Mirtazapine enantiomers in blood and cerebrospinal fluid.
Little information exists on the concentrations of recent antidepressants and their metabolites in cerebrospinal fluid (CSF). Using a stereoselective method, we measured plasma and CSF levels of mirtazapine (MIR), N-demethylmirtazapine and 8-OH-MIR in 3 depressed patients treated with racemic MIR (45 mg/day) for 4 weeks. S-(+)-MIR is considered to be the antidepressant enantiomer, but only R-(-)-MIR reached measurable concentrations in CSF. For R-(-)-MIR, the CSF/plasma ratio varied between 0.08 and 0.31. Further studies are needed to test the hypothesis that there are possible differences in the transport mechanisms of the enantiomers of MIR at the blood-CSF barrier.
Baumann
Pierre
P
Unité de biochimie et psychopharmacologie clinique, Centre de neurosciences psychiatriques, DP-CHUV, Prilly-Lausanne, Suisse. pierre.baumann@chuv.ch
Jonzier-Perey
Michèle
M
Paus
Erik
E
Nikisch
Georg
G
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000097:blood / Q000134:cerebrospinal fluid* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000097:blood / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives* / Q000097:blood / Q000134:cerebrospinal fluid / Q000627:therapeutic use; D000078785:Mirtazapine; D012720:Severity of Illness Index; D013237:Stereoisomerism
D000929:Antidepressive Agents, Tricyclic; D008803:Mianserin; D000078785:Mirtazapine; C415843:8-hydroxymirtazapine; C119256:demethylmirtazapine