Investigating Remedial Strategies for Missed or Delayed Dose of Sertraline in Chinese Adolescent Patients with Depressive Disorders via Population Pharmacokinetics Modeling and Simulation Approaches.

BACKGROUND

Sertraline is a commonly used medication for adolescent patients with depression, and missed or delayed dose has been frequently observed during long-term treatment. However, little is known about the remedial strategies for missed or delayed dose of sertraline. Hence, we designed the remedial strategies of different missed dosage scenarios based on population pharmacokinetics (PPK) model simulation, aiming to provide medication guidance to Chinese adolescent depressive patients.

METHODS

A total of 221 sertraline concentration monitoring data were collected from 103 sertraline-treated adolescent patients with depression. Data analysis was performed using nonlinear mixed-effects model, and situations of different missed doses were simulated in the sertraline PPK model, including one single missed dose and double/triple missed doses under different therapeutic dosages.

RESULTS

A one-compartment model without covariates was established to characterize the PPK of sertraline in adolescent patients with depression. Population typical values of sertraline clearance and apparent distribution volume were 65.8 L/h and 1570 L, respectively. Our simulation results revealed that when adolescent patients missed or delayed sertraline administration, the scheduled dose should be administered immediately. Additionally, our results suggested that the dose of the next remedial time should be adjusted according to the duration of the delay and the frequency of missed doses.

CONCLUSION

In this study, we developed remedy strategies for missed or delayed dosing of sertraline in Chinese adolescents with depression based on our PPK model simulations. These findings may provide valuable clinical guidance for sertraline treatment in this population.