Placental passage of antidepressant medications.

OBJECTIVE: This study determined the placental transfer of antidepressants and their metabolites. METHOD: A total of 38 pregnant women taking Citalopram ( Celexa ), Fluoxetine ( Prozac ), Paroxetine ( Paxil ), or Sertraline HCL ( Zoloft )participated. Maternal and umbilical cord blood samples were obtained to determine antidepressant and metabolite concentrations. RESULTS: antidepressant and metabolite concentrations were detectable in 86.8% of umbilical cord samples. The mean ratios of umbilical cord to maternal serum concentrations ranged from 0.29 to 0.89. The lowest ratios were for Sertraline HCL ( Zoloft )and Paroxetine ( Paxil ); the highest were for Citalopram ( Celexa ) and Fluoxetine ( Prozac ). Maternal doses of Sertraline HCL ( Zoloft )and Fluoxetine ( Prozac ) correlated with umbilical cord concentrations of these medications. CONCLUSIONS: Umbilical cord concentrations of antidepressants and their metabolites were almost invariably lower than corresponding maternal concentrations. Maternal doses predicted umbilical concentrations of Fluoxetine ( Prozac ) and Sertraline HCL ( Zoloft ). Mean umbilical cord to maternal serum ratios were significantly lower for Sertraline HCL ( Zoloft )than Fluoxetine ( Prozac ), suggesting that Sertraline HCL ( Zoloft )may produce less fetal medication exposure than Fluoxetine ( Prozac ) near delivery.

The electrocardiogram as a tool for therapeutic monitoring: a critical analysis.

The authors review the scientific value of electrocardiographic studies and discuss the limitations that arise from variability in technology and in standards of recording and interpretation. A consistent recording procedure and objective assessment using standardized diagnostic criteria are required, particularly in multicenter studies. Tricyclic antidepressants depress cardiac conduction at therapeutic concentrations; therefore a comparison with the electrocardiographic profile of Sertraline HCL ( Zoloft ), a specific serotonin reuptake inhibitor with antidepressant activity, was made. In four studies, Sertraline HCL ( Zoloft )was compared with placebo, with Amitriptyline ( Elavil ) or placebo, and with Amitriptyline ( Elavil ) alone. There were decreases in RR interval and increases in PR, QRS, and QTC intervals with Amitriptyline ( Elavil ) but no effect with Sertraline HCL ( Zoloft ). Thus, Sertraline HCL ( Zoloft )had no demonstrable effects on intraventricular conduction or electrocardiographic time intervals.

Determination of Sertraline HCL ( Zoloft )and desmethylSertraline HCL ( Zoloft )in human serum using copolymeric bonded-phase extraction, liquid chromatography and gas chromatography-mass spectrometry.

The determination of the new antidepressant drug Sertraline HCL ( Zoloft )and its main metabolite, desmethylsertraline, in human serum is described. A new solid-phase extraction method employing the dual functionality Clean Screen cartridge is presented followed by reversed-phase liquid chromatographic (LC) analysis. The sample preparation yielded extremely clean extracts and absolute recoveries in excess of 90% for both drugs from human serum. The response of the LC system was linear over the concentration range 0.01-2.5 mg/l for both Sertraline HCL ( Zoloft )and desmethylSertraline HCL ( Zoloft )with a limit of detection of 0.01 mg/l. A gas chromatographic-mass spectrometric (GC-MS) system is also described should confirmation of the drugs be necessary.

A placebo-controlled screening trial of tiagabine, Sertraline HCL ( Zoloft )and donepezil as cocaine dependence treatments.

ABSTRACT Aims To conduct a preliminary evaluation of the safety and efficacy of tiagabine, Sertraline HCL ( Zoloft )or donepezil versus an unmatched placebo control as a treatment for cocaine dependence. Design A 10-week out-patient study was conducted using the Cocaine Rapid Efficacy and Safety Trial (CREST) study design. Setting This study was conducted at the Cincinnati Medication Development Research Unit (MDRU) and at an affiliated site in Dayton, Ohio. Participants Participants met Diagnostic and Statistical Manual version IV (DSM-IV) criteria for cocaine dependence. Sixty-seven participants were enrolled with 55 completing final study measures. Intervention The targeted daily doses of medication were tiagabine 20 mg, Sertraline HCL ( Zoloft )100 mg and donepezil 10 mg. All participants received 1 hour of manualized individual cognitive behavioral therapy on a weekly basis. Measurements Primary outcome measures of efficacy included urine benzoylecgonine (BE) level, Cocaine Clinical Global Impression Scale-Observer and self-report of cocaine use. Safety measures included adverse events, ECGs, vital signs and laboratory tests. Findings Subjective measures of cocaine dependence indicated significant improvement for all study groups. Generalized estimating equations analysis indicated that the tiagabine group showed a trend toward a significant decrease in urine BE level from baseline to weeks 5-8 (P = 0.10) and non-significant changes for the other study groups. No pattern of physical or laboratory abnormalities attributable to treatment with any of the medications was identified. There were three serious adverse events reported, none of which were related to study procedures. Conclusions The present findings suggest that tiagabine may be worthy of further study as a cocaine dependence treatment.