Evidence map›Paper›PMID 25971243›Full record

Trial reportClinical pharmacokinetics2015

The Impact of Sertraline Co-Administration on the Pharmacokinetics of Olanzapine: A Population Pharmacokinetic Analysis of the STOP-PD.

Simon J C Davies, Benoit H Mulsant, Alastair J Flint, Barnett S Meyers, Anthony J Rothschild, Ellen M Whyte, Margaret M Kirshner, Denise Sorisio, Bruce G Pollock, Robert R Bies

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical pharmacokinetics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Population pharmacokinetics of olanzapine in children.British journal of clinical pharmacology · 2021
    Article
  6. PharmGKB summary: sertraline pathway, pharmacokinetics.Pharmacogenetics and genomics · 2020
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 2 countries.

Simon J C DaviesCentre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada. simon_davies@camh.net.
Benoit H MulsantCentre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.
Alastair J FlintDepartment of Psychiatry, University of Toronto, Toronto, ON, Canada.
Barnett S MeyersWeill Medical College of Cornell University and New York Presbyterian Hospital, New York, NY, USA.
Anthony J RothschildUniversity of Massachusetts Medical School and University of Massachusetts Memorial Health Care, Worcester, MA, USA.
Ellen M WhyteDepartment of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Margaret M KirshnerDepartment of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Denise SorisioDepartment of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Bruce G PollockCentre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.
Robert R BiesCentre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J 1H4, Canada.
Centre for Addiction and Mental Health · CAUniversity of Pittsburgh · USIndiana Clinical and Translational Sciences Institute · USNewYork–Presbyterian Hospital · USUniversity of Massachusetts Chan Medical School · USUniversity of Toronto · CA

Funding

Acute Pharmacotherapy of Unipolar Psychotic DepressionU01MH062565 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI WHYTE, ELLEN M · 2002 to 2015
$3.0M
6 · The paper itself

Abstract

BACKGROUND AND

objectiveClinical evidence and expert opinion support using a combination of an antipsychotic and an antidepressant when treating major depression with psychotic features. We characterized the impact of sertraline co-administration on olanzapine clearance in psychotic depression using population pharmacokinetic methods.

methodsThe Study of Pharmacotherapy for Psychotic Depression (STOP-PD) randomized 259 participants to olanzapine plus placebo or olanzapine plus sertraline. Olanzapine was started at 2.5-5 mg/day and sertraline at 25-50 mg/day. Doses were increased to a maximum of 20 mg/day for olanzapine and 200 mg/day for sertraline. Up to four olanzapine concentration samples were collected during the 12-week trial and 12-week continuation phase. We used NONMEM (Version VII) for population pharmacokinetic analysis, assessing effects of the covariates sex, African American origin, smoking, age, and sertraline co-administration.

resultsPopulation pharmacokinetic analysis comprised 336 samples from 175 individuals. The structural model published by Bigos et al. was sufficient to describe the olanzapine data adequately: a one-compartment model with first-order absorption and elimination, using an additive residual error structure with the absorption rate constant fixed to 0.5. Sertraline co-administration significantly increased olanzapine apparent clearance (p < 0.005) by 25-35 % depending on the patient characteristics included. Male sex was associated with a significantly increased clearance. Age and race did not have a significant impact on clearance.

conclusionsContrary to expectations from the knowledge of cytochrome P450 interactions, sertraline increased olanzapine apparent clearance. Plausible explanations include patients treated with sertraline having poorer adherence to olanzapine, or the impact of sertraline inhibition of transporters resulting in increased intracellular concentrations and thus access to metabolizing enzymes.

Indexed as

AdultAgedBenzodiazepinesDrug InteractionsDrug Therapy, CombinationFemaleHumansMajor Depressive DisorderMaleMiddle AgedModels, BiologicalOlanzapinePsychotic DisordersSertralineSex FactorsBenzodiazepinesOlanzapineSertraline

Identifiers

PMID25971243
OpenAlexW571503340

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.