sertraline, Zoloft
Sertraline in the treatment of anxiety disorders.

Hirschfeld RM.

Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston 77555-0188, USA.

Sertraline was first developed and approved for the treatment of depression. However, considerable research has been conducted on its use in anxiety disorders. This paper reviews the data emerging from controlled and open trials of the use of sertraline in anxiety disorders. Sertraline has been tested extensively in the treatment of panic and obsessive-compulsive disorders. Less extensive testing has been completed on social phobia and post-traumatic stress disorder. The reviewed studies show that sertraline is an effective and well-tolerated treatment of all of these disorders. A comparison of sertraline with other pharmacotherapeutic options shows it to be at least equivalent to other medications for anxiety disorders.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10945134&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
CYP2D6 inhibition in patients treated with sertraline.

Sproule BA, Otton SV, Cheung SW, Zhong XH, Romach MK, Sellers EM.

Addiction Research Foundation, Toronto, Ontario, Canada.

Sertraline, a selective serotonin reuptake inhibitor used to treat depression, inhibits CYP2D6 in vitro (Ki = 1.2 microM) less potently than fluoxetine (Ki = 0.15 microM). To determine the extent and time course of CYP2D6 inhibition in patients, six males (mean age: 40 years, range: 29-64 years), who were starting treatment for depression with sertraline, were phenotyped on five occasions (once before treatment and approximately 3, 7, 14, and 21 days later). Phenotype status was determined using oral dextromethorphan (30 mg) by calculating the urinary ratio of O-demethylated metabolites to parent drug (i.e., log ODMR). CYP2D6 genotype was determined by leukocyte DNA analysis using polymerase chain reaction amplification. Compliance was confirmed by sertraline plasma levels. Daily sertraline dosages ranged from 50 to 150 mg. Genotype results indicated all subjects were extensive metabolizers (four homozygous wild type [wt], two heterozygous wt/B mutation). Phenotype results showed that CYP2D6 inhibition in patients treated with sertraline appeared to be related to baseline CYP2D6 activity and sertraline dosage. Some patients with high CYP2D6 activity can demonstrate inhibition with sertraline dosages as low as 50 mg.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10950472&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
Sertraline inhibits the contractile responses to noradrenaline, KCl and electrical field stimulation of rat isolated vas deferens.

Kalyoncu NI, Ozyavuz R, Karaoglu S.

Karadeniz Technical University Medical School, Department of Pharmacology, Trabzon, Turkey.

1. The aim of this study was to investigate the effect of sertraline, a selective serotonin re-uptake inhibitor, on contractile responses to noradrenaline (NA), KCl, serotonin (5-HT) and electrical field stimulation of rat isolated vas deferens. 2. Pre-treatment with 10(-4) M sertraline showed inhibitory effects on responses to NA, KCl, 5-HT and electrical field stimulation, while pre-treatment with 10(-6) and 10(-5) M sertraline caused potentiation of responses to NA (10(-7) and 10(-6) M). 3. A voltage-dependent calcium channel activator, Bay K 8644, restored the inhibited responses when sertraline was washed out of the organ bath, although restoration could not be seen when sertraline was not removed. 4. The inhibition of the contractile responses by sertraline pre-treatment may be via a mechanism through calcium channels which is additional to the selective serotonin re-uptake inhibitory effect of sertraline.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10961743&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
The effects of sertraline and fluoxetine on anxiety in the elevated plus-maze test in mice.

Kurt M, Arik AC, Celik S.

Department of Pharmacology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. Mehmet-Kurt usa.net

The aim of this study was to evaluate the acute and chronic effects of two SSRIs (sertraline and fluoxetine) on anxiety by the elevated plus-maze test. Diazepam increased the time spent in open arms significantly whereas the anxiogenic m-chlorophenylpiperazine (m-CPP) decreased the time significantly. Acute sertraline (10 mg x kg(-1)) and fluoxetine (20 mg x kg(-1)) treatment significantly decreased the time spent in open arms. Acute fluoxetine (20 mg x kg(-1)) treatment also decreased the total number of enclosed arm entries. Seven days sertraline treatment decreased the time spent in open arms, whereas 14 days fluoxetine treatment increased the time spent in open arms. These results show that acute administration of SSRIs may produce anxiogenic effects in the elevated plus-maze test.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11037770&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
Sertraline and obsessive compulsive disorder: new indication. Limited assessment.

[No authors listed]

(1) Sertraline, a selective serotonin reuptake inhibitor (SSRI), is now licensed in France for the treatment of obsessive-compulsive disorder in adults. (2) In this indication the clinical file is of acceptable methodological quality, but it is incomplete: sertraline has not been compared with the other two serotonin reuptake inhibitors approved in obsessive-compulsive disorder, namely fluoxetine and paroxetine. (3) Three placebo-controlled trials have demonstrated the efficacy of sertraline in obsessive-compulsive disorder. (4) In a trial versus clomipramine, sertraline was no more effective in patients able to tolerate the drug, but the rate of treatment withdrawals for adverse events was higher on clomipramine.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11067720&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
[Sexual dysfunctions induced by serotonin reuptake inhibitors]

[Article in Spanish]

Arias F, Padin JJ, Rivas MT, Sanchez A.

Unidad de Psiqiatria, Fundacion Hospital de Alcorcon, Madrid. farias fhalcorcon.es

OBJECTIVE: To assess the incidence of serotonin reuptake inhibitor (SRI) antidepressant-induced sexual dysfunction (SD) and to compare the sexual side effects of SRI. DESIGN: Naturalistic, prospective, observational study. SETTING: Two urban health centers. PATIENTS: 235 outpatients (164 women, 71 males) who began treatment with some of the following SRI: fluoxetine, sertraline, paroxetine, citalopram and venlafaxine, who had engaged in regular sexual practices with stable partner, who were suffering from different mental disorders who were being treated with SRI. The assignment to each group was according to clinical criteria. INTERVENTIONS: Patients completed questionnaires that allowed reporting of both SD induced by the illness and the treatment, evaluating changes in libido, arousal, and orgasm. The patients were observed over 6 months of treatment. RESULTS: 147 patients (62.6%) reported one or more SD related to SRI treatment. There were differences in the incidence between the different SRI: 39% with fluoxetine, 75.5% with paroxetine, 78.8% with sertraline, 28.9% with citalopram and 80% with venlafaxine. In 78.2% of patients the SD showed no improvement by the end of this period. In a predictive logistical regression model of the presence of SD induced by the SRI, the female category and the presence of previous sexual problems were favourable predictors and the treatment with paroxetine, sertraline or venlafaxine were increased the risk of SD. CONCLUSIONS: SD is one of the most frequent and persistent SRI adverse effect. We recommended to inquiry about SD in patients who were treated with SRI. Significant differences were found in the occurrence of SD between the different SRI. Such data would be particularly valuable to physicians when choosing a specific antidepressant from this therapeutic group.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11111311&dopt=Abstract sertraline Zoloft



sertraline, Zoloft
Sequential improvement of anxiety, depression and anhedonia with sertraline treatment in patients with major depression.

Boyer P, Tassin JP, Falissart B, Troy S.

Hopital de la Salpetriere, Bd de l'hopital, 75013 Paris, France. paboyer ext.jussieu.fr

OBJECTIVE: To establish the therapeutic effect profile of sertraline in major depression. It was hypothesized that the antidepressant effect of sertraline showed three phases: Phase 1 where improvements in anxiety are most pronounced; Phase 2 where the greatest improvements are in depressive symptoms; and Phase 3 where the symptoms of anhedonia show the most improvement. To test this hypothesis, an 8-week, open-label study was conducted. METHODS: Patients with a major depressive episode (DSM-IV) and a score > or = 24 on the 17-item HAM-D were enrolled and treated with sertraline 50-150 mg/day. The three symptomatic clusters, anxiety, depression and hedonia, were defined a priori using the Inventory of Depressive Symptomatology-Clinician rated (IDS-C). Periods of interest were: Days 0-7 for anxiety, Days 7-21 for depression and Days 21-56 for anhedonia. Raters were blinded as to the constitution of the clusters and periods. RESULTS: 140 patients were recruited. Improvement in the anxiety cluster of the IDS-C was greatest during Days 0-7, whereas over Days 7-21 most improvement was observed in the depression cluster and the greatest improvement in the hedonic cluster occurred during Days 21-56. CONCLUSION: These preliminary results are consistent with the hypothesis that the therapeutic effects of sertraline occur in a sequential manner. The symptoms of anxiety improved first, followed by depression and then anhedonia.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11123488&dopt=Abstract sertraline Zoloft