Global scanning of selective serotonin reuptake inhibitors: occurrence, wastewater treatment and hazards in aquatic systems

Effects of fluoxetine on fish: What do we know and where should we focus our efforts in the future?

Fluoxetine is one of the most studied and detected selective serotonin reuptake inhibitors in the aquatic environment, found at concentrations ranging from ng/L to μg/L. Its presence in this environment can induce effects on aquatic organisms that may compromise their fitness. Several experimental studies have demonstrated that fluoxetine can induce neurotoxicity, genetic and biochemical changes, and cause behavioral dysfunction in a wide range of fish species. However, contradictory results can be found. There is thus the need for a comprehensive review of the current state of knowledge on the effects of fluoxetine on fish at different levels of biological organization, highlighting inclusive patterns and discussing the potential causes for the contradictory results, that can be found in the available literature. This review also aims to explore and identify the main gaps in knowledge and areas for future research. We conclude that environmentally relevant concentrations of fluoxetine (e.g., from 0.00345 μg/L) produced adverse effects and often this concentration range is not addressed in conventional environmental risk assessment strategies. Its environmental persistence and ionizable properties reinforce the need for standardized testing with representative aquatic models, targeting endpoints sensitive to the specific mode of action of fluoxetine, in order to assess and rank its actual environmental risk to aquatic ecosystems.

The antipsychotic drug olanzapine altered lipid metabolism in the common carp (Cyprinus carpio L.): Insight from the gut microbiota-SCFAs-liver axis

Olanzapine (OLA) is a common drug used to treat schizophrenia and has recently come under increasing scrutiny as an emerging contaminant. However, its impact on lipid metabolism in fish and its mechanisms of action are not well understood. In this study, common carp were exposed to 0, 10, 100, and 250 μM OLA for 60 days. The results indicated that OLA exposure increased weight gain, total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG) and decreased high-density lipoprotein (HDL). In addition, lipids accumulated in the liver of the common carp. To explore the underlying mechanisms of action, gut microbiota, short-chain fatty acids (SCFAs), liver transcripts, and genes related to lipid metabolism were measured. It was discovered that OLA exposure altered the common carp gut microbiota composition and increased the abundance of SCFA-producing bacteria. Correspondingly, this study showed that OLA exposure increased the levels of SCFAs, which are highly relevant to the development of lipid accumulation. Transcriptome sequencing results indicated that OLA exposure could change lipid metabolism signalling pathways, including steroid biosynthesis, the PPAR signalling pathway, asglycerophospholipid metabolism, glycerolipid metabolism, and fatty acid metabolic pathways of the common carp. Additionally, OLA exposure interrupted lipid metabolism by means of significant upregulation of lipid synthesis-related genes, including pparγ, srebp1, and fas. OLA exposure also resulted in significant lipolysis-related gene downregulation, including cpt, lpl, hsl, and pparα. The results of this study indicated that contamination of aquatic environments with OLA alters lipid metabolism in common carp. In addition, the underlying mechanism might be due in part to the modulation of the gut microbiota-SCFA-PPAR signalling pathway.

Ecotoxicological assessment of the effects of fluoxetine on Daphnia magna based on acute toxicity, multigenerational reproduction effects, and attraction-repellence responses

Fluoxetine, a common pharmaceutical used as an antidepressant, is already considered potentially hazardous to biota due to its increasing use and detection in European, North American, and Asian rivers. We studied the effects of fluoxetine on Daphnia magna, as we hypothesized that fluoxetine might have harmful effects, short and long-term, at different levels: survival, behaviour, and reproduction (offspring production). We applied two different approaches: (i) a scenario at environmentally relevant concentrations (0.1-1.0 μg/L) and (ii) a scenario simulating a future worsening of contamination (1-800 μg/L) until the reach of lethal concentrations. In the former, we examined whether there are multigenerational effects on reproduction and on the avoidance/colonisation behaviour in previously exposed populations. In the latter, three responses were assessed: survival, avoidance behaviour and reproduction. We did not detect differences in the reproduction output of D. magna among the treatments over the three generations examined. Irrespective of the multigenerational treatment, D. magna colonised the environments with fluoxetine in a similar way. In the second scenario, we determined the lethal concentration for 50% of the population (96 h-LC₅₀ = 365 μg/L), which, in spite of the toxic effect, was attractive to organisms during the avoidance tests (24 h); in fact, D. magna were attracted (no repellence) even to the highest concentrations of fluoxetine tested (800 μg/L). Lastly, in a 21-day chronic toxicity test the reproduction output of D. magna increased with higher concentrations of fluoxetine. This effect might be related to the fact that the organisms in the contaminated treatment began their first reproduction earlier, when compared to that in the control treatments. In conclusion, this study discusses an identified hazard for aquatic biota due to the fluoxetine attraction effect and a predictive assessment of the consequences expected if its indiscriminate use increases.

Developmental exposure to sertraline impaired zebrafish behavioral and neurochemical profiles

The number of people suffering from mental health problems is rising, with anxiety and depression now the most commonly diagnosed psychiatric conditions. Selective serotonin reuptake inhibitors (SSRIs) are one of the most prescribed pharmaceuticals to treat these conditions, which has led to their common detection in many aquatic ecosystems. As the monoaminergic system shows a high degree of structural conservation across diverse animal phyla, a reasonable assumption is that the environmental levels of SSRIs in surface water can lead to adverse effects on fish and other aquatic wildlife. For instance, Sertraline (SER), a widely prescribed SSRI, has been shown to induce adverse effects in fish, albeit most of the reports used exposure concentrations exceeding those occurring in natural environments. Therefore, there is still a great lack of knowledge regarding SERs effects in fish species, especially during early life stages. This study describes the evaluation of developmental exposure of zebrafish (Danio rerio) to environmentally relevant concentrations of SER (from 0.01 to 10 μg/L), using a battery of key survival behaviors and further relating them with the expression of genes and neurochemical profiles of the monoaminergic system. We found that developmental exposure to SER did not affect embryo morphogenesis and growth. However, concentrations as low as 0.1 μg/L induced hypolocomotion and delayed learning. The observed behavioral impairment was associated with augmented serotonin levels rather than other neurochemicals and molecular markers, highlighting the relationship between serotonin signaling and behavior in zebrafish.

Anti-Depressant Fluoxetine Hampers Olfaction of Goldfish by Interfering with the Initiation, Transmission, and Processing of Olfactory Signals

The ubiquitous presence of fluoxetine (FLX) in aquatic environments poses great threat to fish species. However, little is known about its deleterious impacts on fish olfaction. In this study, the olfactory toxicity of FLX at environmentally realistic levels was assessed by monitoring the behavioral and electroolfactogram (EOG) responses to olfactory stimuli with goldfish (Carassius auratus), and the toxification mechanisms underlying the observed olfaction dysfunction were also investigated. Our results showed that the behavioral and EOG responses of goldfish to olfactory stimuli were significantly weakened by FLX, indicating an evident toxicity of FLX to olfaction. Moreover, FLX exposure led to significant alterations in olfactory initiation-related genes, suppression of ion pumps (Ca²⁺-ATPase and Na⁺/K⁺-ATPase), tissue lesions, and fewer olfactory sensory neurons in olfactory epithelium. In addition to altering the expression of olfactory transmission-related genes, comparative metabolomic analysis found that olfaction-related neurotransmitters (i.e., l-glutamate and acetylcholine) and the olfactory transduction pathway were significantly affected by FLX. Furthermore, evident tissue lesions, aggravated lipid peroxidation and apoptosis, and less neuropeptide Y were observed in the olfactory bulbs of FLX-exposed goldfish. Our findings indicate that FLX may hamper goldfish olfaction by interfering with the initiation, transmission, and processing of olfactory signals.

Antidepressants promote the spread of antibiotic resistance via horizontally conjugative gene transfer

Antibiotic resistance is a global concern threatening public health. Horizontal gene transfer (HGT) between bacterial species contributes greatly to the dissemination of antibiotic resistance. Conjugation is one of the major HGT pathways responsible for the spread of antibiotic resistance genes (ARGs). Antidepressant drugs are commonly prescribed antipsychotics for major depressive disorders and are frequently detected in aquatic environments. However, little is known about how antidepressants stress bacteria and whether such effect can promote conjugation. Here, we report that commonly prescribed antidepressants, sertraline, duloxetine, fluoxetine, and bupropion, can promote the conjugative transfer of plasmid-borne multidrug resistance genes carried by environmentally and clinically relevant plasmids. Noteworthy, the transfer of plasmids across bacterial genera is significantly enhanced by antidepressants at clinically relevant concentrations. We also reveal the underlying mechanisms of enhanced conjugative transfer by employing flow cytometric analysis, genome-wide RNA sequencing and proteomic analysis. Antidepressants induce the production of reactive oxygen species and the SOS response, increase cell membrane permeability, and upregulate the expression of conjugation relevant genes. Given the contribution of HGT in the dissemination of ARGs, our findings highlight the importance of prudent prescription of antidepressants and to the potential connection between antidepressants and increasing antibiotic resistance.

Sonoelectrochemical oxidation of sulfamethoxazole in simulated and actual wastewater on a piezo-polarizable FTO/BaZr x Ti(1-x)O3 electrode: reaction kinetics, mechanism and reaction pathway studies

The sonoelectrochemical (SEC) oxidation of sulfamethoxazole (SMX) in simulated and actual wastewater on FTO/BaZr_(0.1)Ti_(0.9)O₃, FTO/BaZr_(0.05)Ti_(0.95)O₃ and FTO/BaTiO₃ electrodes is hereby presented. Electrodes from piezo-polarizable BaZr_(0.1)Ti_(0.9)O₃, BaZr_(0.05)Ti_(0.95)O₃, and BaTiO₃ materials were prepared by immobilizing these materials on fluorine-doped tin dioxide (FTO) glass. Electrochemical characterization performed on the electrodes using chronoamperometry and electrochemical impedance spectroscopy techniques revealed that the FTO/BaZr_(0.1)Ti_(0.9)O₃ anode displayed the highest sonocurrent density response of 2.33 mA cm^-2 and the lowest charge transfer resistance of 57 Ω. Compared to other electrodes, these responses signaled a superior mass transfer on the FTO/BaZr_(0.1)Ti_(0.9)O₃ anode occasioned by an acoustic streaming effect. Moreover, a degradation efficiency of 86.16% (in simulated wastewater), and total organic carbon (TOC) removal efficiency of 63.16% (in simulated wastewater) and 41.47% (in actual wastewater) were obtained upon applying the FTO/BaZr_(0.1)Ti_(0.9)O₃ electrode for SEC oxidation of SMX. The piezo-polarizable impact of the FTO/BaZr_(0.1)Ti_(0.9)O₃ electrode was further established by the higher rate constant obtained for the FTO/BaZr_(0.1)Ti_(0.9)O₃ electrode as compared to the other electrodes during SEC oxidation of SMX under optimum operational conditions. The piezo-potential effect displayed by the FTO/BaZr_(0.1)Ti_(0.9)O₃ electrode can be said to have impacted the generation of reactive species, with hydroxyl radicals playing a predominant role in the degradation of SMX in the SEC system. Additionally, a positive synergistic index obtained for the electrode revealed that the piezo-polarization effect of the FTO/BaZr_(0.1)Ti_(0.9)O₃ electrode activated during sonocatalysis combined with the electrochemical oxidation process during SEC oxidation can be advantageous for the decomposition of pharmaceuticals and other organic pollutants in water.

Transcriptome profiling reveals toxicity mechanisms following sertraline exposure in the brain of juvenile zebrafish (Danio rerio)

Sertraline (SER) is one of the most commonly detected antidepressants in the aquatic environment that can negatively affect aquatic organisms at low concentrations. Despite some knowledge on its acute toxicity to fish, the effects of chronic SER exposure remain poorly understood along with any underlying mechanisms of SER-induced toxicity. To address this knowledge gap, the effects of chronic exposure to three SER concentrations from low to high were investigated in zebrafish. Juvenile zebrafish were exposed to three concentrations of 1, 10, or 100 μg/L of SER for 28 d, after which indicators of oxidative stress and neurotoxicity in the brain were measured. Superoxide dismutase (SOD) activity was significantly enhanced by SER at 1 up to 100 μg/L, and catalase (CAT) activity was significantly induced by SER at 1 or 10 μg/L. The activity of acetylcholinesterase (AChE) was significantly induced by 10 and 100 μg/L of SER, and the serotonin (5-HT) level was significantly increased by all three concentrations of SER. To ascertain mechanisms of SER-induced toxicity, transcriptomics was conducted in the brain of zebrafish following 100 μg/L SER exposure. The molecular signaling pathways connected with circadian system and the immune system were significantly altered in the zebrafish brain. Based on transcriptomic data, the expression levels of six circadian clock genes were measured, and three genes were significantly altered in relative abundance in fish from all experimental treatments with SER, including cryptochrome circadian regulator 2 (cry2), period circadian clock 2 (per2), and period circadian clock 3 (per3). We hypothesize that the circadian system may be related to SER-induced neurotoxicity and oxidative stress in the central nervous system. This study reveals potential mechanisms and key events (i.e., oxidative stress and neurotoxicity) associated with SER-induced toxicity, and improves understanding of the molecular and biochemical pathways putatively perturbed by SER.

Antidepressants as emerging contaminants: Occurrence in wastewater treatment plants and surface waters in Hangzhou, China

Aims

Antidepressants have aroused wide public concern due to their widespread presence in water and their harm to human health and environment. This study was designed to evaluate the contribution of wastewater treatment plants (WWTPs) to the presence of antidepressants in the surface water.

Methods

Data was evaluated by analyzing water samples collected from the influent, effluent, upstream and downstream of the WWTPs on the rivers of interest in Hangzhou, Zhejiang Province, China. Besides, the study also assessed the impact of the release of antidepressants from WWTPs to the surface water on the drinking water. An automatic solid-phase extraction combined with ultra-high performance liquid chromatography-tandem triple quadrupole mass spectrometry (UPLC-MS/MS) was used to detect antidepressants.

Results

The most abundant compound was venlafaxine, followed by citalopram, sertraline, and fluvoxamine with concentrations between 0.6 and 87 ng/L. Antidepressants showed maximum concentrations at the effluent outlets of the WWTPs, and greater concentrations were found downstream than upstream of the WWTPs in Qiantang River. The results of source water and finished water showed that the detection concentration was lower than the detection limit of the method.

Conclusions

The less impact of the release of antidepressants from WWTPs to the surface water on the drinking water was identified. Nevertheless, these compounds were hardly removed by wastewater treatment processes. Thus, their risks deserve close attention.

Low doses and lifecycle exposure of waterborne antidepressants in zebrafish model: A survey on sperm traits, reproductive behaviours, and transcriptome responses

Venlafaxine and citalopram have been commonly found in surface water and may disrupt fish reproduction, yet the long-term impact and the underlying mechanism are largely unknown. Here, zebrafish were exposed to 0.1-100 μg/L venlafaxine and citalopram for their entire life cycle from embryo to adult, respectively. After exposure for 180 days, the lowest observable effective concentration (LOEC) of venlafaxine and citalopram to significantly reduce the mean number of egg production in adults were 10 and 1 μg/L, respectively, whereas the fertilization rate displayed no significant changes. Further, we investigated the impacts of venlafaxine and citalopram in a reproductive context, including sperm quality and reproductive behaviour. In contrast, venlafaxine and citalopram exposure did not affect sperm quality but caused a reduction of reproductive behaviour (e.g., mating duration and mating interval) of adults exposed to 1-10 μg/L of the antidepressant. Transcriptomic profiling of the whole ovary revealed that lifecycle venlafaxine and citalopram exposure significantly affected the Na⁺/Cl^- dependent neurotransmitter transporters signaling. Moreover, immune system-mediated ovarian regeneration and creatine metabolism regulated energy metabolism were proposed as the novel mechanism in the observed effects. Taken together, our results highlight the risk of lifecycle venlafaxine and citalopram exposure to fish reproduction and provide novel perspectives for unveiling the mechanism of female reproductive dysfunction.

Antidepressants promote the spread of extracellular antibiotic resistance genes via transformation

The development of antibiotic resistance as an unavoidable consequence of the application of antimicrobials is a significant concern for human health. Antidepressants are being increasingly consumed globally. Human gut microbial communities are frequently exposed to antidepressants, yet little is known about the interaction between antidepressants and antibiotic resistance. This study aimed to investigate whether antidepressants can accelerate the dissemination of antibiotic resistance by increasing the rate of the horizontal transfer of antibiotic resistance genes (ARGs). Results demonstrated that some of the commonly-prescribed antidepressants (Duloxetine, Sertraline, Fluoxetine and Bupropion) at clinically relevant concentrations can significantly (n = 9; padj < 0.01) promote the transformation of extracellular ARGs into Acinetobacter baylyi ADP1 for a maximum of 2.3-fold, which is primarily associated with the overproduction of reactive oxygen species. The increased cell membrane permeability and porosity, stimulated transcription and translation of competence, SOS response, universal stress response and ATP synthesis-related genes are also associated with antidepressants-enhanced transformation. This study demonstrated that some antidepressants can speed up the spread of antibiotic resistance by promoting the transformation of ARGs, which emphasizes the necessity to assess the potential risks of antidepressants in spreading antibiotic resistance during clinical antidepressant applications.

Consumption and ocurrence of antidepressants (SSRIs) in pre- and post-COVID-19 pandemic, their environmental impact and innovative removal methods: A review

Selective serotonin reuptake inhibitors (SSRIs) are pharmaceuticals whose consumption has increased significantly. They are prescribed as first-line treatment in mental disorders such as depression, obsessive-compulsive disorder, phobias, and anxiety; also, they are indicated as adjuvants in diseases such as fibromyalgia and bulimia nervosa. In addition to being linked to the illegal market to be consumed as recreational drugs. The relevance of this review lies in the fact that worldwide consumption has increased significantly during the COVID-19 pandemic, due to the depression and anxiety that originated in the population. As a consequence of this increase in consumption, concentrations of SSRIs in the environment have increased, and these have become a relevant issue for toxicologists due to the effects that they could generate in different organisms, both aquatic and terrestrial. For this reason, the objective of this article was to do a critical evaluation of the existing data on the characteristics and physicochemical properties of SSRIs, consumption data during the COVID-19 pandemic, its occurrence in the environment and the reports of toxic effects that have been generated in different organisms; we also conclude with an updated review of different methods that have been used for their removal. With this analysis, it can be concluded that, despite SSRIs are pharmaceutical products widely studied since their launching to the market, still currently under investigation to clarify their mechanisms of action to understand the different effects on the organisms, adverse reactions, as well as possible toxicological effects on non-target organisms. On the other hand, it has been proven that although it is already possible to eliminate a significant percentage of SSRIs in the laboratory, due to their physicochemical characteristics and their behavior in complex mixtures in the environment, they have not yet been eradicated, showing a persistence in the soil, subsoil and surface waters of the entire planet that may represent a future risk.

Photochemical degradation of the antidepressant sertraline in aqueous solutions by UVC, UVC/H2O2, and UVC/S2O82

Antidepressants are released into the aquatic environment because of their incomplete removal from wastewater treatment plants. In the present work, we investigated the photochemical degradation of a commonly prescribed antidepressant, namely sertraline, in aqueous matrices. The molar absorption coefficient of sertraline at 254 nm and at various pH values in the range from 4.0 to 9.0 was 444±65 L•mol^-1•cm^-1, while the quantum yield of its direct photolysis under UVC radiation (λ = 254 nm) was (1.7±0.1) × 10^-2 mol∙einstein^-1 (i.e., both values were relatively low). Next, we investigated the photochemical degradation of sertraline under UVC radiation in the presence of hydrogen peroxide, H₂O₂ (i.e., UVC/H₂O₂) or persulfate ions, S₂O₈^2- (i.e., UVC/PS). Several parameters were studied, such as the initial concentrations of the oxidants, solution pH, and the composition of the aqueous matrix (experiments were carried out in aqueous phosphate buffers, in synthetic wastewater, as well as in synthetic fresh and hydrolyzed human urine). It was found that, in all aqueous matrices, the photochemical degradation of sertraline followed pseudo first-order kinetics. The values of the observed pseudo first-order rate constants in the UVC/H₂O₂ and UVC/PS processes were from one to three orders of magnitude higher than the corresponding value in the UVC process. The UVC/PS process was more efficient than the UVC/H₂O₂ process, either in aqueous phosphate buffer solutions or in synthetic wastewaters, despite the comparable reactivity of sertraline towards hydroxyl and sulfate radicals. However, both processes resulted in partial mineralization of the compound after prolonged irradiation. In the UVC/H₂O₂ process, there was an optimum H₂O₂ concentration which depended on the aqueous matrix, while in the UVC/PS process, there was an almost linear increase in treatment efficiency as a function of PS concentration, at least in the range of concentrations studied in the present work. Solution pH in the range from 6.0 to 9.0 had a relatively negligible effect on treatment performance for both processes. In synthetic urine matrices, despite the reduction in reaction rate (the observed pseudo first-order rate constants were reduced by approximately one to two orders of magnitude), the photochemical degradation of sertraline proceeded to a relatively satisfactory degree. Finally, the calculations of the electrical energy per order and the associated cost showed that the UVC/H₂O₂ and UVC/PS processes are cost-efficient and suitable for full-scale applications.

Effects of sulphur amino acids on the size and structure of microbial communities of aerobic granular sludge bioreactors

Granular activated sludge has been described as a promising tool in treating wastewater. However, the effect of high concentrations of sulphur amino acids, cysteine and methionine, in the evolution, development and stability of AGS-SBRs (aerobic granular sludge in sequential batch reactors) and their microbial communities is not well-established. Therefore, this study aimed to evaluate microbial communities' size, structure and dynamics in two AGS-SBRs fed with two different concentrations of amino acids (50 and 100 mg L⁻¹ of both amino acids). In addition, the impact of the higher level of amino acids was also determined under an acclimatization or shock strategy. While N removal efficiency decreased with amino acids, the removal of the organic matter was generally satisfactory. Moreover, the abrupt presence of both amino acids reduced even further the removal performance of N, whereas under progressive adaptation, the removal yield was higher. Besides, excellent removal rates of cysteine and methionine elimination were found, in all stages below 80% of the influent values. Generally considered, the addition of amino acids weakly impacts the microbial communities' total abundances. On the contrary, the presence of amino acids sharply modulated the dominant bacterial structures. Furthermore, the highest amino acid concentration under the shock strategy resulted in a severe change in the structure of the microbial community. Acidovorax, Flavobacterium, Methylophilus, Stenotrophomonas and Thauera stood out as the prominent bacteria to cope with the high presence of cysteine and methionine. Hence, the AGS-SBR technology is valuable for treating influents enriched in sulphur Aa inclusively when a shock strategy was used.

Assessing the exposure to human and veterinary pharmaceuticals in waterbirds: The use of feathers for monitoring antidepressants and nonsteroidal anti-inflammatory drugs

Exposure to active pharmaceutical ingredients (APIs) from both human and veterinary sources is an increasing threat to wildlife welfare and conservation. Notwithstanding, tracking the exposure to pharmaceuticals in non-target and sensitive vertebrates, including birds, is seldom performed and relies almost exclusively on analysing internal organs retrieved from carcasses or from experimentally exposed and sacrificed birds. Clearly, this excludes the possibility of performing large-scale monitoring. Analysing feathers collected from healthy birds may permit this, by detecting APIs in wild birds, including protected and declining species of waterbirds, without affecting their welfare. To this end, we set up a non-destructive method for analysing the presence of non-steroidal anti-inflammatory drugs (NSAIDs), selective serotonin reuptake inhibitors (SSRIs) and noradrenaline reuptake inhibitors (SNRIs) in the feathers of fledglings of both the Mediterranean gull (Ichtyaetus melanocephalus) and the Sandwich tern (Thalasseus sandvicensis). The presence of several NSAIDs and SSRIs above the method quantification limits have confirmed that feathers might be a suitable means of evaluating the exposure of birds to APIs. Moreover, the concentrations indicated that waterbirds are exposed to NSAIDs, such as diclofenac, ibuprofen and naproxen, and SSRIs, such as citalopram, desmethylcitalopram, fluvoxamine and sertraline, possibly due to their widespread use and incomplete removal in wastewater treatment plants (WWTPs). The active ingredient diclofenac raises a the primary concern for the ecosystem and the welfare of the waterbirds, due to its high prevalence (100% and 83.3% in Mediterranean gull and Sandwich tern, respectively), its concentrations detected in feathers (11.9 ng g^-1 and 6.7 ng g^-1 in Mediterranean gull and Sandwich tern, respectively), and its documented toxicity toward certain birds.

The mechanism and effects of remdesivir-induced developmental toxicity in zebrafish: Blood flow dysfunction and behavioral alterations

The antiviral drug remdesivir has been used to treat the growing number of coronavirus disease 2019 (COVID-19) patients. However, the drug is mainly excreted through urine and feces and introduced into the environment to affect non-target organisms, including fish, which has raised concerns about potential ecotoxicological effects on aquatic organisms. Moreover, studies on the ecological impacts of remdesivir on aquatic environments have not been reported. Here, we aimed to explore the toxicological impacts of microinjection of remdesivir on zebrafish early embryonic development and larvae and the associated mechanism. We found that 100 μM remdesivir delayed epiboly and impaired convergent movement of embryos during gastrulation, and dose-dependent increases in mortality and malformation were observed in remdesivir-treated embryos. Moreover, 10-100 μM remdesivir decreased blood flow and swimming velocity and altered the behavior of larvae. In terms of molecular mechanisms, eighty differentially expressed genes (DEGs) were identified by transcriptome analysis in the remdesivir-treated group. Some of these DEGs, such as manf, kif3a, hnf1ba, rgn, prkcz, egr1, fosab, nr4a1, and ptgs2b, were mainly involved in early embryonic development, neuronal developmental disorders, vascular disease and the blood flow pathway. These data reveal that remdesivir can impair early embryonic development, blood flow and behavior of zebrafish embryos/larvae, probably due to alterations at the transcriptome level. This study suggests that it is important to avoid the discharge of remdesivir to aquatic ecosystems and provides a theoretical foundation to hinder remdesivir-induced ecotoxicity to aquatic environments.

Global occurrence and probabilistic environmental health hazard assessment of per- and polyfluoroalkyl substances (PFASs) in groundwater and surface waters

Per- and polyfluoroalkyl substances (PFASs) have been used in consumer and military products since the 1950s but are increasingly scrutinized worldwide because of inherent chemical properties, environmental contamination, and risks to public health and the environment. The United States Environmental Protection Agency (USEPA) identified 24 PFASs of interest for further study and possible regulation. We examined 371 peer-reviewed studies published since 2001 to understand the occurrence and distribution of 24 priority PFASs in global surface waters and groundwater. We identified 77,541 and 16,246 data points for surface waters and groundwater, respectively, with total PFAS concentrations ranging from low pg/L to low mg/L levels. Most data were from Asia, Europe, and North America with some reports from Oceania. PFAS information from other geographic regions is lacking. PFASs levels are consistently higher in rivers and streams followed by lakes and reservoirs and then coastal and marine systems. When sufficient data were available, probabilistic environmental hazard assessments (PEHAs) were performed from environmental exposure distributions (EEDs) to identify potential exceedances of available guideline values for each compound by matrix, region, and aquatic system. Specifically, exceedances of USEPA drinking water lifetime health advisory levels were up to 74% for PFOS in groundwater from Oceania and 69% for PFOA in North American groundwater. Our findings support selection of environmentally relevant experimental treatment levels for future toxicology, ecotoxicology and bioaccumulation studies, and potable source water exposure investigations, while highlighting PFASs and major geographic locations requiring additional study and inclusion in global monitoring and surveillance campaigns.

When pharmaceutical drugs become environmental pollutants: Potential neural effects and underlying mechanisms

Pharmaceutical drugs have become consumer products, with a daily use for some of them. The volume of production and consumption of drugs is such that they have become environmental pollutants. Their transfer to wastewater through urine, feces or rinsing in case of skin use, associated with partial elimination by wastewater treatment plants generalize pollution in the hydrosphere, including drinking water, sediments, soils, the food chain and plants. Here, we review the potential effects of environmental exposure to three classes of pharmaceutical drugs, i.e. antibiotics, antidepressants and non-steroidal anti-inflammatory drugs, on neurodevelopment. Experimental studies analyzing their underlying modes of action including those related to endocrine disruption, and molecular mechanisms including epigenetic modifications are presented. In addition, the contribution of brain imaging to the assessment of adverse effects of these three classes of pharmaceuticals is approached.

Multi-generational impacts of exposure to antidepressant fluoxetine on behaviour, reproduction, and morphology of freshwater snail Physa acuta

Contamination of the environment by pharmaceutical pollutants poses an increasingly critical threat to aquatic ecosystems around the world. This is particularly true of psychoactive compounds, such as antidepressant drugs, which have become ubiquitous contaminants and have been demonstrated to modify aquatic animal behaviours at very low concentrations (i.e. ng/L). Despite raising risks to the hydrosphere, there is a notable paucity of data on the long term, multigenerational effects of antidepressants at environmentally realistic concentrations. Moreover, current research has predominantly focused on mean-level effects, with little research on variation among and within individuals when considering key behavioural traits. In this work, we used a multigenerational exposure of a freshwater snail (Physa acuta) to an environmentally relevant concentration of the antidepressant fluoxetine (mean measured concentration: 32.7 ng/L, SE: 2.3). The snails were allowed to breed freely in large mesocosm populations over 3 years. Upon completion of the exposure, we repeatedly measured the locomotory activity (624 measures total), reproductive output (234 measures total) as well as morphometric endpoints (78 measures total). While we found no mean-level differences between treatments in locomotory activities, we did find that fluoxetine exposed snails (n = 46) had significantly reduced behavioural plasticity (i.e. V_W; within-individual variation) in activity levels compared to unexposed snails (n = 32). As a result, fluoxetine exposed snails demonstrated significant behavioural repeatability, which was not the case for unexposed snails. Further, we report a reduction in egg mass production in fluoxetine exposed snails, and a marginally non-significant difference in morphology between treatment groups. These results highlight the potential detrimental effects of long-term fluoxetine exposure on non-target organisms at environmentally realistic dosages. Additionally, our findings demonstrate the underappreciated potential for psychoactive contaminants to have impacts beyond mean-level effects, with consequences for population resilience to current and future environmental challenges.

Proteomics of sea bass skin-scales exposed to the emerging pollutant fluoxetine compared to estradiol

Teleost fish skin-scales are essential for protection and homeostasis and the largest tissue in direct contact with the environment, but their potential as early indicators of pollutant exposure are hampered by limited knowledge about this model. This study evaluated multi-level impacts of in vivo exposure of European sea bass to fluoxetine (FLX, a selective serotonin-reuptake inhibitor and an emerging pollutant) and 17β-estradiol (E2, a natural hormone and representative of diverse estrogenic endocrine-disrupting pollutants). Exposed fish had significantly increased circulating levels of FLX and its active metabolite nor-FLX that, in contrast to E2, did not have estrogenic effects on most fish plasma and scale indicators. Quantitative proteomics using SWATH-MS identified 985 proteins in the scale total proteome. 213 proteins were significantly modified 5 days after exposure to E2 or FLX and 31 were common to both treatments and responded in the same way. Common biological processes significantly affected by both treatments were protein turnover and cytoskeleton reorganization. E2 specifically up-regulated proteins related to protein production and degradation and down-regulated the cytoskeleton/extracellular matrix and innate immune proteins. FLX caused both up- and down-regulation of protein synthesis and energy metabolism. Multiple estrogen and serotonin receptor and transporter transcripts were altered in sea bass scales after E2 and/or FLX exposure, revealing complex disruptive effects in estrogen/serotonin responsiveness, which may account for the partially overlapping effects of E2 and FLX on the proteome. A large number (103) of FLX-specifically regulated proteins indicated numerous actions independent of estrogen signalling. This study provides the first quantitative proteome of the fish skin-scale barrier, elucidates routes of action and biochemical and molecular signatures of E2 or FLX-exposure and identifies potential physiological consequences and candidate biomarkers of pollutant exposure, for monitoring and risk assessment.

Fluoxetine-induced neurotoxicity at environmentally relevant concentrations in adult zebrafish Danio rerio

Fluoxetine (FLX) exerts its therapeutic effect by inhibiting the presynaptic reuptake of the neurotransmitter serotonin. Nonetheless, at high concentrations of this drug, adverse effects occur in the brain of exposed organisms. Bearing this into account, the objective of this study was to evaluate the neurotoxic effects of the fluoxetine through the evaluation of behavior (Novel tank test), determination of oxidative stress, and determination of acetylcholinesterase (AChE) activity in adult zebrafish Danio rerio. For this purpose, Danio rerio adults were exposed to three environmentally relevant concentrations (5, 10, 16ngL^-1) of FLX for 96h. Our results demonstrate fish presented a significant disruption in their behavior, as they remained long-lasting time frozen at the top of the tank. Since we observed a significant reduction of AChE activity in the brain of fish, we believe the above described anxiety-like state is the result of this enzyme impairment. Moreover, as FLX-exposed fish showed a significant increase in the levels of oxidative damage biomarkers, we suggest this AChE disruption is associated with the oxidative stress response fish exhibited. Based on our findings, we believe the environmentally relevant concentration of FLX alters the redox status of the brain, impairing this way the behavior of fish and making them more vulnerable to predation.

A cross-species comparative approach to assessing multi- and transgenerational effects of endocrine disrupting chemicals

A wide range of chemicals have been identified as endocrine disrupting chemicals (EDCs) in vertebrate species. Most studies of EDCs have focused on exposure of both male and female adults to these chemicals; however, there is clear evidence that EDCs have dramatic effects when mature or developing gametes are exposed, and consequently are associated with in multigenerational and transgenerational effects. Several publications have reviewed such actions of EDCs in subgroups of species, e.g., fish or rodents. In this review, we take a holistic approach synthesizing knowledge of the effects of EDCs across vertebrate species, including fish, anurans, birds, and mammals, and discuss the potential mechanism(s) mediating such multi- and transgenerational effects. We also propose a series of recommendations aimed at moving the field forward in a structured and coherent manner.

Comparative analysis of transcriptomic points-of-departure (tPODs) and apical responses in embryo-larval fathead minnows exposed to fluoxetine

Current approaches in chemical hazard assessment face significant challenges because they rely on live animal testing, which is time-consuming, expensive, and ethically questionable. These concerns serve as an impetus to develop new approach methodologies (NAMs) that do not rely on live animal tests. This study explored a molecular benchmark dose (BMD) approach using a 7-day embryo-larval fathead minnow (FHM) assay to derive transcriptomic points-of-departure (tPODs) to predict apical BMDs of fluoxetine (FLX), a highly prescribed and potent selective serotonin reuptake inhibitor frequently detected in surface waters. Fertilized FHM embryos were exposed to graded concentrations of FLX (confirmed at < LOD, 0.19, 0.74, 3.38, 10.2, 47.5 μg/L) for 32 days. Subsets of fish were subjected to omics and locomotor analyses at 7 days post-fertilization (dpf) and to histological and biometric measurements at 32 dpf. Enrichment analyses of transcriptomics and proteomics data revealed significant perturbations in gene sets associated with serotonergic and axonal functions. BMD analysis resulted in tPOD values of 0.56 μg/L (median of the 20 most sensitive gene-level BMDs), 5.0 μg/L (tenth percentile of all gene-level BMDs), 7.51 μg/L (mode of the first peak of all gene-level BMDs), and 5.66 μg/L (pathway-level BMD). These tPODs were protective of locomotor and reduced body weight effects (LOEC of 10.2 μg/L) observed in this study and were reflective of chronic apical BMDs of FLX reported in the literature. Furthermore, the distribution of gene-level BMDs followed a bimodal pattern, revealing disruption of sensitive neurotoxic pathways at low concentrations and metabolic pathway perturbations at higher concentrations. This is one of the first studies to derive protective tPODs for FLX using a short-term embryo assay at a life stage not considered to be a live animal under current legislations.

Proximate causes and ultimate effects of common antidepressants, fluoxetine and venlafaxine, on fish behavior

Antidepressant (AD) drugs are widely prescribed for the treatment of psychiatric disorders, including depression and anxiety disorders. The continuous use of ADs causes significant quantities of these bioactive chemicals to enter the aquatic ecosystems mainly through wastewater effluent discharge. This may result in many aquatic organisms being inadvertently affected by these drugs. Fluoxetine (FLX) and venlafaxine (VEN) are currently among the most widely detected ADs in aquatic systems. A growing body of experimental evidence demonstrates that FLX and VEN have a substantial capacity to induce neurotoxicity and cause behavioral dysfunctions in a wide range of teleost species. At the same time, these studies often report seemingly contradictory results that are confounding in nature. Hence, we clearly require comprehensive reviews that attempt to find overarching patterns and establish possible causes for these variable results. This review aims to explore the current state of knowledge regarding the neurobehavioral effects of FLX and VEN on fishes. This study also discusses the potential mechanistic linkage between the neurotoxicity of ADs and behavioral dysfunction and identifies key knowledge gaps and areas for future research.

Warmer temperatures limit the effects of antidepressant pollution on life-history traits

Pharmaceutical pollutants pose a threat to aquatic ecosystems worldwide. Yet, few studies have considered the interaction between pharmaceuticals and other chronic stressors contemporaneously, even though the environmental challenges confronting animals in the wild seldom, if ever, occur in isolation. Thermal stress is one such environmental challenge that may modify the threat of pharmaceutical pollutants. Accordingly, we investigated how fluoxetine (Prozac), a common psychotherapeutic and widespread pollutant, interacts with temperature to affect life-history traits in the water flea, Daphnia magna. We chronically exposed two genotypes of Daphnia to two ecological relevant concentrations of fluoxetine (30 ng l^-1 and 300 ng l^-1) and a concentration representing levels used in acute toxicity tests (3000 ng l^-1) and quantified the change in phenotypic trajectories at two temperatures (20°C and 25°C). Across multiple life-history traits, we found that fluoxetine exposure impacted the fecundity, body size and intrinsic growth rate of Daphnia in a non-monotonic manner at 20°C, and often in genotypic-specific ways. At 25°C, however, the life-history phenotypes of individuals converged under the widely varying levels of fluoxetine, irrespective of genotype. Our study underscores the importance of considering the complexity of interactions that can occur in the wild when assessing the effects of chemical pollutants on life-history traits.

Water reuse for aquaculture: Comparative removal efficacy and aquatic hazard reduction of pharmaceuticals by a pond treatment system during a one year study

Aquaculture is increasing at the global scale, and beneficial reuse of wastewater is becoming crucial in some regions. Here we selected a unique tertiary treatment system for study over a one-year period. This experimental ecosystem-based approach to effluent management included a treated wastewater pond (TWP), which receives 100% effluent from a wastewater treatment plant, and an aquaculture pond (AP) that receives treated water from the TWP for fish production. We examined the fate of a wide range of pharmaceutically active compounds (PhACs) in this TWP-AP system and a control pond fed by river water using traditional grab sampling and passive samplers. We then employed probabilistic approaches to examine exposure hazards. Telmisartan, carbamazepine, diclofenac and venlafaxine, exceeded ecotoxicological predicted no effect concentrations in influent wastewater to the TWP, but these water quality hazards were consistently reduced following treatment in the TWP-AP system. In addition, both grab and passive sampling approaches resulted in similar occurrence patterns of studied compounds, which highlights the potential of POCIS use for water monitoring. Based on the approach taken here, the TWP-AP system appears useful as a tertiary treatment step to reduce PhACs and decrease ecotoxicological and antibiotic resistance water quality hazards prior to beneficial reuse in aquaculture.

Physiological Roles of Serotonin in Bivalves: Possible Interference by Environmental Chemicals Resulting in Neuroendocrine Disruption

Contaminants of Emerging Concerns (CECs) are defined as chemicals not commonly monitored in aquatic ecosystems, but with the potential to cause adverse effects on biota. CECs include Endocrine Disrupting Chemicals (EDCs) and Neuro-Endocrine disruptors (NEDs) of vertebrates. However, most invertebrates only rely on neuroendocrine systems to maintain homeostatic processes. Although conserved neuroendocrine components have been characterized in ecologically relevant groups, limited knowledge on invertebrate neuroendocrinology makes it difficult to define EDCs and NEDs in most species. The monoamine serotonin (5-hydroxytryptamine, 5-HT) acts both as a neurotransmitter and as a peripheral hormone in mammals. In molluscs, 5-HT is involved in multiple physiological roles and molecular components of the serotonergic system have been identified. This review is focused on the effects of CECs on the serotonergic system of bivalve molluscs. Bivalves are widespread in all aquatic environments, estuarine and coastal areas in particular, where they are exposed to a variety of chemicals. In bivalves, 5-HT is involved in gametogenesis and spawning, oocyte maturation and sperm motility, regulates heart function, gill ciliary beating, mantle/siphon function, the ''catch'' state of smooth muscle and immune responses. Components of 5-HT transduction (receptors and signaling pathways) are being identified in several bivalve species. Different CECs have been shown to affect bivalve serotonergic system. This particularly applies to antidepressants, among the most commonly detected human pharmaceuticals in the aquatic environment. In particular, selective serotonin reuptake inhibitors (SSRIs) are frequently detected in seawater and in bivalve tissues. Information available on the effects and mechanisms of action of SSRIs on the serotonergic system of adult bivalves is summarized. Data are also reported on the effects of CECs on development of neuroendocrine pathways of early larval stages, in particular on the effects of model EDCs in the marine mussel Mytilus galloprovincialis. Overall, available data point at the serotonergic system as a sensitive target for neuroendocrine disruption in bivalves. The results contribute drawing Adverse Outcome Pathways (AOPs) for model EDCs and SSRIs in larvae and adults. However, basic research on neuroendocrine signaling is still needed to evaluate the potential impact of neuroendocrine disruptors in key invertebrate groups of aquatic ecosystems.

Remediation of pharmaceuticals from contaminated water by molecularly imprinted polymers: a review

The release of pharmaceuticals into the environment induces adverse effects on the metabolism of humans and other living species, calling for advanced remediation methods. Conventional removal methods are often non-selective and cause secondary contamination. These issues may be partly solved by the use of recently-developped adsorbents such as molecularly imprinted polymers. Here we review the synthesis and application of molecularly imprinted polymers for removing pharmaceuticals in water. Molecularly imprinted polymers are synthesized via several multiple-step polymerization methods. Molecularly imprinted polymers are potent adsorbents at the laboratory scale, yet their efficiency is limited by template leakage and polymer quality. Adsorption performance of multi-templated molecularly imprinted polymers depends on the design of wastewater treatment plants, pharmaceutical consumption patterns and the population serviced by these wastewater treatment plants.

The potential for adverse effects in fish exposed to antidepressants in the aquatic environment

Antidepressants are one of the most commonly prescribed pharmaceutical classes for the treatment of psychiatric conditions. They act via modulation of brain monoaminergic signaling systems (predominantly serotonergic, adrenergic, dopaminergic) that show a high degree of structural conservation across diverse animal phyla. A reasonable assumption, therefore, is that exposed fish and other aquatic wildlife may be affected by antidepressants released into the natural environment. Indeed, there are substantial data reported for exposure effects in fish, albeit most are reported for exposure concentrations exceeding those occurring in natural environments. From a critical analysis of the available evidence for effects in fish, risk quotients (RQs) were derived from laboratory-based studies for a selection of antidepressants most commonly detected in the aquatic environment. We conclude that the likelihood for effects in fish on standard measured end points used in risk assessment (i.e., excluding effects on behavior) is low for levels of exposure occurring in the natural environment. Nevertheless, some effects on behavior have been reported for environmentally relevant exposures, and antidepressants can bioaccumulate in fish tissues. Limitations in the datasets used to calculate RQs revealed important gaps in which future research should be directed to more accurately assess the risks posed by antidepressants to fish. Developing greater certainty surrounding risk of antidepressants to fish requires more attention directed toward effects on behaviors relating to individual fitness, the employment of environmentally realistic exposure levels, on chronic exposure scenarios, and on mixtures analyses, especially given the wide range of similarly acting compounds released into the environment.

Prescribed aggression of fishes: Pharmaceuticals modify aggression in environmentally relevant concentrations

Traces of psychoactive substances have been found in freshwaters globally. Fish are chronically exposed to pollution at low concentrations. The changes of aggressive behaviour of chub (Squalius cephalus) were determined under the exposure to four psychoactive compounds (sertraline, citalopram, tramadol, methamphetamine) at environmentally relevant concentrations of 1 μg/L for 42 days. We tested whether (A) the behavioural effect of compounds varies within a single species; (B) there is a correlation between the individual brain concentration of the tested pollutants and fish aggression using the novel analysis of pollutants in brain; and (C) there is detectable threshold to effective pollutant concentration in brain. Behaviour and pollutant concentrations in brain were determined repeatedly (1st, 7th, 21st, 42nd and 56th days), including a two-week-long depuration period. The effect of particular compounds varied. Citalopram and methamphetamine generally increased the fish aggression, while no such effect was found after exposure to tramadol or sertraline. The longitudinal analysis showed an aggression increase after depuration, indicating the presence of withdrawal effects in methamphetamine- and tramadol-exposed fish. The analysis of pollutant concentration in brain revealed a positive linear relationship of citalopram concentration and aggression, while no such effect was detected for other compounds and/or their metabolites. Structural break analyses detected concentration thresholds of citalopram (1 and 3 ng/g) and sertraline (1000 ng/g) in brain tissue, from which a significant effect on behaviour was manifested. While the effect of sertraline was not detected using traditional approaches, there was a reduction in aggression after considering its threshold concentration in the brain. Our results suggest that pursuing the concentration threshold of psychoactive compounds can help to reduce false negative results and provide more realistic predictions on behavioural outcomes in freshwater environments, especially in the case of compounds with bioaccumulation potential such as sertraline.

Context is Key: Social Environment Mediates the Impacts of a Psychoactive Pollutant on Shoaling Behavior in Fish

Behavior-modifying drugs, such as antidepressants, are increasingly being detected in waterways and aquatic wildlife around the globe. Typically, behavioral effects of these contaminants are assessed using animals tested in social isolation. However, for group-living species, effects seen in isolation may not reflect those occurring in realistic social settings. Furthermore, interactions between chemical pollution and other stressors, such as predation risk, are seldom considered. This is true even though animals in the wild are rarely, if ever, confronted by chemical pollution as a single stressor. Here, in a 2 year multigenerational experiment, we tested for effects of the antidepressant fluoxetine (measured concentrations [±SD]: 42.27 ± 36.14 and 359.06 ± 262.65 ng/L) on shoaling behavior in guppies (Poecilia reticulata) across different social contexts and under varying levels of perceived predation risk. Shoaling propensity and shoal choice (choice of groups with different densities) were assessed in a Y-maze under the presence of a predatory or nonpredatory heterospecific, with guppies tested individually and in male-female pairs. When tested individually, no effect of fluoxetine was seen on shoaling behavior. However, in paired trials, high-fluoxetine-exposed fish exhibited a significantly greater shoaling propensity. Hence, effects of fluoxetine were mediated by social context, highlighting the importance of this fundamental but rarely considered factor when evaluating impacts of environmental pollution.

Antipredator phenotype in crucian carp altered by a psychoactive drug

Predator-inducible defenses constitute a widespread form of adaptive phenotypic plasticity, and such defenses have recently been suggested linked with the neuroendocrine system. The neuroendocrine system is a target of endocrine disruptors, such as psychoactive pharmaceuticals, which are common aquatic contaminants. We hypothesized that exposure to an antidepressant pollutant, fluoxetine, influences the physiological stress response in our model species, crucian carp, affecting its behavioral and morphological responses to predation threat. We examined short- and long-term effects of fluoxetine and predator exposure on behavior and morphology in crucian carp. Seventeen days of exposure to a high dose of fluoxetine (100 µg/L) resulted in a shyer phenotype, regardless of the presence/absence of a pike predator, but this effect disappeared after long-term exposure. Fluoxetine effects on morphological plasticity were context-dependent as a low dose (1 µg/L) only influenced crucian carp body shape in pike presence. A high dose of fluoxetine strongly influenced body shape regardless of predator treatment. Our results highlight that environmental pollution by pharmaceuticals could disrupt physiological regulation of ecologically important inducible defenses.

Development of a method for assessing the accumulation and metabolization of antidepressant drugs in zebrafish (Danio rerio) eleutheroembryos

Antidepressant drugs are widely used for the treatment of common mental or other psychiatric disorders such as depression, which affect about 121 million people worldwide. This widespread use has contributed to the input of these pharmaceuticals and their metabolites into the environment. The aim of this work was to develop an analytical method to quantify the most widely used antidepressant drugs, selective serotonin reuptake inhibitors (SSRI), and their main metabolites in the environment. For this, a new and reliable miniaturized extraction method based on dispersive SPE cleanup procedure for extraction of SSRI followed by derivatization with n-heptafluorobutyrylimidazole, and detection by GC-MS was developed. The methodology, including a first-order one-compartment model, was then applied to a bioconcentration study in zebrafish (Danio rerio) eleutheroembryos. The results showed low bioaccumulation of these compounds; however, a biotransformation evidence of the parent compounds into their metabolites was observed after 6 h of exposure. These results indicate the need to integrate metabolic transformation rates to fully model and understand the bioaccumulation patterns of SSRI and their metabolites.

Ethnopharmacological uses, phytochemistry, pharmacology, and toxicology of Olax subscorpioidea Oliv (Olacaceae): a review

Background

The plant Olax subscorpioidea Oliv (Olacaceae) is a shrub that is widely available in Africa. It has been used in traditional medicine to treat various diseases including asthma, pain, inflammation, gastrointestinal and central nervous system (CNS) disorders, cough, diabetes mellitus, cancer, infectious diseases, hepatic diseases, and many other diseases. Several phytochemical and pharmacological investigations were conducted on this plant. However, comprehensive information on this medicinally important plant is not available in the literature. Therefore, in this review, we aimed to provide comprehensive and critical information on all the reported ethnomedicinal uses, phytochemistry, pharmacological activities, and potential toxicity of Olax subscorpioidea to highlight its therapeutic potentials based on traditional usage and identify research gaps as a basis for further investigations to develop novel therapeutic compounds.

Main body

The available information about the plant was retrieved from the online bibliographic databases (PubMed and Google Scholar) and published PhD dissertation using the search terms Olax subscorpioidea, traditional uses, ethnomedicinal uses, phytochemistry, pharmacology, toxicology, and safety. Phytochemical studies have shown that the plant contains several bioactive compounds such as rutin, morin, quercetin, caffeic acid, santalbic acid, n-hexadecanoic acid, squalene, nonacosane, hentriacontane, and many more compounds. Also, pharmacological investigations revealed that Olax subscorpioidea has antidepressant, antiepileptic, anti-Alzheimer’s, cytotoxic, antioxidant, antihyperlipidemic, analgesic, antiinflammatory, antiarthritic, antidiabetic, anticancer, antiulcer, antimicrobial, hepatoprotective, apoptotic, antiprotease, and other CNS effects.

Conclusion

Several pharmacological studies on Olax subscorpioidea have established its ethnopharmacological uses. However, there are limited phytochemical and pharmacological studies to validate other folkloric claims of the plant. Therefore, extensive phytochemical and further pre-clinical efficacy and safety evaluations to fully establish its therapeutic potentials and elucidate its mechanisms of pharmacological actions could be necessary.

Graphical abstract

Toxicological Study on Chiral Fluoxetine Exposure to Adult Zebrafish (Danio rerio): Enantioselective and Sexual Mechanism on Disruption of the Brain Serotonergic System

The increasing number of people with depression worldwide has led to concerns regarding antidepressant contamination in aquatic environments, which could have the risk of negative effects on aquatic organisms. Chirality increases its toxicity potentials. Accordingly, we investigated the negative effects of racemic (rac-), R-, and S-FX at environmental levels (100 ng/L) on the brain serotonergic system in zebrafish (Danio rerio) for 42 days. Additionally, we measured the whole-body concentrations of FX and norfluoxetine (NFX). We found that S-FX exposure disrupted the brain serotonergic system more severely than rac- and R-FX exposure. The mechanism underlying this disruption induced by S-FX was sex-specific, with female zebrafish showing disruption of the serotonin (5-HT) release process but male zebrafish showing disruption of the 5-HT synthesis process. In addition, enantioselective enrichment and biotransformation (R-FX to R-NFX and S-FX to S-NFX) occurred in zebrafish. Sex-specific accumulation was also observed, with higher concentrations in females. Our study provides evidence for enantiomer- and sex-specific effects of FX exposure at biologically relevant concentrations. More broadly, our study demonstrated that SSRI antidepressants, such as FX, can affect aquatic life by causing important shifts in not only their active sites of the serotonin transporter.

Risks to aquatic environments posed by 14 pharmaceuticals as illustrated by their effects on zebrafish behaviour

The presence of pharmaceutical residues in aquatic ecosystems is a worldwide problem that may pose serious threats and challenges to the environment, especially to the safety of aquatic biota. In the present study, we investigated the effects of 14 environmentally relevant pharmaceutical compounds on individual and collective-related behaviours in juvenile zebrafish (Danio rerio) for 21 days. The tested concentrations of the compounds spanned three orders of magnitude. This study also compared the potential risks of these compounds in Chinese surface waters based on the data on their toxic effects or only on behavioural effects. In the case of individual behaviours, most antidepressants, but not anti-inflammatory agents or blood lipid-lowering agents, decreased fish locomotor activity (LMA) and individual social activity (IDS); however, all three classes of compounds induced significant disruptions in the light/dark transition locomotor response (LMR-L/D) performance, even at lower treatment levels (0.1-1 μg/L). Furthermore, collective behaviour (CLB) analysis suggested that most of the compounds significantly altered the group sociability of fish and frequently occurred at environmentally relevant concentrations. Finally, a risk assessment suggested that the presence of ibuprofen, fluoxetine, and venlafaxine in the surface waters of China poses a relatively high risk to fish, regardless of the risk ranking based on the data of the toxic or behavioural effects.

Proposal for fluorescence-based in vitro assay using human and zebrafish monoamine transporters to detect biological activities of antidepressants in wastewater

Antidepressants are among the most commonly detected pharmaceuticals in the aquatic environment. As they modulate neurotransmission in nervous systems, behavioural abnormalities among aquatic species are of concern. It is possible to measure the concentrations of selected antidepressants by chemical analysis, but other non-target antidepressants and active metabolites might also be present. Here, we propose an "in vitro monoamine transporter inhibition assay" to measure the biological activity of antidepressants, particularly monoamine transporter inhibitors, in wastewater. We used APP, a fluorescent substrate for monoamine transporters, to measure the activity of wastewater extracts at inhibiting APP uptake through the human serotonin transporter (hSERT), norepinephrine transporter (hNET), and dopamine transporter, and the zebrafish SERT (zSERT). We confirmed that the assay could measure the biological activity of test antidepressants. Interestingly, the IC₅₀ values of antidepressants (the concentration that gave a 50% reduction of APP uptake) for the zSERT were smaller than those for the hSERT. For example, IC₅₀ value of desipramine for the zSERT was 1/200 of that for the hSERT. These results indicate that antidepressants inhibited zSERT more strongly than hSERT. Then we applied the assay to extracts of effluent from municipal wastewater treatment plants and detected biological activity of antidepressants specifically against the hSERT, hNET, and zSERT for the first time. For the hSERT, antidepressant-equivalent quantities (EQs) ranged from 2.2 × 10¹ to 2.5 × 10² ng-clomipramine-EQ/L. For the hNET, EQs ranged from below limit of detection to 8.2 × 10¹ ng-desipramine-EQ/L. For the zSERT, EQs ranged from 2.8 × 10² to 3.3 × 10² ng-duloxetine-EQ/L. The in vitro monoamine transporter inhibition assay is thus useful for measuring the biological activity of antidepressants in the aquatic environment.

Environmentally relevant concentrations of sertraline disrupts behavior and the brain and liver transcriptome of juvenile yellow catfish (Tachysurus fulvidraco): Implications for the feeding and growth axis

Sertraline (SER) is one of the most prevalent antidepressants detected in aquatic environments, but its impact on fish behavior and growth remain poorly understood. As such, behavior and growth were assessed in yellow catfish (Tachysurus fulvidraco) following SER exposure. SER induced shoaling, reduced food consumption and growth, and increased cannibalism at environmentally relevant concentrations. To ascertain toxicity mechanisms, acetylcholinesterase (AChE) activity and transcripts related to growth and feeding were measured. AChE activity was increased in fish exposed to 10 and 100 μg/L SER. Transcript levels of neuropeptide Y, somatostatin, growth hormone, and insulin growth factor 1 were reduced in the brain following SER exposure. RNA-seq conducted in brain and liver revealed that gene networks associated with feeding and growth (i.e. leptin expression networks in the brain and insulin signaling pathways in the liver) were altered, proposed to be associated with the decreased food intake and growth. The brain also accumulated SER, which may relate to neurobehavioral responses. Lastly, the main metabolite of SER, norsertraline, was detected in the liver, and may also relate to toxicity. This study uncovers mechanisms and key events proposed to lead to impaired behavior and growth after exposure to some antidepressants.

An overview of homogeneous and heterogeneous photocatalysis applications for the removal of pharmaceutical compounds from real or synthetic hospital wastewaters under lab or pilot scale

The last few decades, Pharmaceutical Active Compounds (PhACs) have been considered as emerging contaminants due to their continuous release and persistence to aquatic environment even at low concentrations. A growing number of research articles have shown the occurrence of numerous PhACs in various wastewater treatment plant influents, hospital effluents, and surface waters all over the world. The rising concern regarding PhACs, which present high recalcitrance towards conventional treatment methods, has provoked extensive research in the field of their effective remediation. This review provides a comprehensive assessment of homogeneous and heterogeneous photocatalytic applications for the removal of PhACs, from real or artificial hospital wastewater effluents. These two representative advanced oxidation processes (AOPs) are assessed in terms of their efficiency to remove PhACs, reduce the COD and toxicity as well as increase the biodegradability of the effluent. Simultaneously with their efficiency the operational costs of the processes are considered. Their potential combination with other processes is critically discussed, as this option seems to enhance the treatment efficiency and simultaneously overcome the limitations of each individual process. Moreover, the type of reactors as well as the main parameters that should be considered for the design and the development of photoreactors for wastewater treatment are reviewed. Finally, based on the literature survey, indications for future work are provided.

Antidepressant drugs as emerging contaminants: Occurrence in urban and non-urban waters and analytical methods for their detection

Antidepressants are drugs with a direct action on the brain's biochemistry through their interaction with the neurotransmitters, such as dopamine, norepinephrine, and serotonin. The increasing worldwide contamination from these drugs may be witnessed through their increasing presence in the urban water cycle. Furthermore, their occurrence has been detected in non-urban water, such as rivers and oceans. Some endemic aquatic animals, such as certain fish and mollusks, have bioaccumulated different antidepressant drugs in their tissues. This problem will increase in the years to come because the present COVID-19 pandemic has increased the general worldwide occurrence of depression and anxiety, triggering the consumption of antidepressants and, consequently, their presence in the environment. This work provides information on the occurrence of the most administrated antidepressants in urban waters, wastewater treatment plants, rivers, and oceans. Furthermore, it provides an overview of the analytical approaches currently used to detect each antidepressant presented. Finally, the ecotoxicological effect of antidepressants on several in vivo models are listed. Considering the information provided in this review, there is an urgent need to test the presence of antidepressant members of the MAOI and TCA groups. Furthermore, incorporating new degradation/immobilization technologies in WWTPs will be useful to stop the increasing occurrence of these drugs in the environment.

Study of the photoinduced transformations of sertraline in aqueous media

In the present study, the photoinduced degradation of the antidepressant drug sertraline under artificial solar radiation was examined. Photolysis was studied under different experimental conditions to explore its photolytic fate in the aqueous environment. Photolytic degradation kinetics were carried out in ultrapure water, wastewater effluent, as well as in the presence of dissolved organic matter (humic acids), bicarbonate and nitrate ions which enabled their assessment on sertraline photo-transformation. The reaction of sertraline with photoactive compounds accelerated sertraline transformation in comparison with direct photolysis. Moreover, TiO₂-mediated photocatalytic degradation of sertraline was investigated, and focus was placed on the identification of by-products. As expected, photocatalysis was extremely effective for sertraline degradation. Photocatalytic degradation proceeded through the formation of forty-four transformation products identified by HPLC-HRMS and after 240 min of irradiation total mineralization was achieved. Microtox bioassay (Vibrio fischeri) was employed to assess the ecotoxicity of the photocatalysis-treated solutions and results have indicated that sertraline photo-transformation proceeds through the formation of toxic compounds.

Psychoactive pollution suppresses individual differences in fish behaviour

Environmental contamination by pharmaceuticals is global, substantially altering crucial behaviours in animals and impacting on their reproduction and survival. A key question is whether the consequences of these pollutants extend beyond mean behavioural changes, restraining differences in behaviour between individuals. In a controlled, two-year, multigenerational experiment with independent mesocosm populations, we exposed guppies (Poecilia reticulata) to environmentally realistic levels of the ubiquitous pollutant fluoxetine (Prozac). Fish (unexposed: n = 59, low fluoxetine: n = 57, high fluoxetine: n = 58) were repeatedly assayed on four separate occasions for activity and risk-taking behaviour. Fluoxetine homogenized individuals' activity, with individual variation in populations exposed to even low concentrations falling to less than half that in unexposed populations. To understand the proximate mechanism underlying these changes, we tested the relative contribution of variation within and between individuals to the overall decline in individual variation. We found strong evidence that fluoxetine erodes variation in activity between but not within individuals, revealing the hidden consequences of a ubiquitous contaminant on phenotypic variation in fish-likely to impair adaptive potential to environmental change.

New insights into cardiotoxicity induced by chiral fluoxetine at environmental-level: Enantioselective arrhythmia in developmental zebrafish (Danio rerio)

Fluoxetine is frequently detected in aquatic environment, and chronic FLX exposure exhibits adverse effects on aquatic communities. Its chirality makes the adverse effects more complicated. This study aimed at the enantioselective cardiotoxicity in developmental zebrafish induced by racemic (rac-)/S-/R-fluoxetine. The accumulation profiles demonstrated that biotransformation of fluoxetine to norfluoxetine occurred during rac-fluoxetine exposure, with a higher enrichment of S-norfluoxetine than R-norfluoxetine. Heart malformations including pericardial edema, circulation abnormalities, and thrombosis were observed, and enantioselective changes also occurred. According to H&E staining and Masson's trichrome staining, the loose severity of cardiac structure and cardiac fibrosis in rac-norfluoxetine treated group was worse than that in fluoxetine treated groups. Results of toxicity-associated parameters in our homochiral enantiomers' exposure also indicated that the toxicity induced by S-fluoxetine was more severe than R-fluoxetine. Enantioselective arrhythmia in developmental zebrafish after chiral fluoxetine exposure could be caused by myocardial fibrosis, abnormal developmental processes, and the biotransformation of fluoxetine to norfluoxetine could make that worse. Our findings can be used to assess the environmental risk of the two enantiomers of fluoxetine that induce cardiotoxicity in aquatic organisms.

Molecular and behavioral responses of zebrafish embryos/larvae after sertraline exposure

Sertraline (SER) is one of the most frequently detected antidepressant drugs in aquatic environments. However, knowledge regarding SER-induced behavioral alterations in fish is insufficient, as well as the mechanisms underlying SER-induced toxicity. The present study aimed to determine behavioral and molecular responses in larval fish following SER exposure with a focus on its mode of action. Zebrafish embryos (~6 h-post-fertilization, hpf) were exposed to one of three concentrations of SER (1, 10, 100 μg/L) for 6 days, respectively. Evaluated parameters included development, behavior, transcripts related to serotonin signaling, serotonin levels, and acetylcholinesterase activity. Accelerated hatching of zebrafish embryos was observed for those fish exposed to 100 μg/L SER at 54 hpf. Locomotor activity (e.g. distance moved and mobile cumulative duration) was significantly reduced in larval zebrafish following exposure to 10 and 100 μg/L SER. Conversely, larval fish showed increased dark-avoidance after exposure to 1-100 μg/L SER. Of the measured transcripts related to serotonin signaling, only serotonin transporter (serta) and serotonin receptor 2c (5-ht2c) mRNA levels were increased in fish in response to 10 μg/L SER treatment. However, serotonin levels were unaltered in larvae exposed to SER. There were no differences among groups in acetylcholinesterase activity at any concentration tested. Taking together, the results evidenced that exposure to SER alters behavioral responses in early-staged zebrafish, which may be related to the abnormal expression of 5-ht2c. This study elucidates molecular responses to SER and characterizes targets that may be sensitive to antidepressant pharmaceuticals in larval fish.

Combined toxicity of therapeutic pharmaceuticals to duckweed, Lemna minor

Pharmaceuticals, which are designed to be biologically active at low concentrations, are found in surface waters, meaning aquatic organisms can be exposed to complex mixtures of pharmaceuticals. In this study, the adverse effects of four pharmaceuticals, 17α-ethynylestradiol (synthetic estrogen), methotrexate (anticancer drug), diclofenac (nonsteroidal anti-inflammatory drug) and fluoxetine (antidepressant), and their binary mixtures at mg/L concentrations were assessed using the 7-day Lemna minor test, with both apical and biochemical markers evaluated. The studied biochemical markers included chlorophyll a, chlorophyll b, carotenoids and oxidative stress enzymes catalase, glutathione-S-transferase and glutathione reductase, with effects compared to solvent controls. The adverse effects on Lemna minor were dose-dependent for frond number, surface area, relative chlorophyll content and activity of glutathione S-transferase for both individual pharmaceuticals and binary mixtures. According to the individual toxicity values, all tested pharmaceuticals can be considered as toxic or harmful to aquatic organisms, with methotrexate considered highly toxic. The most sensitive endpoints for the binary mixtures were photosynthetic pigments and frond surface area, with effects observed in the low mg/L concentration range. The concentration addition model and toxic unit approach gave similar mixture toxicity predictions, with binary mixtures of methotrexate and fluoxetine or methotrexate and 17α-ethynylestradiol exhibiting synergistic effects. In contrast, mixtures of diclofenac with fluoxetine, 17α-ethynylestradiol or methotrexate mostly showed additive effects. While low concentrations of methotrexate are expected in surface water, chronic ecotoxicological data for invertebrates and fish are lacking, but this is required to better assess the environmental risk of methotrexate.

A combination of six psychoactive pharmaceuticals at environmental concentrations alter the locomotory behavior of clonal marbled crayfish

Pharmaceutically active compounds (PhACs) are ubiquitous in the aquatic environment worldwide and considered emerging contaminants. Their effects on growth, behavior, and physiological processes of aquatic organisms have been identified even at very low concentrations. Ecotoxicological investigations have primarily focused on single compound exposure, generally at a range of concentrations. In the natural environment, pollutants seldom occur in isolation, but little is known about the effects and risks of combinations of chemicals. This study aimed to investigate the effects of concurrent exposure to six psychoactive PhACs on locomotory behavior and life history traits of clonal marbled crayfish Procambarus virginalis. Crayfish were exposed to ~1 μg L^-1 of the antidepressants sertraline, citalopram, and venlafaxine; the anxiolytic oxazepam; the opioid tramadol; and the widely abused psychostimulant methamphetamine. In the absence of shelter, exposed crayfish moved significantly shorter distances and at lower velocity and showed significantly less activity than controls. With available shelter, exposed crayfish moved significantly more distance, showed higher activity, and spent a significantly more time outside the shelter than controls. Molting, mortality, and spawning frequency did not vary significantly between the groups. Hemolymph glucose level did not vary among groups and was not correlated with observed behaviors. Results suggest that environmental concentrations of the tested compounds in combination can alter the behavior of non-target aquatic organisms as individual exposure of these compounds, which may lead to disruption of ecosystem processes due to their reduced caution in polluted conditions. Further research is needed using varied chemical mixtures, exposure systems, and habitats, considering molecular and physiological processes connected to behavior alterations.

Micropollutant fluxes in urban environment - A catchment perspective

This study provided a holistic understanding of the sources, fate and behaviour of 142 compounds of emerging concern (CECs) throughout a river catchment impacted by 5 major urban areas. Of the incoming 169.3 kg d^-1 of CECs entering the WwTWs, 167.9 kg d^-1 were present in the liquid phase of influent and 1.4 kg d^-1 were present in the solid phase (solid particulate matter, SPM). Analysis of SPM was important to determine accurate loads of incoming antidepressants and antifungal compounds, which are primarily found in the solid phase. Furthermore, these classes and the plasticiser, bisphenol A (BPA) were the highest contributors to CEC load in digested solids. Population normalised loads showed little variation across the catchment at 154 ± 12 mg d^-1 inhabitant^-1 indicating that population size is the main driver of CECs in the studied catchment. Across the catchment 154.6 kg d^-1 were removed from the liquid phase during treatment processes. CECs discharged into surface waters from individual WwTWs contributed between 0.19 kg d^-1 at WwTW A to 7.3 kg d^-1 at WwTW E, which correlated strongly with the respective contributing populations. Spatial and temporal variations of individual CECs and their respective classes were found in WwTW influent (both solid (influent_SPM) and liquid phases (influent_AQ)) throughout the catchment, showing that different urban areas impact the catchment in different ways, with key variables being lifestyle, use of over-the-counter pharmaceuticals and industrial activity. Understanding of both spatial and temporal variation of CECs at the catchment level helped to identify possible instances of direct disposal, as in the case of carbamazepine. Analysis of surface waters throughout the catchment showed increasing mass loads of CECs from upstream of WwTW A to downstream at WwTW D, showing clear individual contributions from WwTWs. Many CECs were ubiquitous throughout the river water in the catchment. Daily loads ranged from 0.005 g d^-1 (ketamine, WwTW A) up to 1890.3 g d^-1 (metformin, WwTW C) for the 84/138 CECs that were detected downstream of the WwTWs. For metformin this represents the equivalent of ∼1,890 tablets (1,000 mg per tablet) dissolved in the river water downstream of WwTW C.

Preparation of bovine serum albumin restricted access octadecyl/phenyl-mixed-functionalized magnetic silica nanoparticles for magnetic solid phase extraction of antidepressants in aquatic products followed by UHPLC-MS/MS

Pharmaceuticals are widespread in aquatic ecosystem, which may pose a potential threat to fish and human. In the study, a robust and reliable magnetic solid-phase extraction (MSPE) based on bovine serum albumin (BSA) restricted access octadecyl/phenyl-mixed-functionalized magnetic silica nanoparticles (BSA-C18/Ph-Fe₃O₄@SiO₂ NPs) as sorbent was developed for the extraction of venlafaxine, paroxetine, fluoxetine, norfluoxetine, sertraline and diphenhydramine from the muscle extracts of aquatic products followed by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) detection. The homemade sorbent showed appropriate compatibility in aqueous solution and good performance in reducing matrix interference of snakehead muscle tissue extracts with absolute matrix effect ranging in 95.4%-105.5%. The protocol was validated in analyte-free snakehead muscle with favorable recoveries ranging in 91.6%-103.6% and relative standard deviations (RSDs) less than 9.5%. Limits of detection (LODs) of the drugs were lower than 0.018 μg kg^-1. Short-term drug-exposure experiments at low and high doses were conducted on snakeheads, and the measured contents of analytes were in the range 0.029-9.58 μg kg^-1 with appropriate recoveries (90.0%-114.0%). The approach was extensively applied for the analysis of twelve species of market-sale aquatic products (total 37 samples), and up to 1.868 and 0.521 μg kg^-1 of diphenhydramine and venlafaxine were measured, respectively. The approach shows remarkable potential in biological complex samples.

De facto reuse at the watershed scale: Seasonal changes, population contributions, instream flows and water quality hazards of human pharmaceuticals

With increasing population growth and climate change, de facto reuse practices are predicted to increase globally. We investigated a longitudinal gradient within the Uhlava River, a representative watershed, where de facto reuse is actively occurring, during Fall and Spring seasons when instream flows vary. We observed human pharmaceutical levels in the river to continuously increase from the mountainous areas upstream to downstream locations and a potable intake location, with the highest concentrations found in small tributaries. Significant relationship was identified between mass flow of pharmaceuticals and the size of human populations contributing to wastewater treatment plant discharges. Advanced ozonation and granular activated carbon filtration effectively removed pharmaceuticals from potable source waters. We observed a higher probability of encountering a number of targeted pharmaceuticals during colder Spring months when stream flows were elevated compared to warmer conditions with lower flows in the Fall despite a dilution paradigm routinely applied for surface water quality assessment and management efforts. Such observations translated to greater water quality hazards during these higher Spring flows. Future water monitoring efforts should account for periods when higher chemical uses occur, particularly in the face of climate change for regions experiencing population growth and de facto reuse.