Cooper, Joyce M., Duffull, S.B., Saiao, A.S., and Isbister, Geoffrey K. (2015) The pharmacokinetics of sertraline in overdose and the effect of activated charcoal. British Journal of Clinical Pharmacology, 79 (2). pp. 307-315.

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Abstract

Aims: To investigate the pharmacokinetics (PK) of sertraline in overdose and the effect of single dose activated charcoal (SDAC).

Methods: Patients presenting to a toxicology unit with sertraline overdoses had demographic and clinical information recorded, and serial serum collected for measurement of sertraline concentrations. Monolix® version 4.2 was used to develop a population PK model of sertraline overdose and the effect of SDAC. Uncertainty in dose time was accounted for by shifting dose time using lag time with between subject variability (BSV). BSV on relative fraction absorbed was used to model uncertainty in dose.

Results: There were 77 timed sertraline concentrations measured in 28 patients with sertraline overdoses with a median dose of 1550 mg (250-5000 mg). SDAC was given to seven patients between 1.5 and 4 h post-overdose. A one compartment model with lag time of 1 h and first order input and elimination adequately described the data. Including BSV on both lag time and relative fraction absorbed improved the model. The population PK parameter estimates for absorption rate constant, volume of distribution and clearance were 0.895 h(-1) , 5340 l and 130 l h(-1) , respectively. The calculated half-life of sertraline following overdose was 28 h (IQR 19.4-30.6h). When given up to 4 h post-overdose, SDAC significantly increased the clearance of sertraline by a factor of 1.9, decreased the area under the curve and decreased the maximum plasma concentration (Cmax ).

Conclusions: Sertraline had linear kinetics in overdose with parameter values similar to those in therapeutic use. SDAC is effective in increasing clearance when given 1.5 to 4 h post-overdose.

Item ID:	73240
Item Type:	Article (Research - C1)
ISSN:	1365-2125
Keywords:	activated charcoal; overdose; pharmacokinetics; poisoning; sertraline; antidepressant
Copyright Information:	© 2014 The British Pharmacological Society
Date Deposited:	23 Nov 2023 03:51
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3214 Pharmacology and pharmaceutical sciences > 321407 Toxicology (incl. clinical toxicology) @ 100%
SEO Codes:	20 HEALTH > 2003 Provision of health and support services > 200311 Urgent and critical care, and emergency medicine @ 100%
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