Search

Objective Methods Results Conclusion The study aims to investigate the efficacy of sertraline medication plus dialectical behavior therapy (DBT) in reducing nonsuicidal self‐injury (NSSI) behavior and depression among adolescents.Participants were 100 adolescents with depression and NSSI behaviors, 50 of whom received sertraline medication plus DBT and 50 of whom received sertraline medication plus cognitive behavioral therapy (CBT) for 12 weeks.During 6 months post intervention, 26 (57.8%) participants did not report having engaged in any form of NSSI in the sertraline + DBT group and 15 (32.6%) in the sertraline + CBT group, showing significant difference. The sertraline + DBT group and the sertraline + CBT group exhibited significant difference regarding the proportions of cutting skin and biting self. The scores of anxiety, depression, aggression against self in four modified overt aggression scale categories, and Personal and Social Performance were notably lower in the sertraline + DBT group than those in the sertraline + CBT group at 6 months post intervention.Sertraline medication plus DBT could decrease NSSI episodes and improve symptoms of anxiety and depression for adolescents, and these changes were comparable to those of CBT. More importantly, DBT was demonstrated better clinical improvements at 6‐month follow‐up. [ABSTRACT FROM AUTHOR]

Background: We decided to compare the effects of sertraline and escitalopram in the treatment of major depressive disorder in hemodialysis patients. Materials and Methods: In this single-blind randomized clinical trial, 100 patients with End-Stage Renal Disease (ESRD) undergoing hemodialysis with a Beck Depression Inventory (BDI) score greater than 15 who were not using medication for depression were included in the study. Then randomly assigned to two groups: (one receiving sertraline and one receiving escitalopram). Both groups were monitored using the Beck questionnaire at the end of the first, second, and third months. Additionally, side effects, treatment compliance, and mortality were compared between the two groups. Results: In total, 100 patients with ESRD were included in the study (48 in the sertraline treatment group and 52 in the escitalopram treatment group). The results indicate that in both treatment groups, depression rates significantly decreased over time with medication (P<0.001). Comparing the depression scores over time revealed that the effect of sertraline and escitalopram in reducing depression was not significantly different. However, the depression score in the sertraline group was slightly lower than that in the escitalopram group, although this difference was not statistically significant. Side effects, treatment compliance, and mortality were comparable between the two groups. Conclusion: In general, both sertraline and escitalopram significantly reduced the score of depression in patients, but sertraline in reducing the depression score was greater than that of escitalopram, although this difference was not significant. [ABSTRACT FROM AUTHOR]

This study aimed to characterize the population pharmacokinetics of sertraline in Mexican patients with psychiatric and substance use disorders. Fifty‐nine patients (13 to 76 years old) treated with doses of sertraline between 12.5 and 100 mg/day were included. Plasma sertraline concentrations were determined in blood samples and five of the main substances of abuse were determined by rapid tests in urine samples. Demographic, clinical, and pharmacogenetic factors were also evaluated. Population pharmacokinetic analysis was performed using NONMEM software with first‐order conditional estimation method. A one‐compartment model with proportional residual error adequately described the sertraline concentrations versus time. CYP2D6*2 polymorphism and CYP2C19 phenotypes significantly influenced sertraline clearance, which had a population mean value of 66 L/h in the final model. The absorption constant and volume of distribution were fixed at 0.855 1/h and 20.2 L/kg, respectively. The model explained 11.3% of the interindividual variability in sertraline clearance. The presence of the CYP2D6*2 polymorphism caused a 23.1% decrease in sertraline clearance, whereas patients with intermediate and poor phenotype of CYP2C19 showed 19.06% and 48.26% decreases in sertraline clearance, respectively. The model was internally validated by bootstrap and visual predictive check. Finally, stochastic simulations were performed to propose dosing regimens to achieve therapeutic levels that contribute to improving treatment response. [ABSTRACT FROM AUTHOR]

Background: The comparative effectiveness of selective serotonin reuptake inhibitors (SSRIs) has been subjected to relatively little research. However, a recent study based on target trial emulation suggested that sertraline may be more effective than escitalopram. Aims: To investigate whether sertraline, citalopram, and escitalopram differ in their effectiveness—assessed via the risk of psychiatric hospital admission and suicide following treatment initiation. The choice to focus on sertraline, citalopram, and escitalopram was made to limit confounding by indication, as the Danish depression treatment guideline from 2007 specifically listed these three SSRIs as first choice. Method: We conducted a target trial emulation based on data from Danish registers. We identified all individuals that initiated treatment for depression with sertraline, citalopram, or escitalopram in the period from January 1, 2007, to March 1, 2019. These individuals were followed until psychiatric hospital admission or suicide (separate analyses), death, 1 year after treatment initiation or end of data. Cox proportional hazards regression adjusted for relevant baseline covariates was performed to emulate randomized treatment allocation, comparing the rate of psychiatric hospital admission and suicide for individuals treated with sertraline (used as reference), citalopram or escitalopram, respectively. For escitalopram, we conducted a sensitivity analysis excluding data from the period during which the drug was sold under patent, as the price of the drug during that time likely entailed a different prescription pattern, increasing the risk of ("patent‐related") confounding by indication. Results: We identified 56,865, 118,145, and 31,083 individuals initiating treatment with sertraline, citalopram, and escitalopram, respectively. Using sertraline as reference, the adjusted hazard rate ratio (aHRR) for psychiatric admission was 0.98 (95% CI = 0.91–1.05) for citalopram and 1.21 (95% CI = 1.10–1.32) for escitalopram. Notably, in the sensitivity analysis only including patients initiating treatment after the escitalopram patent had expired, the increased risk of psychiatric hospital admission associated with escitalopram treatment was no longer present (aHRR = 0.98, 95% CI = 0.82–1.18). The results of the analyses of suicide were inconclusive, due to few outcome events. Conclusions: Sertraline, citalopram, and escitalopram do not seem to have differential effectiveness in the treatment of depression. Taking potential patent‐related, time varying, confounding by indication (via severity) into account is critical for pharmacoepidemiological studies, including those employing target trial emulation. [ABSTRACT FROM AUTHOR]

Background: Depression is a common mood disorder that manifests itself simultaneously with chronic diseases. It is especially common in patients diagnosed with cancer, and when neglected, it reduces the success of cancer treatment. The fact that breast cancer is the most common type of cancer in women shows that the treatment of depression in women with cancer is very important. As a result, cancer patients undergoing chemotherapy in oncology units also use antidepressants simultaneously. It is critical to correctly understand the interactions between drugs used in combination. Method: In this study, doses were prepared for MCF7 and MDAMB-231 cell lines by serial dilution from 1000 ng/mL to 1.95 ng/mL. Cell viability was calculated with the WST-1 kit by applying the prepared doses of capecitabine and sertraline alone. In the sertraline/capecitabine combination study, cell viability was examined in MDAMB-231 and MCF-7 cells by applying doses of 300, 100, 50, 25, 10 ng/mL. Combinations that showed selective cytotoxicity after the combination were analyzed with the CompuSyn program and the combination index (CI<1 = synergism) was calculated. Studies on caspase 3-8-9, DNA fragmentation and mTOR were continued using a combination that showed a synergistic effect. Result: It was determined that compared to drug use alone, the sertraline/capecitabine combination decreased cell viability. There is no significant difference in caspase-3,-8,-9 and DNA fragmentation in cancer cells, but there is a reduction in the level of mTOR. This suggests that the death mechanism may be autophagy. Docking studies with autophagy pathway-related proteins further support our results. It is noteworthy that the AKT1-sertraline complex had the best binding affinity among the target proteins (−9.1 kcal/mol). [ABSTRACT FROM AUTHOR]

The simultaneous occurrence of various pollutants in the aquatic environment raises questions about their mutual interactions. There is a gap in research on the sorption of polar substances on microplastics. This study aimed to assess the adsorption of the antidepressants sertraline, fluoxetine and duloxetine on microplastic polystyrene, polyethylene terephthalate and polyvinyl chloride, each in two versions: virgin and aged. To assess the affinity of the tested drugs for plastic and planktonic organisms, the experiment was conducted in microplastic suspensions and in a mixture of microplastics with the protozoan Spirostomum ambiguum. The Fourier transform infrared technique assessed the identity of microplastics and changes during ageing. No significant differences were found between the sorption of the tested drugs on virgin and aged microplastics. The sorption of sertraline onto microplastics was 1.5–3 times lower in the presence of the protozoa than in samples with microplastics alone. Moreover, its concentration in the protozoan cells was 10–30 times higher than in the microplastics. Considering that the amount of plankton in freshwaters is much greater than that of microplastics, it should be concluded that microplastics have a negligible share in the transport of antidepressants in surface waters. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide. It is important to discover new therapeutic regimens for treating CRC. Depression is known to be an important complication of cancer diseases. Repurposing antidepressants into anticancer drugs and exploring the combinational efficacy of antidepressants and chemotherapy are potentially good options for developing CRC treatment regimens. In this study, sertraline, an antidepressant drug, and paclitaxel, an anticancer drug, were chosen to study their antitumor effects in the treatment of colorectal cancer, alone or in combination, and to explore their underlying mechanisms. The data showed that sertraline exerted a dose-dependent cytotoxic effect on MC38 and CT26 colorectal cancer cell lines with IC50 values of 10.53 μM and 7.47 μM, respectively. Furthermore, sertraline synergistically sensitized chemotherapeutic agent paclitaxel efficacy in CRC cells with combination index (CI) values at various concentrations consistently lower than 1. Sertraline remarkably augmented paclitaxel-induced autophagy by increasing autophagosome formation indicated by elevated LC3-II/I ratio and promoting autophagic flux by degrading autophagy cargo receptor SQSTM1/p62, which may explain the synergistically cytotoxic effect of sertraline and paclitaxel combination therapy on CRC cells. This study provides important evidence to support repurposing sertraline as an anticancer agent and suggests a novel combinational regimen for effectively treating CRC as well as in the simultaneous treatment of CRC and depression. [ABSTRACT FROM AUTHOR]

This case report describes a patient with major depressive disorder (MDD) who developed acute hepatocellular liver injury after being treated with sertraline, a selective serotonin reuptake inhibitor (SSRI). The diagnosis of MDD was made two years prior, and the patient had previously responded partially to escitalopram and cognitive-behavioral therapy (CBT). Upon switching to sertraline 50 mg daily, the patient presented with severe symptoms indicative of acute liver injury, including elevated liver enzymes, jaundice, and gastrointestinal distress. Following the discontinuation of sertraline, the patient's liver function tests gradually normalized over a 90-day period, confirming the diagnosis of sertraline-induced hepatotoxicity. This case underscores the importance of continuous monitoring for potential liver injury in patients treated with sertraline. The findings contribute to the existing body of evidence on the hepatotoxic risks associated with SSRIs and highlight the need for personalized treatment strategies to mitigate adverse effects and enhance patient safety. Further research is needed to explore the long-term safety and efficacy of sertraline, particularly in vulnerable populations. [ABSTRACT FROM AUTHOR]

Sertraline is used as an antidepressant drug for the treatment of psychiatric disorders, including anxiety and depression. In the current study, a simple and effective method was developed for the sensitive monitoring of sertraline in water samples using a GC–MS system. The spray-assisted droplet formation liquid-phase microextraction (SADF-LPME) method was used as a sample preparation method for the enrichment of analytes. Accordingly, dichloromethane was used as an extraction solvent and easily dispersed into a sample/standard solution using a lab-made modified spray device without using a dispersing solvent. The significant factors affecting the SADF-LPME efficiency, including sample pH, mixing conditions, extraction solvent type, and spray cycle, were univariately optimized to ascertain the extraction performance and applicability of the system. Under the optimized conditions, the plotted calibration curve of the method was linear in the range of 100.2–2011.7 µg/kg (mass-based standard preparation) with a good correlation coefficient (R2) of 0.9997. The detection and quantification limits of method were found to be 37.5 and 125 µg/kg, respectively. Validation of the method was successfully carried out using different tap water samples and applying a matrix-matching calibration strategy. The acceptable percent recoveries were recorded between 77.3 and 133.7%, with high repeatability. The recommended method is an alternative and fast extraction method with several advantages, including a simple experimental process, good dispersibility, and fast and superior extraction performance. It can be readily applicable to the monitoring and quantification of sertraline in tap water samples with good precision and accuracy. [ABSTRACT FROM AUTHOR]

Primrose syndrome (PS) is a rare genetic disease characterized by developmental delay, intellectual disability, sensorineural hearing loss, and dysmorphic features. PS is caused by de novo pathogenic variants in the ZBTB20 gene, which encodes a transcription factor modulating neurogenesis. We describe resolution with sertraline of neurobehavioral difficulties in a 17‐year‐old Hispanic male with PS with de novo heterozygous c.1916G > A (p.C639Y) variant of ZBTB20. Neurobehavioral difficulties included aggression towards self and others, irritability, tearfulness, and mood liability that did not respond to behavioral interventions or aripiprazole. Treatment with sertraline, a medication indicated for psychiatric disorders including anxiety and depression, led to the resolution of neurobehavioral difficulties after 2 weeks of initiation of medication. The treatment course suggests that selective serotonin reuptake inhibitors, such as sertraline, may be a useful tool for neurobehavioral difficulties in PS over antipsychotics that are accompanied by complex side effect profiles, and suggest that anxiety is the primary cause of the neurobehavioral difficulties in this patient. [ABSTRACT FROM AUTHOR]

Abstract In recent years, buspirone has been co-administered with sertraline to resolve sexual disorders caused by sertraline. Therefore, the present study was conducted to investigate the interaction effect of two antidepressants and anxiolytic drugs, sertraline and buspirone, on human serum albumin (HSA) using spectroscopic and molecular docking techniques. Fluorescence emission spectroscopy and molecular docking were used to calculate the binding affinity and determine the best binding sites for these two drugs. Additionally, UV-visible and circular dichroism spectroscopy were performed to investigate the effect of these drugs on the conformational changes of HSA. The results showed that both drugs have a strong ability to quench the fluorescence of HSA through a static mechanism, and cause structural changes in HSA. It was also found that binding of sertraline and buspirone to HSA is spontaneous (ΔG°

Abstract Sertraline is used as an antidepressant drug for the treatment of psychiatric disorders, including anxiety and depression. In the current study, a simple and effective method was developed for the sensitive monitoring of sertraline in water samples using a GC–MS system. The spray-assisted droplet formation liquid-phase microextraction (SADF-LPME) method was used as a sample preparation method for the enrichment of analytes. Accordingly, dichloromethane was used as an extraction solvent and easily dispersed into a sample/standard solution using a lab-made modified spray device without using a dispersing solvent. The significant factors affecting the SADF-LPME efficiency, including sample pH, mixing conditions, extraction solvent type, and spray cycle, were univariately optimized to ascertain the extraction performance and applicability of the system. Under the optimized conditions, the plotted calibration curve of the method was linear in the range of 100.2–2011.7 µg/kg (mass-based standard preparation) with a good correlation coefficient (R 2) of 0.9997. The detection and quantification limits of method were found to be 37.5 and 125 µg/kg, respectively. Validation of the method was successfully carried out using different tap water samples and applying a matrix-matching calibration strategy. The acceptable percent recoveries were recorded between 77.3 and 133.7%, with high repeatability. The recommended method is an alternative and fast extraction method with several advantages, including a simple experimental process, good dispersibility, and fast and superior extraction performance. It can be readily applicable to the monitoring and quantification of sertraline in tap water samples with good precision and accuracy.

Serotonin syndrome is a potentially life-threatening condition caused by a toxic excess of serotonin leading to overstimulation of the nervous system. Because it is a diagnosis of exclusion, it can be underrecognized, making the true incidence unknown. The classic triad of serotonin syndrome includes neuromuscular excitation, autonomic instability and altered mental status. If left unrecognized and untreated, patients are at a high risk of mortality. The most common class of medication that carries an increased risk of serotonin syndrome, when used in combination, is selective serotonin reuptake inhibitors (SSRIs); however, medications that increase serotonin production, increase serotonin release, inhibit serotonin metabolism and stimulate serotonin receptors can increase the possibility of serotonin syndrome. We report a case that details the presentation and treatment of a 25-year-old man who developed serotonin syndrome in the setting of rapid titration of risperidone, trazodone, and sertraline. The patient presented to the ED with acute agitation, diaphoresis, and altered mental status. He also had lower extremity myoclonus and was tremulous with an oral temperature of 100°F (37.8°C) and heart rate of 103 beats per minute. Serotonin syndrome was confirmed and the patient was treated successfully with benzodiazepines before being discharged from the hospital after 4 days. [ABSTRACT FROM AUTHOR]

Yongfeng Lao,1,2 Yanan Bai,1,2 Xin Guan,1,2 Jian Wang,1,2 Yanan Wang,1,2 Rongxin Li,1,2 Yongqiang Ding,1,2 Zhilong Dong1,2 1Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu, People’s Republic of China; 2Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of ChinaCorrespondence: Zhilong Dong, Department of Urology, The Second Hospital of Lanzhou University, No. 82, Cuiyingmen, Chengguan District, Lanzhou, Gansu, People’s Republic of China, Email dzl1997.student@sina.comIntroduction: Although sertraline has been widely used for chronic prostatitis (CP), the mechanisms are unclear. Herein, we explored the mechanisms of sertraline in treating CP.Methods: Network pharmacology methods were used to explore the potential targets and molecular mechanisms. LPS was used to stimulate RWPE-1 cells to construct an in vitro model of CP. An experimental autoimmune prostatitis (EAP) mice model was built. CCK-8 assay, EdU assay, BrdU detection, and Tunel assay were performed to evaluate the proliferation and apoptosis process of cells or tissues, respectively. DCFH-DA and Fluo-4 fluorescence probes were used to detect intracellular ROS and calcium concentrations. Von Frey filaments and open-field tests were utilized to evaluate pain response and depressive-like behavior of mice. Histopathology was evaluated through hematoxylin and eosin staining. RT-qPCR, Western blot, immunofluorescence, and immunohistochemistry were utilized to evaluate the transcription, expression, and location of related proteins. Molecular dynamics (MD) simulation and surface plasmon resonance (SPR) assay were performed to measure the binding capacity of sertraline and related proteins.Results: Through a network pharmacology analysis, 27 potential targets of sertraline for CP were obtained, and 5 key targets (CHRM1, ADRA1B, HTR2B, HTR2A, and TRPV1) were finally identified. Functional experiments suggested that TRPV1 was involved in the proliferation, apoptosis inhibition, and ROS production of LPS-induced RWPE-1 cells. In vitro experiments showed that sertraline significantly inhibited cell proliferation, ROS generation, and transcription of inflammation cytokines of LPS-induced RWPE-1 cells. Additionally, sertraline markedly promoted the apoptosis level of LPS-stimulated RWPE-1 cells and elevated the expression level of BAX while reducing the expression levels of Bcl2 and Caspase-3. MD simulation and SPR assay confirmed the direct binding of sertraline to TRPV1. Moreover, sertraline significantly down-regulated the expression level of TRPV1 and inhibited calcium influx of LPS-induced RWPE-1 cells. TRPV1 agonist (Capsaicin) significantly restored the effects on proliferation, apoptosis, ROS production, and calcium influx of sertraline on LPS-induced RWPE-1 cells. Mice experiments demonstrated that sertraline treatment could reduce pain response, improve depression-like symptoms, and relieve local prostate inflammation of EAP mice, as well as down-regulated the expression level of TRPV1, inhibit the proliferation, and promote apoptosis of prostate tissues in EAP mice.Discussion: The results revealed the anti-inflammatory effect of sertraline for RWPE-1 cells and EAP mice, and the potential mechanism was regulating the TRPV1 channel. It indicated that sertraline might serve as a complementary anti-inflammatory agent for CP.Keywords: chronic prostatitis, sertraline, RWPE-1, mice, TRPV1

Abstract Objectives This study aims to evaluate the safety and efficacy of escitalopram and sertraline in post-stroke depression (PSD) patients, to provide more reliable therapeutics for cardiovascular and psychiatric clinical practice. Methods We recruited 60 patients (aged 40–89 years old) with an ICD-10 diagnosis of PSD, who were then randomly assigned to two groups and treated with flexible doses of escitalopram (10 to 20 mg/day, n = 30) or sertraline (50 to 200 mg/day, n = 30) for consecutive 8 weeks, respectively. The 24-item Hamilton Depression Rating Scale (HAMD-24), the 14-item Hamilton Anxiety Rating Scale (HAMA-14), the Treatment Emergent Symptom Scale (TESS), the Montreal Cognitive Assessment Scale (MOCA), and the Activity of Daily Living scale (ADL) were used to assess patients before, during, and after treatment for depression, anxiety, adverse effects, cognitive function, and daily living activities. Repeated measures ANOVA, the Mann–Whitney U test, the chi-square test (χ2), or Fisher’s exact test was employed to assess baseline demographics, response rate, adverse effects rate, and changes in other clinical variables. Results Significant reduction in HAMD-24 and HAMA-14 scores was evaluated at baseline, as well as 1, 3, 4, 6, and 8 weeks of drug intervention (p 0.05). Further analysis showed a significant variance in the HAMD-24 scores between the two groups at the end of the first week (p 0.05). Conclusion Escitalopram and sertraline showed comparable efficacy for anxiety symptoms, cognitive function, and daily living abilities in PSD patients. In addition, escitalopram was more appropriate for alleviating depressive symptoms. To validate the conclusion, trials with a larger sample size are in demand in the future. The registration number is ChiCTR1800017373.

Abstract Psychiatric drugs do not vanish after being carried to wastewater treatment plants by the urine or feces of patients and, a variable portion of their dose and also unused or expired drugs are lost to the environment. This is because the technology of plants is not intended to eradicate pharmaceuticals and their metabolites. Above all, psychotropics can change population dynamics and behavior at lower doses. We believe that antipsychotics have not gotten enough attention when it comes to drug pollution and that their importance as environmental pollutants has been underestimated. An innovative approach to eliminating pharmaceutical pollutants from water is the application of advanced oxidation methods. Among these oxidation methods are photocatalysis, ozonation, UV/hydrogen peroxide oxidation, and photo-Fenton oxidation. Photocatalytic degradation of pharmaceuticals is now the most widely used method since it is affordable and ecologically beneficial due to the reusable nature of the photocatalyst. When light is absorbed during photocatalytic degradation, electrons in the valence band (VB) get excited and migrate into the conduction band (CB). Consequently, hydroxyl radicals (•OH) are produced by VB’s holes carrying out oxidation processes on photocatalyst surfaces. The charge difference between the two bands encourages reduction reactions by CB electrons at the surface. To perform successfully, a photocatalyst has to have enough surface-active sites, a favorable band edge location, modest bandgap energy, increased charge separation, and charge transfer. Due to the above-mentioned concerns, the investigation and analysis of the photocatalytic degradation of six psychiatric drugs—carbamazepine, sertraline, amisulpride, amitriptyline, diazepam, and alprazolam—are the main objectives of this review.

Brain-derived neurotrophic factor (BDNF) dysfunction is one of the most important mechanisms underlying depression. It seems that selective serotonin reuptake inhibitors (SSRIs) improve depression via affecting BDNF level. In this systematic review, for the first time, we aimed to review the effect of three SSRIs including fluoxetine, escitalopram, and sertraline, on both depression and BDNF level in preclinical and clinical studies. PubMed electronic database was searched, and 193 articles were included in this study. After reviewing all manuscripts, only one important difference was found: subjects. We found that SSRIs induce different effects in animals vs. humans. Preclinical studies showed many controversial effects, while human studies showed only two effects: improvement of depression, with or without the improvement of BDNF. However, most studies used chronic SSRIs treatment, while acute SSRIs were not effectively used and evaluated. In conclusion, it seems that SSRIs are reliable antidepressants, and the improvement effect of SSRIs on depression is not dependent to BDNF level (at least in human studies). [ABSTRACT FROM AUTHOR]