Posted by Ritch on February 11, 2002, at 19:51:36
In reply to Re: possible interaction carbamazepine risperidone?, posted by e503 on February 11, 2002, at 13:59:52
> mitch-
>
> thanks so much for your help...since ben cannot verbalize to me how he feels , it is always a guessing game. WHere can i find some info about what you said about zoloft? As far as it's metabolites? thanks,
> eliseI got that information here-I don't know if it is still around or not-it had to do with antidepressant guidelines or something and showed antidpressants, their primary metabolites and the respective half-lives. Also, I noticed the effect that Zoloft had on me that was a little weird. I always took my dose in the morning only and I would always feel kind of tired and foggy most of the day, but then in the evening, and then especially when I got up the next morning-my sleep was abbreviated, and I was going 100mph! After I read about the metabolites here I started to put two and two together. Also, I went to the monograph for Zoloft and here is an excerpt from the Clinical Pharmacology section:
Metabolism: Sertraline undergoes extensive first pass metabolism. The principal initial pathway of metabolism for sertraline is N-demethylation. **N-desmethylsertraline has a plasma terminal elimination half-life of 62 to 104 hours**. Both in vitro biochemical and in vivo pharmacological testing have shown N-desmethylsertraline to be substantially less active than sertraline. Both sertraline and N-desmethylsertraline undergo oxidative deamination and subsequent reduction, hydroxylation, and glucuronide conjugation. In a study of radiolabeled sertraline involving two healthy male subjects, sertraline accounted for less than 5% of the plasma radioactivity. About 40-45% of the administered radioactivity was recovered in urine in 9 days. Unchanged sertraline was not detectable in the urine. For the same period, about 40-45% of the administered radioactivity was accounted for in feces, including 12-14% unchanged sertraline.
That is when I got some kind of confirmation of the idea that the primary metabolite of sertraline has denite pharmacological action (for good or ill). And the metabolite must have quite different actions from the primary med given the above information.
The last time I was taking Zoloft I tried taking it at bedtime (because it definitely was causing sleep disturbances), and it worked better taking it at bedtime instead of during the day (when I would become drowsy). So, if someone was getting benefit from the primary metabolite, taking it twice daily might be more effective.
Mitch
poster:Ritch
thread:93523
URL: http://www.dr-bob.org/babble/20020208/msgs/93811.html