Sertraline INDEX

CONTENTS Preface. Bruce E. Maryanoff and Cynthia A. Maryanoft. Novel An-tipsychotics with Unique D /5-HT1A Affinity and Minimal Extrapyramidal Side Effect Liability. Allen B. Reitz and Malcolm K. Scott. Antiplatelet and Antithrombotic Agents From Viper Venom Proteins, to Peptides and Peptidomimetics. to Small Organic Molecules, Peter L. Barker and Robert R. Webb. II. Discovery and Preclinical Development of the Serotonin Reuptake Inhibitor Sertraline, Willard M. Welch. Boronic Acid Inhibitors of Dipeptidyipeptidase IV A New Class of Immunosuppressive Agents, Roger J. Snow. Index. 

CANNABIS SERTRALINE, VENLAFAXINE Unpredictable changes in plasma concentration. Risk of toxicity or therapeutic failure, particularly of drugs with a narrow therapeutic index Induction or inhibition of CYP3A4-mediated metabolism by cannabis. It is not yet known whether the effects are dependent on the degree of cannabis consumption Be aware. Watch for signs of toxicity, especially when cannabis use abruptly changes... 

Sertraline has a relatively low risk of toxicity. It is less sedating and has fewer cardiovascular effects than the tricyclic antidepressants. It has a high therapeutic index, which is consistent with other serotonin uptake inhibitors. 

Antidepressant drugs A major class of psychotropic drugs with diverse chemical configurations including the monoamine oxidase inhibitors (MAOIs), the heterocyclic drugs (composed of mono-, di-, tri-, and hetero-cyclics), the serotonin reuptake inhibitors (fluoxetine, paroxetine, sertraline, trazodone, and venlafaxine), and bupropion are more recent innovations. Antidepressants usually must be taken for several weeks to have the desired effect and they often have a low therapeutic index, so they must be closely monitored. 

Potentially clinically significant interactions include the tendency for fluvoxamine to increase circulating concentrations of oxidatively metabolized benzodiazepines, clozapine, theophylline, and warfarin. Sertraline and fluoxetine can increase levels of benzodiazepines, clozapine, and warfarin. Paroxetine increases levels of clozapine, theophylline, and warfarin. Fluoxetine also potentiates tricyclic antidepressants and some class 1C antiarrhythmics with a narrow therapeutic index (including encainide, flecainide, and propafenone). Nefazodone potentiates benzodiazepines other than lorazepam and oxazepam. 

Sertraline, ds(+) l-methylamino-4-(3-4-dichlorophenyl)tetralin, absolute configuration IS, 4S, is a potent and selective 5-HT uptake inhibitor [70] in dinical use as an antidepressant since 1990. The selectivity index in regard to NE uptake inhibition (NE/5-HT) or DA uptake inhibition in vitro is in both cases 20 [61,70]. 

The potency of sertraline in 5-HT uptake inhihition is the same as that of the racemate but the selectivity index NE/5-HT has increased from 10 to 20. 

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