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Fluoxetine and escitalopram are the only antidepressants approved by the Food and Drug Administration of the United States of America (FDA) for treatment of major depression in children and adolescents. Both drugs are selective serotonin reuptake inhibitors (SSRIs). In recent years there has been a growing concern over the long-term developmental effects of early-life exposure to SSRIs. The current study employed male Flinders Sensitive Line (FSL) rats, a well described and validated translational model of depression, to investigate the long term effects of pre-pubertal fluoxetine exposure. First we examined the effect of such early-life exposure on the development of depressive-like behaviour, locomotor activity and anxiety-like behaviour as manifested in early adulthood. Next, the current study investigated the effect of pre-pubertal fluoxetine exposure on the acute monoaminergic stress response, as displayed later in life. Animals received either saline (vehicle control), or 10 mg/kg/day fluoxetine from postnatal day (ND+) 21 to ND+34 (pre-puberty). The treatment period was chosen to coincide with a developmental phase where the serotonergic system’s neurodevelopment had been completed, yet the noradrenergic and dopaminergic systems had not, a scenario comparable to neurodevelopment in human adolescents. Both behavioural and in vivo intra-cerebral microdialysis experiments were conducted after ND+60 (early adulthood). On ND+60 rats allocated to behavioural experiments were evaluated for depressive-like behaviour in the forced swim test (FST), locomotor activity in the open field test (OFT), and anxiety-like behaviour in the OFT. Corticosterone concentrations were shown to be significantly higher in male FSL rats exposed to a 10 minute forced swim stress when compared to male FSL rats not exposed to a forced swim stress on ND+60. In the microdialysis experiments the rats were exposed to an acute 10 minute forced swim stress and the concentrations of the monoamines and their metabolites were measured before, during, and after the acute stressor. Relative to saline-treated (control) rats, fluoxetine-treated FSL rats did not show long-term changes in immobility in the FST (i.e. no anti-depressant-like activity) on ND+60. Like-wise anxiety-like behaviour in the OFT did not change. However, a significant decrease in locomotor activity was observed in fluoxetine-treated FSL rats compared to saline-treated (control) rats. These data suggest that a long-lasting anti-depressant-like effect of fluoxetine may be masked by the effect on locomotor activity. With measurements from the microdialysis experiments a significant attenuation of the noradrenergic stress response was observed in fluoxetine-treated rats compared to saline controls. A similar picture was observed for 5-hydroxyindole-3-acetic acid (5-HIAA), a metabolite of serotonin (5-HT), although the latter was not statistically significant. At baseline, before the stressor, significant increase in dopamine (DA) levels were observed in fluoxetine treated rats when compared to saline controls, suggesting that enhanced dopamine neurotransmission may comprise a long-term effect of pre-pubertal fluoxetine treatment. There were no discernible differences in homovanilllic acid (HVA) concentrations between fluoxetine-treated rats and saline controls. In conclusion significant developmental effects of pre-pubertal fluoxetine exposure were observed later in life and these findings warrant further investigation. / MPharm (Pharmacology), North-West University, Potchefstroom Campus, 2015

Fluoxetine and escitalopram are the only antidepressants approved by the Food and Drug Administration of the United States of America (FDA) for treatment of major depression in children and adolescents. Both drugs are selective serotonin reuptake inhibitors (SSRIs). In recent years there has been a growing concern over the long-term developmental effects of early-life exposure to SSRIs. The current study employed male Flinders Sensitive Line (FSL) rats, a well described and validated translational model of depression, to investigate the long term effects of pre-pubertal fluoxetine exposure. First we examined the effect of such early-life exposure on the development of depressive-like behaviour, locomotor activity and anxiety-like behaviour as manifested in early adulthood. Next, the current study investigated the effect of pre-pubertal fluoxetine exposure on the acute monoaminergic stress response, as displayed later in life. Animals received either saline (vehicle control), or 10 mg/kg/day fluoxetine from postnatal day (ND+) 21 to ND+34 (pre-puberty). The treatment period was chosen to coincide with a developmental phase where the serotonergic system’s neurodevelopment had been completed, yet the noradrenergic and dopaminergic systems had not, a scenario comparable to neurodevelopment in human adolescents. Both behavioural and in vivo intra-cerebral microdialysis experiments were conducted after ND+60 (early adulthood). On ND+60 rats allocated to behavioural experiments were evaluated for depressive-like behaviour in the forced swim test (FST), locomotor activity in the open field test (OFT), and anxiety-like behaviour in the OFT. Corticosterone concentrations were shown to be significantly higher in male FSL rats exposed to a 10 minute forced swim stress when compared to male FSL rats not exposed to a forced swim stress on ND+60. In the microdialysis experiments the rats were exposed to an acute 10 minute forced swim stress and the concentrations of the monoamines and their metabolites were measured before, during, and after the acute stressor. Relative to saline-treated (control) rats, fluoxetine-treated FSL rats did not show long-term changes in immobility in the FST (i.e. no anti-depressant-like activity) on ND+60. Like-wise anxiety-like behaviour in the OFT did not change. However, a significant decrease in locomotor activity was observed in fluoxetine-treated FSL rats compared to saline-treated (control) rats. These data suggest that a long-lasting anti-depressant-like effect of fluoxetine may be masked by the effect on locomotor activity. With measurements from the microdialysis experiments a significant attenuation of the noradrenergic stress response was observed in fluoxetine-treated rats compared to saline controls. A similar picture was observed for 5-hydroxyindole-3-acetic acid (5-HIAA), a metabolite of serotonin (5-HT), although the latter was not statistically significant. At baseline, before the stressor, significant increase in dopamine (DA) levels were observed in fluoxetine treated rats when compared to saline controls, suggesting that enhanced dopamine neurotransmission may comprise a long-term effect of pre-pubertal fluoxetine treatment. There were no discernible differences in homovanilllic acid (HVA) concentrations between fluoxetine-treated rats and saline controls. In conclusion significant developmental effects of pre-pubertal fluoxetine exposure were observed later in life and these findings warrant further investigation. / MPharm (Pharmacology), North-West University, Potchefstroom Campus, 2015

As determinações, em níveis de traços, de fármacos em fluidos biológicos e de multirresíduos (contaminantes) em amostras alimentícias são de extrema importância, pois geram valiosos dados para fins, respectivamente, de monitorização terapêutica (individualização do regime de dosagem) e controle de qualidade (segurança alimentar). A demanda por métodos analíticos de alta resolução e com baixos limites de quantificação, para análises de amostras complexas, tem impulsionado a química analítica para o desenvolvimento de soluções inovadoras, destacando-se aquelas voltadas ao desenvolvimento ou avaliação de novos sistemas analíticos. Neste contexto, na primeira etapa desta tese, o sistema automatizado de microextração em fase sólida no capilar de polipirrol (in-tube PPY SPME) acoplado à cromatografia líquida com detecção fluorimétrica foi desenvolvido (lab-made) para a determinação enantiosseletiva de fluoxetina e de seu metabólito norfluoxetina em amostras de plasma, para fins de monitorização terapêutica. Na segunda etapa, o método cromatografia gasosa bidimensional abrangente acoplada à espectrometria de massas com analisador quadrupolo (GC x GC / qMS) foi padronizado e validado para análise de multirresíduos de agrotóxicos em tomates frescos, para fins de controle de qualidade. Dentre os resultados obtidos podemos destacar: na primeira etapa o ganho de seletividade da fase extratora de polipirrol, em sistema miniaturizado e automatizado de preparo de amostra, hifenado à separação cromatográfica (LC) com detecção fluorimétrica; e na segunda etapa, o incremento da resolução cromatográfica e detectabilidade do sistema de cromatografia gasosa bidimensional com detecção espectrométrica com analisador quadrupolo. As análises de amostras de plasma de pacientes em terapia com fluoxetina e de amostras de tomates comerciais comprovaram a aplicabilidade dos métodos propostos, padronizados e validados, em níveis de concentrações que incluem o intervalo terapêutico preconizado para a fluoxetina em plasma e os limites máximos de resíduos de agrotóxicos estabelecidos para a cultura de tomate. / Determination of trace levels of drugs in biological fluids and multiresidue (contaminants) in food samples is extremely important because this generates valuable data for therapeutic drug monitoring (individualization of dosage regimen) and quality control (food safety), respectively. Because of the demand for analytical methods with high resolution and low limits of quantification for analysis of complex samples, analytical chemistry has stimulated the development of innovative approaches, especially those aimed at developing or evaluating new analytical systems. In this context, in the first stage of this thesis the automated solid-phase microextraction capillary polypyrrole (in-tube \"PPY SPME) coupled to liquid chromatography with fluorimetric detection was developed (lab-made) for enantioselective determination of fluoxetine and its metabolite norfluoxetine in plasma samples for therapeutic drug monitoring. In the second stage of this work, the GC x GC / qMS method was developed for multiresidues analysis of pesticides in fresh tomatoes for the purpose of quality control. In the first stage of the research the gain in terms of the selectivity of the polypyrrole extraction phase in hyphenated and automated system for sample preparation and chromatographic separation (LC) with fluorimetric detection is worthy of note. As for the second step, the highlight is the improvement in chromatographic resolution as well as in the detectability system of the system consisting of two-dimensional gas chromatography and spectrometric detection with quadrupole analyzer. Analyses of plasma samples from patients undergoing therapy with fluoxetine and of samples of commercially available tomatoes proved the applicability of the proposed methods, which were optimized and validated at concentrations levels that include the therapeutic range for the analyzed drugs in plasma and the maximum residue limits of pesticides for growing tomatoes.

Contaminants such as pharmaceuticals are of increasing concern due to their ubiquitous use and persistence in surface waters worldwide. Limited attention has been paid to the effects of pharmaceuticals on marine life, despite widespread detection of these contaminants in the marine environment. Of the existing studies, the majority assess the negative effects of pharmaceuticals over an exposure period of 30 days or less and focus on cellular and subcellular biomarkers. Longer studies are required to determine if chronic contaminant exposure poses risks to marine life at environmentally relevant concentrations. Also scarce in the literature is examination of whole organism effects to identify potential community-level consequences. Two long-term studies with the antidepressant pharmaceutical, fluoxetine (the active constituent in Prozac®) were conducted to determine whether nominal concentrations detected in estuarine and coastal environments affect organism health and interactions. First, we measured whole organism metrics in the California mussel, Mytilus californianus over a period of 107 days. Specifically, we measured algal clearance rates, growth, and condition indices for both reproductive and overall health. We found that fluoxetine negatively affects all measured characteristics, however many effects are mediated by length of exposure. Perhaps the most notable result was that mussels spiked with fluoxetine cleared less algae after 30 days of exposure. Reduced growth and condition indices likely are a consequence of improper nutrition among fluoxetine-treated mussels. Any level of fluoxetine significantly affected the gonadosomatic index after 47 days. The results from this study on mussels fill an important data gap, highlighting organism-level effects of chronic exposure periods; such data more explicitly identify the impacts of pharmaceuticals and other contaminants on marine communities and ecosystems. Fluoxetine has also been documented to affect the behavior of fish and invertebrates, including freshwater and marine bivalves, crustaceans, and fish. Given that other crustaceans exhibited increased activity levels under fluoxetine exposure, we hypothesized that this would subject them to greater predation risk. In our second exposure study, we assessed whether a similar range of fluoxetine concentrations used in the mussel study altered the risk behavior of the Oregon mud crab, Hemigrapsus oregonensis, in response to a common predator, the red rock crab, Cancer productus. We conducted this study for 60 days, conducting day and night behavioral trials (with and without predators) four times a week. We found that crabs exposed to any amount of fluoxetine (3 or 30 ng/L) had increased activity levels relative to controls; however behaviors of 3 ng/L-spiked crabs were not always significantly different from controls. Among control crabs, day and night trials yielded similar results, where a clear response to the addition of the predator was observed. Crabs dosed with fluoxetine exhibited more foraging and active behaviors in the presence of the predator. Additionally, crabs spiked with fluoxetine at 30 ng/L had the greatest risk of mortality either by predation by red rock crabs or due to more aggressive behaviors among conspecifics. The results of this study shed light on a particularly unexplored area of contaminants research: how do psychoactive pharmaceuticals affect animal behavior when exposed to the low concentrations persisting in the aquatic environment for a prolonged period of time?

Made available in DSpace on 2016-06-02T19:22:13Z (GMT). No. of bitstreams: 1 6764.pdf: 3884512 bytes, checksum: bdca3c9f3391c512a817c23fee8ef734 (MD5) Previous issue date: 2015-03-20 / Universidade Federal de Minas Gerais / The pain is an universal experience, and frequently follows anxiety and depression cases. Some specific drugs used in depression and anxiety treatment are also used for the relief of pain. There are evidences showing that exposure to threatening situations can result in pain inhibition. In this way, studies involving pain and anxiety use animal models as tools for potential therapeutic agents screening as well as for enhance the knowledge about the neurobiology of emotions. This study investigated the following effects: acute and chronic fluoxetine treatment; microinjections of 5-HT1A and 5HT2C receptors agonists intraperiaqueductal gray matter (PAG), and the administration combined of these drugs on antinociception induced by the open arms (OAA) of the elevated plus maze (EPM). Furthermore, we investigated the effects of fluoxetine chronic treatment on serotonin, 5- HIAA, 5-HT1A and 5HT2C receptors levels within PAG. Our results showed that: (I) fluoxetine acute treatment (20 mg/kg) was able to increase the OAA; (II) fluoxetine chronic treatment (21 days) (20 mg/kg) also enhances the OAA, and decreased the number of writhes on animal confined in the enclosed arm, featuring an analgesic effect; (III) the administration of 8-OH-DPAT (5-HT1A agonist) intra-PAG did not change the number of writhes in animals confined in the arms of the EPM; (IV) the infusions of mCPP and MK- 212 (5HT2C agonists) intra-PAG increased the OAA. (V) The blockade of 5HT2C receptors located in the PAG by SB 242080 injection (5HT2C antagonist) was able to completely reverse the OAA; (VI) the combined administration of fluoxetine (acute treatment) and 8- OH-DPAT intra-PAG also blocked completely the OAA; (VII) the combined administration of fluoxetine (acute treatment) and MK-212 intra-PAG reversed the increase of OAA observed with MK-212 injection; (VII) combined administration of fluoxetine (chronic treatment) and 8-OH-DPAT intra-SCP once more blocked OAA; (IX) the fluoxetine (chronic treatment) + MK-212 intra-PAG, impairs the OAA increase observed with isolated MK-212 injection; (X) fluoxetine chronic treatment was not capable to change the serotonin, 13 5-HIAA levels, and serotonin turnover in the PAG (XI) fluoxetine chronic treatment promoted up-regulation of 5-HT1A and 5HT2C receptors within PAG. These findings suggest that OAA is médiated by 5-HT2C receptors located in the PAG. Furthermore, fluoxetine was capable to interact with this serotonergic receptor promoting functional (acute treatment) and quantitative (chronic treatment) changes on 5-HT1A and 5HT2C receptors within PAG. / A dor é uma experiência universal, e frequentemente acompanha quadros de ansiedade e depressão. Alguns tipos específicos de fármacos utilizados no tratamento da depressão e ansiedade são também empregados como analgésicos. Há evidências mostrando que a exposição a situações ameaçadoras podem resultar em inibição da dor. Desta forma, pesquisas que envolvem dor e ansiedade frequentemente empregam modelos animais como instrumentos para a seleção de potenciais agentes terapêuticos, e para investigações acerca da neurobiologia das emoções. Diante destas evidências, esse estudo investigou os efeitos: do tratamento agudo e crônico de fluoxetina; tratamento intra-substância cinzenta periaquedutal (SCP) com agonistas serotoninérgicos 5-HT1A e 5HT2C e administração combinada destes fármacos sobre a antinocicepção induzida pelo confinamento ao braço aberto (BA) do labirinto em cruz elevado (LCE). Além disso, investigamos os efeitos do tratamento crônico com fluoxetina sobre os níveis de serotonina, 5-HIAA e de receptores 5- HT1A e 5HT2C da SCP. Nossos resultados demonstraram que: (I) o tratamento agudo com fluoxetina, na dose de 20 mg/kg, foi capaz de aumentar a antinocicepção induzida pelos BA s do LCE; (II) o tratamento crônico (21 dias) com fluoxetina (20 mg/kg) aumentou a antinocicepção induzida pelo ambiente aversivo, e diminuiu o número de contorções dos animais confinados no braço fechado, o que caracteriza um efeito analgésico; (III) a administração intra-SCP do agonista dos receptores 5-HT1A (8-OHDPAT); não alterou o número de contorções nos animais confinados nos braços do LCE; (IV) as infusões intra- SCP de agonistas dos receptores 5HT2C (mCPP e MK-212), acentuaram a antinocicepção nos animais confinados no BA; (V) o bloqueio dos receptores 5HT2C localizados na SCP, através de injeções do antagonista SB 242080, foi capaz de reverter completamente a antinocicepção induzida pelo BA do LCE; (VI) a administração combinada de fluoxetina (aguda) e 8-OH-DPAT intra-SCP, bloqueou a antinocicepção induzida pelo confinamento ao 11 BA; (VII) a administração combinada de fluoxetina (aguda) e MK-212 intra-SCP reverteu o aumento da antinocicepção observada com a injeção isolada de MK-212; (VIII) a administração combinada de fluoxetina (crônica) e 8-OH-DPAT intra-SCP bloqueou a antinocicepção induzida pelo confinamento ao BA; (IX) o tratamento combinado com fluoxetina (crônica) e MK-212 intra-SCP prejudicou o aumento da antinocicepção observada com a injeção isolada de MK-212; (X) o tratamento crônico com fluoxetina não foi capaz de alterar os níveis de serotonina, 5-HIAA e turnover da serotonina na SCP; (XI) o tratamento crônico com fluoxetina promoveu um aumento nos níveis de receptores 5-HT1A e 5HT2C localizados na SCP. Estes achados sugerem que a antinocicepção induzida pelos BA s do LCE é médiada pelos receptores 5-HT2C localizados na SCP. Além disso, a fluoxetina é capaz de interagir com este subtipo de receptor serotoninérgico promovendo alterações funcionais (tratamento agudo) e quantitativas (tratamento crônico) sobre os receptores 5-HT1A e 5HT2C localizados na SCP.

As determinações, em níveis de traços, de fármacos em fluidos biológicos e de multirresíduos (contaminantes) em amostras alimentícias são de extrema importância, pois geram valiosos dados para fins, respectivamente, de monitorização terapêutica (individualização do regime de dosagem) e controle de qualidade (segurança alimentar). A demanda por métodos analíticos de alta resolução e com baixos limites de quantificação, para análises de amostras complexas, tem impulsionado a química analítica para o desenvolvimento de soluções inovadoras, destacando-se aquelas voltadas ao desenvolvimento ou avaliação de novos sistemas analíticos. Neste contexto, na primeira etapa desta tese, o sistema automatizado de microextração em fase sólida no capilar de polipirrol (in-tube PPY SPME) acoplado à cromatografia líquida com detecção fluorimétrica foi desenvolvido (lab-made) para a determinação enantiosseletiva de fluoxetina e de seu metabólito norfluoxetina em amostras de plasma, para fins de monitorização terapêutica. Na segunda etapa, o método cromatografia gasosa bidimensional abrangente acoplada à espectrometria de massas com analisador quadrupolo (GC x GC / qMS) foi padronizado e validado para análise de multirresíduos de agrotóxicos em tomates frescos, para fins de controle de qualidade. Dentre os resultados obtidos podemos destacar: na primeira etapa o ganho de seletividade da fase extratora de polipirrol, em sistema miniaturizado e automatizado de preparo de amostra, hifenado à separação cromatográfica (LC) com detecção fluorimétrica; e na segunda etapa, o incremento da resolução cromatográfica e detectabilidade do sistema de cromatografia gasosa bidimensional com detecção espectrométrica com analisador quadrupolo. As análises de amostras de plasma de pacientes em terapia com fluoxetina e de amostras de tomates comerciais comprovaram a aplicabilidade dos métodos propostos, padronizados e validados, em níveis de concentrações que incluem o intervalo terapêutico preconizado para a fluoxetina em plasma e os limites máximos de resíduos de agrotóxicos estabelecidos para a cultura de tomate. / Determination of trace levels of drugs in biological fluids and multiresidue (contaminants) in food samples is extremely important because this generates valuable data for therapeutic drug monitoring (individualization of dosage regimen) and quality control (food safety), respectively. Because of the demand for analytical methods with high resolution and low limits of quantification for analysis of complex samples, analytical chemistry has stimulated the development of innovative approaches, especially those aimed at developing or evaluating new analytical systems. In this context, in the first stage of this thesis the automated solid-phase microextraction capillary polypyrrole (in-tube \"PPY SPME) coupled to liquid chromatography with fluorimetric detection was developed (lab-made) for enantioselective determination of fluoxetine and its metabolite norfluoxetine in plasma samples for therapeutic drug monitoring. In the second stage of this work, the GC x GC / qMS method was developed for multiresidues analysis of pesticides in fresh tomatoes for the purpose of quality control. In the first stage of the research the gain in terms of the selectivity of the polypyrrole extraction phase in hyphenated and automated system for sample preparation and chromatographic separation (LC) with fluorimetric detection is worthy of note. As for the second step, the highlight is the improvement in chromatographic resolution as well as in the detectability system of the system consisting of two-dimensional gas chromatography and spectrometric detection with quadrupole analyzer. Analyses of plasma samples from patients undergoing therapy with fluoxetine and of samples of commercially available tomatoes proved the applicability of the proposed methods, which were optimized and validated at concentrations levels that include the therapeutic range for the analyzed drugs in plasma and the maximum residue limits of pesticides for growing tomatoes.

Background: Antidepressants are widely used in the treatment of chronic pain. Applied doses are lower than those needed to unfold an antidepressive effect. While efficacy of antidepressants for chronic pain has been reported in large randomized-controlled trials (RCT), there is inconsistent data on adverse effects and tolerability. We aimed at synthesizing data from RCT to explore adverse effect profiles and tolerability of antidepressants for treatment of chronic pain. Methods: Systematic literature research and meta-analyses were performed regarding side effects and safety of different antidepressants in the treatment of chronic pain according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The National Center for Biotechnology Information library and MEDLINE were searched. Randomized placebo-controlled trials were included in quantitative data synthesis. results: Out of 1,975 screened articles, 33 papers published between 1995 and 2015 were included in our review and 23 studies were included in the meta-analyses. A higher risk for adverse effects compared to placebo was observed in all antidepressants included in our analyses, except nortriptyline. The most prevalent adverse effects were dry mouth, dizziness, nausea, headache, and constipation. Amitriptyline, mirtazapine, desipramine, venlafaxine, fluoxetine, and nortriptyline showed the highest placebo effect-adjusted risk of adverse effects. Risk for withdrawal due to adverse effects was highest in desipramine (risk ratio: 4.09, 95%-confidence interval [1.31; 12.82]) followed by milnacipran, venlafaxine, and duloxetine. The most common adverse effects under treatment with antidepressants were dry mouth, dizziness, nausea, headache, and constipation followed by palpitations, sweating, and drowsiness. However, overall tolerability was high. Each antidepressant showed distinct risk profiles of adverse effects. conclusion: Our synthesized data analysis confirmed overall tolerability of low-dose antidepressants for the treatment of chronic pain and revealed drug specific risk profiles. This encompassing characterization of adverse effect profiles might be useful in defining multimodal treatment regimens for chronic pain which also consider patients’ comorbidities and co-medication.