A simple and sensitive LC-MS/MS method for the quantitation of sertraline and N-desmethylsertraline in human plasma

A simple and sensitive LC-MS/MS method for the simultaneous quantification of the second-generation antidepressant sertraline, and its active metabolite, N-desmethylsertraline, in human plasma was developed and validated. The analytes were extracted from 200 µL human plasma using a simple protein precipitation method. A gradient elution mode of water and 0.1% formic acid and acetonitrile was used for chromatographic separation on a Poroshell EC-C18 column (3 × 100 mm, 2.7 µm) at a flow rate of 0.450 mL/min. MS/MS analysis was performed in positive ionization mode using the transitions of m/z 306.1 → 159.1, 309.1 → 275.2, 292.1 → 159.1, and 296.2 → 279.0 for sertraline, sertraline-d3, N-desmethylsertraline, and N-desmethylsertraline-d4, respectively. The calibration curves for sertraline and N-desmethylsertraline in human plasma ranged from 2.50-320 ng/mL and 10.0-1280 ng/mL, respectively, with correlation coefficients (r) of ≥ 0.9992. The intra- and inter-assay precisions for both analytes at four concentrations (LLOQ, QCL, QCM, and QCH) ranged between 2.2% and 12.2%, respectively, while their accuracies ranged between 92.0 and 111.7%, with the exception of LLOQ, which ranged between 84.3 and 106.0%. The mean percentage recovery and process efficiency at three concentrations (QCL, QCM, and QCH) was 94.2 and 87.9% for sertraline, and 95.7 and 95.2% for N-desmethylsertraline, respectively. Both analytes were stable in plasma at room temperature for 2 h, at -80 °C for 28 days and through three freeze/thaw cycles. This method was successfully applied to a clinical study investigating the use of sertraline during pregnancy.

Identification and characterization of forced degradation products of sertraline hydrochloride using UPLC, ultra-high-performance liquid Chromatography-Quadrupole-Time of flight mass spectrometry (UHPLC-Q-TOF/MS/MS) and NMR

The present study focused on the forced degradation behavior of sertraline hydrochloride (SRT), selective serotonin reuptake inhibitor (SSRI). The drug was exposed to different stressed conditions (hydrolytic, oxidative, thermal and photolytic) according to ICH Q1A (R2) guidelines. The study revealed that SRT was stable in hydrolytic (acidic, basic and neutral) and thermal degradation conditions. In contrast, five degradation products (DPs) were formed under oxidative and photolytic degradation conditions. The chromatographic separation of drug substance and its DPs was achieved on an Acquity HSS T3 column (100 × 2.1 mm, 1.7 μ) using 0.1% formic acid and acetonitrile as the mobile phase in gradient mode using a UHPLC-DAD system. The DPs were identified and characterized by high-resolution LC/MS and LC/MS/MS in ESI positive mode. Two DPs (DP-I and DP-II) were formed when SRT was exposed to oxidative degradation conditions. Three DPs formed (DP III-V) when exposed to photolytic degradation conditions. All the five major DPs were isolated using Preparative HPLC. The structures of major DPs formed were further confirmed using NMR technique (1D and 2D). The proposed mechanism for the formation of the SRT DPs via the photolytic/oxidative stress degradation pathway are discussed and outlined.

Development of a Novel Bilosomal System for Improved Oral Bioavailability of Sertraline Hydrochloride: Formulation Design, In Vitro Characterization, and Ex Vivo and In Vivo Studies

This study was proposed to develop an optimized sertraline hydrochloride (SER)-loaded bilosomal system and evaluate its potential for enhancement of drug oral bioavailability. A full 2³ factorial design was used to prepare SER-loaded bilosomal dispersions by thin film hydration using span 60, cholesterol (CHL), and sodium deoxycholate (SDC). The investigated factors included the total concentration of span 60 and CHL (X₁), span 60:CHL molar ratio (X₂), and SER:SDC molar ratio (X₃). The studied responses were entrapment efficiency (EE%) (Y₁), zeta potential (Y₂), particle size (Y₃), and in vitro % drug released at 2 (Y₄), 8 (Y₅), and 24 h (Y₆). The selected optimal bilosomal dispersion (N1) composition was 0.5% w/v (X₁), 1:1 (X₂), and 1:2 (X₃). Then, N1 was freeze dried into FDN1 that compared with pure SER for in vitro drug release, ex vivo permeation through rabbit intestine, and in vivo absorption in rats. Moreover, storage effect on FDN1 over 3 months was assessed. The optimal dispersion (N1) showed 68 ± 0.7% entrapment efficiency, - 41 ± 0.78 mV zeta potential, and 377 ± 19 nm particle size. The freeze-dried form (FDN1) showed less % drug released in simulated gastric fluids with remarkable sustained SER release up to 24 h compared to pure SER. Moreover, FDN1 showed good stability, fivefold enhancement in SER permeation through rabbit intestine, and 222% bioavailability enhancement in rats' in vivo absorption study compared to pure SER. The SER-loaded bilosomal system (FDN1) could improve SER oral bioavailability with minimization of gastrointestinal side effects.

Toxicity Profile, Pharmacokinetic, and Drug-Drug Interaction Study of Citalopram and Sertraline Following Oral Delivery in Rat: An LC-MS/MS Method for the Simultaneous Determination in Plasma

The burden of depression and other mental disorders is on the rise globally, and successful treatment sometimes requires modifications of drugs and/or dose regimens. The development of novel analytical methods for the determination of antidepressant drugs in biological fluids is thus urgently required. Herein, a sensitive, robust, and rapid liquid chromatographic coupled tandem mass spectrometric method was developed and validated for the determination of citalopram (CIT) and sertraline (SER) in rat plasma after oral administration. The analytes of interest and internal standard (duloxetine (DUL)) were extracted from 100 μL of plasma with solid-phase extraction on an Oasis HLB cartridge followed by the separation with gradient elution with water containing 0.1% formic acid and acetonitrile on an Agilent Eclipse Plus ODS (4.6 × 100 mm, 3.5 μm) column at flow rate 0.2 mL min^-1. The triple quadrupole mass spectrometry was applied via electrospray ionization source for detection. The fragmentation pattern of the protonated CIT, SER, and DUL was elucidated using multiple reaction monitoring of the transitions of m/z 325.2 to 109, 306.1 to 158.9, and 298.1 to 154.1 as [M + H]⁺ for CIT, SER, and DUL, respectively. The proposed method has been validated as per US-FDA bioanalytical guidelines in terms of linearity, accuracy, precision, matrix effects, stability, selectivity, and recovery. The method was linear over the concentration range of 1-2000 and 1-1000 ng mL^-1 with the lower limit of detection of 0.12 and 0.19 ng mL^-1 for CIT and SER, respectively. The interday and intraday precisions and accuracy expressed by the relative standard deviation and the relative standard error were both lower than 11.1% and 2.1%, respectively. The proposed method was successfully applied for the pharmacokinetics and drug monitoring studies of CIT and SER in rat plasma after a single oral dose of 120 mg kg^-1 of CIT and SER. Coadministration of SER with CIT has affected the peak plasma concentrations, maximum plasma concentration time, area under the concentration-time curve, and oral clearance of CIT. Molecular modeling study showed that SER could competitively inhibit CYP2D6, the main enzyme involved in CIT metabolism. A possible drug-drug interaction in psychiatric patients undergoing chronic SER and CIT treatment is therefore worthy of more attention in an effort to avoid side effects and serotonin syndrome.

Population Pharmacokinetics of Sertraline in Healthy Subjects: a Model-Based Meta-analysis

Sertraline pharmacokinetics is poorly understood and highly variable due to large between-subject variability with inconsistent reports for oral bioavailability. The study objective was to characterize sertraline pharmacokinetics by developing and validating a sertraline population pharmacokinetic (PK) model in healthy subjects using published clinical PK data. We carried a systematic literature search in PubMed in October 2015 and identified 27 pharmacokinetic studies of sertraline conducted in healthy adult subjects and reported in the English language. Sixty mean plasma concentration-time profiles made of 748 plasma concentrations following IV, single, and multiple oral doses ranging from 5 to 400 mg were extracted and analyzed for dose proportionality by a log-linear model and fitted to a 2-compartment pharmacokinetic model in NONMEM using a model-based meta-analysis (MBMA) approach. After a single oral dose, sertraline C_max and AUC_∞ increased with dose proportionally between 50 and 200 mg, and bioavailability increased nonlinearly with dose from 5 to 50 mg and plateaued afterwards while T_max and t_1/2 did not change with dose. Following multiple oral doses, C_max and AUC_∞ increased proportionally with dose across the entire dose range (5-200 mg) while bioavailability, T_max, and t_1/2 remained constant with dose. Sertraline absorption was time-dependent and best described by a sigmoidal E_max function of time after dose. Study findings indicate that sertraline PK is linear in healthy adult subjects at doses ≥ 50 mg, and exposures were nonlinear only after single oral doses < 50 mg likely due to reduced bioavailability.