Environmental pollution with psychiatric drugs

Molecular basis for the effects of SSRIs in non-target aquatic invertebrates: A case study with Mytilus galloprovincialis early larvae

Selective Serotonin Reuptake Inhibitors (SSRIs) are among the most prescribed antidepressants, whose increasing consumption results in a continuous discharge into aquatic compartments, where they are detected at ng-µg/L levels. Whilst designed to modulate endogenous levels of circulating Serotonin (5-HT) in humans by selectively interfering with serotonin reuptake transporters (SERTs), SSRIs have been shown to induce a variety of adverse effects in non-target species, including aquatic invertebrates. In bivalve molluscs, adult exposure to environmental concentrations of SSRIs results in tissue bioaccumulation and induces different biomarker responses. However, the effects were not related to the mechanisms of action of SSRIs, due to poor knowledge of their direct molecular targets, SERT in particular. Much less information is available in embryo-larval stages. In this work, the effects of different SSRIs (Fluoxetine, Citalopram, Sertraline, 1-100 µg/L) were compared in the model of Mytilus galloprovincialis embryo-larval development. SSRIs showed small or no effects on normal larval development at 48 h post fertilization (hpf). The possible direct or indirect molecular targets of SSRIs were thus investigated in mussel larvae. Two conserved SERT sequences, SERT1-like and SERT2-like, were identified in M. galloprovincialis genome: their developmental expression showed increased transcription only from 44 and 20 hpf, respectively. A much higher and earlier expression (from 12 hpf) was observed for TPH (Tryptophan Hydroxylase), the rate limiting enzyme in 5-HT synthesis. Double in situ Hybridization Chain Reaction (HCR) showed partial colocalisation of TPH with SERT1-like and SERT2-like transcripts in 48 hpf larvae. At this stage, SSRIs induced a small but significant decrease in the number of TPH-positive cells. Finally, 19 Nose Resistance to Fluoxetine (nrf) sequences were identified, that were highly expressed across all early stages (0-48 hpf). At 48 hpf, nrf expression was associated with the digestive system. The results represent the first data on the establishment of the serotonergic system in mussel early larvae, representing the molecular basis for understanding the effects of SSRIs and their mechanisms of action in model non-target marine invertebrates.

Carbamazepine-exposed earthworms are characterized by tissue-specific accumulation patterns and transcriptional profiles

Pharmaceutically active compounds enter soils via wastewater reuse and biosolid application. A ubiquitous drug present in wastewater is carbamazepine, a frequently prescribed anti-convulsant. Its mode of action is not species-specific and affects the nervous system of non-target organisms, including most likely the soil dwelling earthworms, which in turn has the potential to negatively impact soil quality. In this project, soils were amended with carbamazepine to explore uptake dynamics and resultant changes in molecular and life cycle endpoints of earthworms (Dendrobaena veneta). Earthworms were maintained, under laboratory conditions, for 28 days in soil spiked with either a solvent control, 0.6 mg/kg carbamazepine (encountered in the terrestrial system) or 10 mg/kg carbamazepine (significantly above an environmental hotspot). Carbamazepine concentrations were quantified in soils and worms by liquid chromatography tandem mass spectrometry (LC-MS/MS) which revealed tissue, dose and time-dependent differences in accumulation. Carbamazepine also modulated the make-up of the microbiome in the soil as well as the earthworm's gut. De novo RNA sequencing identified novel transcripts and complex tissue-specific transcriptomic changes, where, for example, the expression of the tubulin polymerisation promoting protein (tppp) was inhibited (9-fold) in the gut but induced (11-fold) in the cerebral ganglion of exposed earthworms. However, the notable absence of a strong cytochrome P450 response across all conditions suggests that the terrestrial earthworm also relies on detoxification pathways that differ to those observed in well-studied aquatic models. The novel finding that carbamazepine exposure triggers tissue-specific impacts in non-target soil organisms highlights the value and need for a more comprehensive understanding of how contaminants of emerging concern behave within an ecotoxicological context. This, in turn, will lead to informed and reliable risk assessments defining the consequences of wastewater and biosolid amendment practices on soil ecology and ecosystem function.

Tracing Pharmaceuticals in Water Systems: Focus on Neurodegenerative and Psychiatric Treatments

Pharmaceutical residues in aquatic ecosystems pose significant environmental and public health challenges. Identifying the presence and levels of these pharmaceuticals is crucial. This study developed an analytical method to detect pharmaceuticals used for Alzheimer's (AD) and Parkinson's (PD) disease, including psychiatric drugs and the stimulant caffeine, targeting 30 compounds. Optimized mass spectrometric and liquid chromatographic parameters enabled robust detection and quantification. The methodology was applied to 25 surface and wastewater samples. Twenty-one compounds were detected including eight psychiatric drugs, five metabolites (citalopram N-oxide, citalopram propionic acid, desmethylcitalopram, O-desmethylvenlafaxine, and 10,11-epoxycarbamazepine), and seven AD/PD pharmaceuticals along with caffeine. Nine compounds (apomorphine, benserazide, donepezil, didemethylcitalopram, carbidopa, norfluoxetine, galantamine, pramipexole, and safinamide) were not detected. Fluoxetine was found in all samples, and caffeine had the highest concentration at 76,991 ng/L, reflecting its high consumption. Concentrations ranged from 29.8 to 656 ng/L for caffeine, Collapse

Key Words

• aquatic ecosystems
• caffeine
• environmental and public health
• pharmaceuticals (neurodegenerative diseases and psychiatric disorders)
• surface water
• wastewaters

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MESH Headings Collapse

Grants

• UIDB/50006/2020 Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES)
• UIDP/50006/2020 Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES)
• LA/P/0008/2020 Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES)
• PTDC/QUI-QAN/3899/2021 Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES)
• 101003777 BiodivRestore Joint Call 2020-2021, part of the European Union's Horizon 2020

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Affiliation(s)

Paula Paíga REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal
Cristina Delerue-Matos REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal

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[Planetary health and mental health]

Climate change is the greatest global health threat of the twenty-first century. Greenhouse gas emissions and the resulting rise in average temperatures are directly linked to heatwaves, droughts, water and food shortages, extreme weather events, rising sea levels and migration movements as well as the loss of biodiversity and the alteration and degradation of ecosystems as we know them. Current estimates suggest that societies need to show much greater efforts to ensure that the global average temperature does not rise by more than 1.5 °C by 2029. Not only climate change but also other man-made factors, such as noise, light, particulate matter and plastics are threatening the health of the planet and therefore inevitably human health as well, both physical and mental health. Poorer planetary health also has an impact on human mental health. This article extends the DGPPN 2023 position paper on climate change and mental health to include the concept of planetary health. In particular, the normative dimension of the Canmore Declaration on Planetary Health, the concept of transdisciplinarity and specific calls for action are presented with their relevance to psychiatry, psychotherapy and mental health and the associations are graphically illustrated.

Evaluation of the citalopram toxicity on early development of zebrafish: Morphological, physiological and biochemical responses

Citalopram, an antidepressant drug have been detected in different environmental matrices due to its high consumption. Previous study has proved that citalopram may alter the behaviour of aquatic organisms at environmentally relevant concentrations. However, scientific knowledge is still lacking on the ecotoxicological effects of citalopram on aquatic organisms. For this reason, the present study is aimed to investigate the potential toxicity of citalopram in terms of development, antioxidant, neurotoxicity, apoptosis, lipogenesis, and bone mineralization in embryonic and larval zebrafish (Danio rerio) at environmentally relevant concentrations. We noticed that citalopram exposure at 1 and 10 μg/L concentration delays hatching and heartbeat at 24, 48, 72 and 96 hpf. Exposure to citalopram also significantly increased mortality at 10 μg/L. Abnormal development with yolk sac edema, pericardial edema and scoliosis were also observed after citalopram treatment. In addition, citalopram significantly (P < 0.001) induced superoxide dismutase (SOD), catalase (CAT), glutathione-S-transferase (GST) and lipid peroxidation (LPO) levels. A significant decrease in acetylcholine esterase (AChE) activity was also observed in citalopram exposed groups. We found significant dose-and time-dependent increases in apoptosis, lipogenesis, and bone mineralization. In conclusion, the findings of the present study can provide new insights on the ecotoxicity of citalopram in the aquatic environment.

Antipsychotic drug-induced behavioral abnormalities in common carp: The potential involvement of the gut microbiota-brain axis

The effects of antipsychotic drugs on aquatic organisms have received widespread attention owing to their widespread use and continued release in aquatic environments. The toxicological effects of antipsychotics on aquatic organisms, particularly fish, are unexplored, and the underlying mechanisms remain unelucidated. This study aimed to use common carp to explore the effects of antipsychotics (olanzapine [OLA] and risperidone [RIS]) on behavior and the potential mechanisms driving these effects. The fish were exposed to OLA (0.1 and 10 μg/L) and RIS (0.03 and 3 μg/L) for 60 days. Behavioral tests and neurological indicators showed that exposure to antipsychotics could cause behavioral abnormalities and neurotoxicity in common carp. Further, 16 S rRNA sequencing revealed gut microbiota alteration and decreased relative abundance of some strains related to SCFA production after OLA and RIS exposure. Subsequently, a pseudo-sterile common carp model was successfully constructed, and transplantation of the gut microbiota from antipsychotic-exposed fish caused behavioral abnormalities and neurotoxicity in pseudo-sterile fish. Further, SCFA supplementation demonstrated that SCFAs ameliorated the behavioral abnormalities and neurological damage caused by antipsychotic exposure. To our knowledge, the present study is the first to investigate the effects of antipsychotics on various complex behaviors (swimming performance and social behavior) in common carp, highlighting the potential health risks associated with antipsychotic drug-induced neurotoxicity in fish. Although these results do not fully elucidate the mechanisms underlying the effects of antipsychotic drugs on fish behavior, they serve as a valuable initial investigation and form the basis for future research.

Assessing Environmental Risks during the Drug Development Process for Parasitic Vector-Borne Diseases: A Critical Reflection

Parasitic vector-borne diseases (VBDs) represent nearly 20% of the global burden of infectious diseases. Moreover, the spread of VBDs is enhanced by global travel, urbanization, and climate change. Treatment of VBDs faces challenges due to limitations of existing drugs, as the potential for side effects in nontarget species raises significant environmental concerns. Consequently, considering environmental risks early in drug development processes is critically important. Here, we examine the environmental risk assessment process for veterinary medicinal products in the European Union and identify major gaps in the ecotoxicity data of these drugs. By highlighting the scarcity of ecotoxicological data for commonly used antiparasitic drugs, we stress the urgent need for considering the One Health concept. We advocate for employing predictive tools and nonanimal methodologies such as New Approach Methodologies at early stages of antiparasitic drug research and development. Furthermore, adopting progressive approaches to mitigate ecological risks requires the integration of nonstandard tests that account for real-world complexities and use environmentally relevant exposure scenarios. Such a strategy is vital for a sustainable drug development process as it adheres to the principles of One Health, ultimately contributing to a healthier and more sustainable world.

An Overview of Degradation Strategies for Amitriptyline

Antidepressant drugs play a crucial role in the treatment of mental health disorders, but their efficacy and safety can be compromised by drug degradation. Recent reports point to several drugs found in concentrations ranging from the limit of detection (LOD) to hundreds of ng/L in wastewater plants around the globe; hence, antidepressants can be considered emerging pollutants with potential consequences for human health and wellbeing. Understanding and implementing effective degradation strategies are essential not only to ensure the stability and potency of these medications but also for their safe disposal in line with current environment remediation goals. This review provides an overview of degradation pathways for amitriptyline, a typical tricyclic antidepressant drug, by exploring chemical routes such as oxidation, hydrolysis, and photodegradation. Connex issues such as stability-enhancing approaches through formulation and packaging considerations, regulatory guidelines, and quality control measures are also briefly noted. Specific case studies of amitriptyline degradation pathways forecast the future perspectives and challenges in this field, helping researchers and pharmaceutical manufacturers to provide guidelines for the most effective degradation pathways employed for minimal environmental impact.

Hermit crabs as model species for investigating the behavioural responses to pollution

Human impacts on the environment affect organisms at all levels of biological organisation and ultimately can change their phenotype. Over time, phenotypic change may arise due to selection but individual phenotypes are also subject to change via genotype × environment interactions. In animals, behaviour is the most flexible aspect of phenotype, and hence the most liable to change across environmental gradients including exposure to pollution. Here we review current knowledge on the impacts of pollution, broadly defined to include the release of substances, energy, and the effects of carbon emissions, on the behaviour of a highly studied group, the globally distributed hermit crabs. We first show how their obligate association with empty gastropod shells underpins their use as model organisms for the study of resource-assessment, contest, and risk-coping behaviours. Intense study of hermit crabs has advanced our understanding of how animals use information, and we discuss the ways in which pollutants can disrupt the cognitive processes involved. We then highlight current studies of hermit crabs, which paint a clear picture of behavioural changes due to multiple pollutants. Impacts on behaviour vary across pollutants and entire suites of behaviours can be influenced by a single pollutant, with the potential for interactive and cascade effects. Hermit crabs offer the opportunity for detailed behavioural analysis, including application of the repeated measures animal-personality framework, and they are highly amenable to experimental manipulations. As such, we show how they now provide a model system for studying the impacts of pollution on behaviour, yielding insights broadly applicable across animal diversity.

Insights in Pharmaceutical Pollution: The Prospective Role of eDNA Metabarcoding

Environmental pollution is a growing threat to natural ecosystems and one of the world's most pressing concerns. The increasing worldwide use of pharmaceuticals has elevated their status as significant emerging contaminants. Pharmaceuticals enter aquatic environments through multiple pathways related to anthropogenic activity. Their high consumption, insufficient waste treatment, and the incapacity of organisms to completely metabolize them contribute to their accumulation in aquatic environments, posing a threat to all life forms. Various analytical methods have been used to quantify pharmaceuticals. Biotechnology advancements based on next-generation sequencing (NGS) techniques, like eDNA metabarcoding, have enabled the development of new methods for assessing and monitoring the ecotoxicological effects of pharmaceuticals. eDNA metabarcoding is a valuable biomonitoring tool for pharmaceutical pollution because it (a) provides an efficient method to assess and predict pollution status, (b) identifies pollution sources, (c) tracks changes in pharmaceutical pollution levels over time, (d) assesses the ecological impact of pharmaceutical pollution, (e) helps prioritize cleanup and mitigation efforts, and (f) offers insights into the diversity and composition of microbial and other bioindicator communities. This review highlights the issue of aquatic pharmaceutical pollution while emphasizing the importance of using modern NGS-based biomonitoring actions to assess its environmental effects more consistently and effectively.

A psychiatric drug found in waste-water plant effluents alters the migratory behavior of critically endangered Anguilla anguilla juveniles

Migratory fishes cross or settle in several environments potentially polluted. Psychiatric drugs, which represent one growing pollution and are found in discharges from waste-water treatment plants, may alter individual behaviors. Here, we assessed behavioral alterations in the upstream migratory behavior of Anguilla anguilla caused by diazepam, an anxiolytic. We monitored the swimming activity, swimming behavior, and boldness to assess whether diazepam impacts them or not. Our 7-day behavioral follow-up allowed us to test the kinetics of the potential effects of diazepam. We found diazepam reduced swimming activity and altered individual swimming behavior, with fewer individuals swimming against the current, so swimming upstream. Those effects varied over time and were stronger at the end of our monitoring, suggesting chemical pollutants encountered in estuaries may act as a chemical burden for individuals, despite metabolisation. We also found diazepam favored bolder behavior in glass eels. Our results provide new knowledge on chemical pollution and psychiatric drugs inducing behavioral alterations. Those alterations may have ecological and evolutionary consequences for glass eels, by diminishing predator avoidance and impacting spatial colonization, and thus, local density.

Knowledge and attitude about drug pollution in pharmacy students: A questionnaire-based cross sectional study

INTRODUCTION

The environmental impact of drugs or pharmaceuticals is an issue of growing concern. Healthcare professionals, and pharmacists in particular, are used to managing medicines, yet aspects about drug pollution are generally neglected in schools of pharmacy worldwide. Formation in this issue is essential to tackle the problem. In this study, we aimed to find out the degree of knowledge about the problem of pharmaceuticals in the environment and the attitude about the matter of pharmacy students at the University of the Basque Country.

METHODS

We conducted a pilot study (186 students) using an online questionnaire available in two languages (Basque and Spanish). The attitude scale was validated for Spanish. To improve participation, a combination of indirect and direct recruitment was applied in the final study.

RESULTS

Four hundred eighty-seven students participated in the final study (response rate: 65.8%). The final questionnaire contained a total of 25 questions: 13 (knowledge), eight (attitude), and three (opinion). The results showed that knowledge can be considered relatively poor, whereas attitude was generally positive, and students considered drug pollution to be a relevant issue in general and in pharmacy practice.

CONCLUSIONS

We believe there is an urgent need to include aspects about pharmaceuticals in the environment in pharmacy studies worldwide.

Antidepressant pharmaceuticals in aquatic systems, individual-level ecotoxicological effects: growth, survival and behavior

The growing consumption of antidepressant pharmaceuticals has resulted in their widespread occurrence in the environment, particularly in waterways with a typical concentration range from ng L^-1 to μg L^-1. An increasing number of studies have confirmed the ecotoxic potency of antidepressants, not only at high concentrations but also at environmentally relevant levels. The present review covers literature from the last decade on the individual-level ecotoxicological effects of the most commonly used antidepressants, including their impact on behavior, growth, and survival. We focus on the relationship between antidepressants physico-chemical properties and dynamics in the environment. Furthermore, we discuss the advantages of considering behavioral changes as sensitive endpoints in ecotoxicology, as well as some current methodological shortcomings in the field, including low standardization, reproducibility and context-dependency.

Environmental concerns and bioaccumulation of psychiatric drugs in water bodies - Conventional versus biocatalytic systems of mitigation

The COVID-19 pandemic has brought increments in market sales and prescription of medicines commonly used to treat mental health disorders, such as depression, anxiety, stress, and related problems. The increasing use of these drugs, named psychiatric drugs, has led to their persistence in aquatic systems (bioaccumulation), since they are recalcitrant to conventional physical and chemical treatments typically used in wastewater treatment plants. An emerging environmental concern caused by the bioaccumulation of psychiatric drugs has been attributed to the potential ecological and toxicological risk that these medicines might have over human health, animals, and plants. Thus, by the application of biocatalysis-assisted techniques, it is possible to efficiently remove psychiatric drugs from water. Biocatalysis, is a widely employed and highly efficient process implemented in the biotransformation of a wide range of contaminants, since it has important differences in terms of catalytic behavior, compared to common treatment techniques, including photodegradation, Fenton, and thermal treatments, among others. Moreover, it is noticed the importance to monitor transformation products of degradation and biodegradation, since according to the applied removal technique, different toxic transformation products have been reported to appear after the application of physical and chemical procedures. In addition, this work deals with the discussion of differences existing between high- and low-income countries, according to their environmental regulations regarding waste management policies, especially waste of the drug industry.

Computational Modelling and Sustainable Synthesis of a Highly Selective Electrochemical MIP-Based Sensor for Citalopram Detection

A novel molecularly imprinted polymer (MIP) has been developed based on a simple and sustainable strategy for the selective determination of citalopram (CTL) using screen-printed carbon electrodes (SPCEs). The MIP layer was prepared by electrochemical in situ polymerization of the 3-amino-4 hydroxybenzoic acid (AHBA) functional monomer and CTL as a template molecule. To simulate the polymerization mixture and predict the most suitable ratio between the template and functional monomer, computational studies, namely molecular dynamics (MD) simulations, were carried out. During the experimental preparation process, essential parameters controlling the performance of the MIP sensor, including CTL:AHBA concentration, number of polymerization cycles, and square wave voltammetry (SWV) frequency were investigated and optimized. The electrochemical characteristics of the prepared MIP sensor were evaluated by both cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) techniques. Based on the optimal conditions, a linear electrochemical response of the sensor was obtained by SWV measurements from 0.1 to 1.25 µmol L-1 with a limit of detection (LOD) of 0.162 µmol L-1 (S/N = 3). Moreover, the MIP sensor revealed excellent CTL selectivity against very close analogues, as well as high imprinting factor of 22. Its applicability in spiked river water samples demonstrated its potential for adequate monitoring of CTL. This sensor offers a facile strategy to achieve portability while expressing a willingness to care for the environment.