Serum monitoring of antipsychotic drug levels during concomitant administration of sertraline and antipsychotic medication

Can J Psychiatry. 2006 Oct;51(11):715-8. doi: 10.1177/070674370605101109.

Abstract

Objective: To assess whether pharmacokinetic drug interactions occur when sertraline is added to antipsychotic medications.

Method: 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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antipsychotic Agents / blood*
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / blood
  • Benzodiazepines / therapeutic use
  • Comorbidity
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Double-Blind Method
  • Drug Monitoring / methods*
  • Humans
  • Middle Aged
  • Olanzapine
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Risperidone / blood*
  • Risperidone / therapeutic use*
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy
  • Schizophrenia / epidemiology
  • Serotonin Uptake Inhibitors / blood*
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sertraline / blood*
  • Sertraline / therapeutic use*

Substances

  • Antipsychotic Agents
  • Serotonin Uptake Inhibitors
  • Benzodiazepines
  • Risperidone
  • Olanzapine
  • Sertraline