Sertraline nervous system

SSRIs are theorized to reduce the frequency of hot flashes by increasing serotonin in the central nervous system and by decreasing LH. Of the SSRIs, citalopram, paroxetine, and sertraline all have been studied and have demonstrated a reduction in hot flashes while treating other symptomatic complaints such as depression and anxiety.33 Venlafaxine, which blocks the reuptake of serotonin and norepinephrine, has demonstrated a reduction in hot flashes primarily in the oncology population.34 Overall, these antidepressant medications offer a reasonable option for women who are unwilling or cannot take hormonal therapies, particularly those who suffer from depression or anxiety. These agents should be prescribed at the lowest effective dose to treat symptoms and may be titrated based on individual response. 

Sertraline (Zoloft, Pfizer) Central nervous system GPCR... 

Sertraline is a recent antidepressant that is called a selective serotonin reuptake inhibitor (SSRI). It is chemically unrelated to the older tricyclic antidepressants (see Section 5.3). It works by preventing the movement of the neurohormone serotonin into nerve endings. It can help to improve mood and mental alertness, increase physical activity, and improve sleep patterns. It is prescribed for obsessive-compulsive disorder and obesity. It may offer some advantage over fluoxetine by exhibiting little central nervous system (CNS) action. It has less sedation and anxiety and is shorter acting. 

We recently surveyed pharmaceutical companies producing antidepressant medication or central nervous system (CNS) stimulants for the European market. Approval for use of such drugs in children and adolescents is limited worldwide. Sertraline, clomipramine, and flu-voxamine have been approved for use in children (for some drugs down to the age of 6 years) for OCD in some European countries (the most wide spread approval being for sertraline in Austria, France, Hungary, Italy, Latvia, Norway, Portugal, Romania, Slovenia, Spain, Sweden, Switzerland, Turkey, United Kingdom, and Denmark) and countries outside Europe. Methyl-phenidate has been approved for the treatment of children with ADHD in a number of European and non-European countries (Novartis Health care A/S, personal communication). 

Sertraline (16) is an antidepressant that inhibits the uptake of serotonin in the central nervous system.148 It is marketed by Pfizer under the name Zoloft.149 One methodology that can be used relies on an asymmetric reduction (see also Chapter 16) (Scheme 31.11).150-156 The lactone can be used as a chiral starting material for the Friedel-Crafts reaction. The established stereogenic center in the tetralone controls the reduction of the imine.157 The alternative is a resolution approach (Scheme 31.12).148-153-158-161... 

FLUOXETINE, FLUVOXAMINE, PAROXETINE BZDs - ALPRAZOLAM, DIAZEPAM, MIDAZOLAM t in plasma concentrations of these BZDs. Likely t sedation and interference with psychomotor activity Alprazolam, diazepam and midazolam are subject to metabolism by CYP3A4. Fluvoxamine, fluoxetine and possibly paroxetine are inhibitors of CYP3A4 sertraline is a weak inhibitor. SSRIs are relatively weak compared with ketoconazole, which is possibly 100 times more potent as an inhibitor Warn patients about risks associated with activities that require alertness. Consider use of alternatives such as oxazepam, lorazepam and temazepam, which are metabolized by glucuronidation >- For signs and symptoms of CNS depression, see Clinical Features of Some Adverse Drug Interactions, Central nervous system depression... 

Selective serotonin reuptake inhibitors (SSRIs) inhibit the neuronal reuptake of serotonin in the central nervous system and have shown mixed efficacy in the treatment of autistic symptoms (Moore et al., 2004). A number of studies have shown reductions in repetitive behaviors, lethargy, inappropriate speech, and improvements in the ability to relate to others, cognition, language improvement with fluoxetine (DeLong et al., 1998 Fatemi et al., 1998 Peral et al., 1999), fluvoxamine (McDougle et al., 1996b), and sertraline (Steingard et al., 1997). However, other studies have shown a lack of response with fluvoxamine (Martin et al., 2003) and citalopram (Couturier and Nicolson, 2002). 

This is a 5-HT1 agonist (inhibiting the release of serotonin from presynaptic nerve terminals). Hence, even though it suppresses central serotonergic transmission (opposite to the effect of sertraline), there is an increased risk of central nervous system toxicity. Thus, the combined use of sertraline and sumatriptan is not usually recommended. 

Nervous system The addition of serfraline to ziprasidone in a 30-year-old female resulted in tixe development of a serotonin syndrome [282 ]. Ziprasidone is bofh a 5-HTlA agonist and inhibitor of serotonin transporters sertraline was discontinued and the patient was maintained on ziprasidone. 

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