Table 15.2 (continued)

Antidepressant

Clinical study

Clinical observations

although there is a large degree of overlap in the ranges

of corresponding parameters. In severe renal

impairment, higher plasma levels of paroxetine are

achieved than in healthy individuals after single dose.

In moderate hepatic impairment, the PK after single

doses are similar to those of normal subjects.

Paroxetine is not a general inducer or inhibitor of

hepatic oxidation processes and has little or no effect on

the PK of other drugs examined

Sertraline

Oslin et al. (2000)

There were no differences in the tolerability of

sertraline vs. nortriptyline. However, in this group of

frail older adults, sertraline was not as effective as

nortriptyline for the treatment of depression

Ronfeld et al.

(1997)

The terminal elimination half-life (t1/2 beta) of sertraline

was similar in young females, elderly males and elderly

females (mean t1/2 beta ranged from 32.1 to 36.7 h in

these groups), but shorter (22.4 h) in the young males.

The mean maximum plasma sertraline concentration

(Cmax) and the mean steady-state area under the plasma

concentration-time curve from time zero to 24 h post-

dose (AUC0-24) were also similar between the young

females, elderly males and elderly females, but were

approx. 25% lower in the young males. The time to

Cmax was unaffected by age or gender and ranged from

6.4 to 6.9 h

Saiz-Rodriguez

et al. (2018)

PK and PD parameters were similar in men and women.

Polymorphisms in CYP2C19 and CYP2B6 genes

influenced sertraline PK, with a greater effect on

CYP2C19. Individuals carrying defective alleles for

CYP2C19 and CYP2B6 showed higher area under the

curve (AUC) and T1/2. Moreover, CYP2C19*17 was

related to a decreased AUC and T1/2. No significant

effect was found for polymorphisms in CYP2C9,

CYP2D6, and ABCB1 on sertraline PK.

Bondareff et al.

(2000)

Nortriptyline treatment was associated with a

significant increase in pulse rate, whereas sertraline was

associated with nonsignificant decrease

Citalopram

Wu et al. (2020)

Most of the predicted PK values of citalopram after

single oral dose administration were within the 70–

130% range of the corresponding PK values obtained

from observed data from eight studies. After multiple

oral administrations, the percentage of Cmax and AUC

ranged between 21% and +25% and 31% and

+21%, respectively

Bezchlibnyk-

Butler et al. (2000)

Citalopram is reasonably safe for elderly populations

vulnerable to PK effects

Cipriani et al.

(2014)

Some older people may be more vulnerable to side

effects associated with citalopram antidepressant, and

decreased dosage is often recommended for them

(continued)

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