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Article
SSRI-antipsychotic combination in psychotic depression: sertraline pharmacokinetics in the presence of olanzapine, a brief report from the STOP-PD study
University of Massachusetts Medical School Faculty Publications
  • Simon J.C. Davies, Centre for Addiction and Mental Health
  • Benoit H. Mulsant, University of Toronto
  • Alastair Flint, University of Toronto
  • Barnett S. Meyers, Weill Cornell Medical College
  • Anthony J. Rothschild, University of Massachusetts Medical School
  • Ellen M. Whyte, University of Pittsburgh
  • Margaret M. Kirshner, University of Pittsburgh
  • Denise Sorisio, University of Pittsburgh
  • Bruce G. Pollock, University of Toronto
  • Robert R. Bies, Centre for Addiction and Mental Health
  • STOP-PD study group, STOP-PD study group
UMMS Affiliation
Department of Psychiatry
Publication Date
5-1-2016
Document Type
Article
Abstract
OBJECTIVE: We recently reported an unexpected interaction between olanzapine and sertraline in a population being treated for psychotic depression. Contrary to knowledge of cytochrome p450 interactions sertraline increased apparent clearance of olanzapine by 30%. Here we examined the pharmacokinetics of sertraline in the same population. Existing studies suggest that sertraline apparent clearance is significantly increased in male subjects and suggested an age/sex interaction. METHODS: We studied subjects undergoing combination of sertraline/olanzapine treatment for psychotic depression in the Study of the Pharmacotherapy of Psychotic Depression. Nonlinear mixed effect modelling software was used to examine the sertraline pharmacokinetics, evaluating age, sex, race, and olanzapine exposure as covariates. RESULTS: Eighty-seven subjects (median age 62 years, 28 male subjects, 11 African-Americans) provided 138 samples for sertraline concentration. Olanzapine exposure had a 14.8-fold range. A one compartment model with combined residual error described the sertraline concentration data adequately. Half-life and sex effect on sertraline apparent clearance (males averaging 50% higher (p < 0.005); 96.6 l/h vs 64.8 in female subjects) were similar to previous reports. No other covariate (age, race or olanzapine exposure) had a significant impact on apparent clearance, and no age/sex interaction emerged. CONCLUSION: Sertraline pharmacokinetics were similar to historical descriptions in populations not taking antipsychotics. Unlike our unexpected finding that sertraline increases olanzapine apparent clearance, olanzapine exposure had no impact on sertraline pharmacokinetics.
Keywords
  • olanzapine,
  • pharmacokinetics,
  • sertraline
DOI of Published Version
10.1002/hup.2532
Source
Hum Psychopharmacol. 2016 May;31(3):252-5. doi: 10.1002/hup.2532. Epub 2016 Apr 6. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
27060853
Citation Information
Simon J.C. Davies, Benoit H. Mulsant, Alastair Flint, Barnett S. Meyers, et al.. "SSRI-antipsychotic combination in psychotic depression: sertraline pharmacokinetics in the presence of olanzapine, a brief report from the STOP-PD study" Vol. 31 Iss. 3 (2016) ISSN: 0885-6222 (Linking)
Available at: http://works.bepress.com/anthony_rothschild/144/