title: Changing tides: Adaptive monitoring, assessment, and management of pharmaceutical hazards in the environment through time.
abstract: Pharmaceuticals are ubiquitous contaminants in aquatic ecosystems. Adaptive monitoring, assessment, and management programs will be required to reduce the environmental hazards of pharmaceuticals of concern. Potentially underappreciated factors that drive the environmental dose of pharmaceuticals include regulatory approvals, marketing campaigns, pharmaceutical subsidies and reimbursement schemes, and societal acceptance. Sales data for 5 common antidepressants (duloxetine [Cymbalta], escitalopram [Lexapro], venlafaxine [Effexor], bupropion [Wellbutrin], and sertraline [Zoloft]) in the United States from 2004 to 2008 were modeled to explore how environmental hazards in aquatic ecosystems changed after patents were obtained or expired. Therapeutic hazard ratios for Effexor and Lexapro did not exceed 1; however, the therapeutic hazard ratio for Zoloft declined whereas the therapeutic hazard ratio for Cymbalta increased as a function of patent protection and sale patterns. These changes in therapeutic hazard ratios highlight the importance of considering current and future drivers of pharmaceutical use when prioritizing pharmaceuticals for water quality monitoring programs. When urban systems receiving discharges of environmental contaminants are examined, water quality efforts should identify, prioritize, and select target analytes presently in commerce for effluent monitoring and surveillance.
authors.affiliation: Department of Chemistry, University of Canterbury, Christchurch, New Zealand.
authors.forename: Sally
authors.initials: S
authors.lastname: Gaw
authors.affiliation: Department of Environmental Science, Center for Reservoir and Aquatic Systems Research, Institute of Biomedical Studies, Baylor University, Waco, Texas, USA.
authors.forename: Bryan W
authors.initials: BW
authors.lastname: Brooks
mesh_terms: D000928:Antidepressive Agents / Q000032:analysis* / Q000633:toxicity; D017753:Ecosystem; D004784:Environmental Monitoring; D015386:Hazardous Substances / Q000032:analysis* / Q000633:toxicity; D013997:Time Factors; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000633:toxicity; D060753:Water Quality
chemical_list: D000928:Antidepressive Agents; D015386:Hazardous Substances; D014874:Water Pollutants, Chemical
keywords: Environmental monitoring; Pharmaceuticals; Prioritization; Therapeutic hazard ratios; Urbanization