Serum monitoring of antipsychotic drug levels during concomitant administration of sertraline and antipsychotic medication.
OBJECTIVE
To assess whether pharmacokinetic drug interactions occur when sertraline is added to antipsychotic medications.


METHODS
Forty-eight patients with remitted DSM-IV schizophrenia and comorbid major depression were randomized to placebo for 6 weeks or sertraline 50 mg for 4 weeks followed by sertraline 50 mg to 100 mg for 2 weeks for nonresponders. Treatment with the patients' usual antipsychotic continued. Weekly clinical outcome assessments occurred for 6 weeks, and serum samples for drug monitoring were collected at Weeks 1, 5, and 6. Serum concentrations of sertraline and antipsychotics were measured with standard assays.


RESULTS
In both placebo- and sertraline-treated groups, most patients displayed minor fluctuations in antipsychotic serum levels over 6 weeks. There was no clinical evidence of drug interactions in the sertraline-treated group.


CONCLUSIONS
Clinically significant adverse effects did not occur despite variable antipsychotic serum levels with or without sertraline. Concern about pharmacokinetic interactions should not deter the use of sertraline for depression in individuals with schizophrenia.
Pierson
Kathleen
K
Department of Psychiatry, University of Calgary, Foothills Hospital, Alberta. kathleen.pierson@calgaryhealthregion.ca
Addington
Donald
D
Addington
Jean
J
Patten
Scott
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000097:blood* / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000097:blood / Q000627:therapeutic use; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D016903:Drug Monitoring / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D000077152:Olanzapine; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D018967:Risperidone / Q000097:blood* / Q000627:therapeutic use*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D017367:Selective Serotonin Reuptake Inhibitors / Q000097:blood* / Q000627:therapeutic use*; D020280:Sertraline / Q000097:blood* / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D018967:Risperidone; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline