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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Paroxetine and sertraline are listed under the old FDA category B drugs, but recent research calls the safety of paroxetine use during pregnancy into question. The frequency of congenital anomalies was not increased above background among 394 infants exposed to paroxetine during the first trimester (Diav-Citrin et al., 2002; Ericson et al., 1999; Inman et al., 1993; Kulin et al., 2002; McElhatton et al., 1996; Wilton et al., 1998). However, as recently as July 2006, the manufacturer of Paxil (paroxetine) reported that first trimester use increased the risk of birth defects by between two and three times, with the risk of congenital heart defects being doubled. This contradicts prior studies of the drug’s use during the first trimester.
General Principles of Clinical Psychopharmacology in Children and Adolescents
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
The prescriber should be aware that for some medications, both the dose and the duration of treatment can influence pharmacokinetics, e.g. it has been calculated that after a single dose of Sertraline 50 mg in adolescents, the mean half-life is about 27 hours, but after repeated administration this decreases to about 15 hours. Moreover, the steady-state half-life is about 20 hours after administration of higher doses (100–150 mg). Lower doses, i.e. 50 mg of Sertraline, should be given twice a day to prevent withdrawal, while higher doses, i.e. 100–150 mg doses, can be given once a day (IACAPAP, 2019).
Pharmacological Management of Huntington’s Disease
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Sonia Sharma, Sushant Sharma, Shallina Gupta
Sertraline drug is also used against behavioral disturbance such as aggressiveness or irritability. Caution is advised when sertraline is coadministered with warfarin, linezolid, tramadol, lithium, and so on. Main side effects of this drug are dizziness, fatigues, nausea, insomnia, and so on (Alpay and Koroshetz, 2006).
SSRI withdrawal syndrome in children and adolescents: a narrative literature review
Published in Expert Opinion on Drug Safety, 2023
Yasser Saeed Khan, Mohamed Adil Shah Khoodoruth, Yahia Albobali, Peter M. Haddad
A book chapter by Hernández-Otero and colleagues reviewed the scientific evidence for the use of antidepressants in children and adolescents [34]. It reported that downward titration at the time of discontinuation is not needed in the case of fluoxetine due to its long half-life. For Sertraline, it proposed a gradual reduction of dose to avoid withdrawal symptoms. It concluded that some patients could tolerate a reduction of 50% of the total dose over 3 days and the remaining 50% dose reduction over the subsequent 3 days. The recommendation is not much different for citalopram except that no progressive reduction is necessary however, a gradual reduction in the rate similar to what is reported for Sertraline is advisable. In relation to Escitalopram, the authors advise that it is wise to carry out a gradual titration to avoid withdrawal syndrome.
Pregnancy-related issues in women with multiple sclerosis: an evidence-based review with practical recommendations
Published in Journal of Drug Assessment, 2020
Beatriz Canibaño, Dirk Deleu, Boulenouar Mesraoua, Gayane Melikyan, Faiza Ibrahim, Yolande Hanssens
In addition to their MS symptoms, pregnant and lactating women with MS may face other conditions such as urinary tract infections, incontinence, depression, fatigue, spasticity or gait abnormalities, which can all worsen during and after pregnancy. The management of these conditions includes the use of oral drugs many of them with small MW and almost all of them are categorized FDA pregnancy risk B, C and D173. Except for a few antidepressants the safety data of these drugs is very scanty. Clinical data on the use of antidepressants by pregnant women and nursing mothers revealed that these drugs are essentially not teratogenic174–175. Sertraline has been well-studied during pregnancy with more than 10,000 sertraline-exposed pregnancies during the first trimester. The drug shows little interaction and has a linear pharmacokinetic profile with a half-life of 24–26 h. The drug may also be beneficial for treating depression during breastfeeding176.
Pharmacological management of agitation among individuals with moderate to severe acquired brain injury: A systematic review
Published in Brain Injury, 2018
Swati Mehta, Amanda McIntyre, Shannon Janzen, Jerome Iruthayarajah, Ali Bateman, Robert Teasell
Antidepressants have been studied in a number of populations in which agitation and aggression can be problematic, including Huntington’s disease (35), pervasive developmental disorders (36–38), and psychiatric illness (39), with varying degrees of success. Sertraline has been studied more often for reducing agitation and aggression compared to other antidepressants. Both Kant et al. (26) and Meythalar et al. (16) reported no side effects as a result of using this medication within an ABI population. Thus, when antidepressants are being considered for use, sertraline should be the first drug of choice (4). Mysiw et al. (28) found that amitriptyline resulted in several adverse effects including arrhythmia, vasomotor instability, and urinary retention. Therefore, amitriptyline should be considered as a second-line antidepressant for the treatment of ABI-related agitation. Considering the low level of evidence for both drugs, antidepressants should be primarily prescribed when there is another indication for their use, such as coexisting agitation and major depressive disorder (4).