     ISO Abbreviation:  J Clin Psychopharmacol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109496     Medline TA:  J Clin Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-53     Citation Subset:  IM    
Affiliation:
Department of Psychiatry, Women's Mental Health Center, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA. mfreeman@partners.org
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MeSH Terms
Descriptor/Qualifier:
1-Naphthylamine / analogs & derivatives,  pharmacokinetics
Adult
Body Weight
Depressive Disorder, Major / drug therapy*,  metabolism
Female
Humans
Longitudinal Studies
Postpartum Period / metabolism*
Pregnancy
Pregnancy Complications / drug therapy*,  metabolism
Pregnancy Trimester, Second / metabolism*
Pregnancy Trimester, Third / metabolism*
Serotonin Uptake Inhibitors / blood,  pharmacokinetics*,  therapeutic use
Sertraline / blood,  pharmacokinetics*,  therapeutic use
Young Adult
Grant Support
ID/Acronym/Agency:
K23 MH66265/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Serotonin Uptake Inhibitors; 0/norsertraline; 134-32-7/1-Naphthylamine; 79617-96-2/Sertraline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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