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http://dx.doi.org/10.4196/kjpp.2012.16.5.327

Wide Spectrum of Inhibitory Effects of Sertraline on Cardiac Ion Channels  

Lee, Hyang-Ae (Next-Generation Pharmaceutical Research Center, Korea Institute of Toxicology, Korea Research Institute of Chemical Technology)
Kim, Ki-Suk (Next-Generation Pharmaceutical Research Center, Korea Institute of Toxicology, Korea Research Institute of Chemical Technology)
Hyun, Sung-Ae (Next-Generation Pharmaceutical Research Center, Korea Institute of Toxicology, Korea Research Institute of Chemical Technology)
Park, Sung-Gurl (Next-Generation Pharmaceutical Research Center, Korea Institute of Toxicology, Korea Research Institute of Chemical Technology)
Kim, Sung-Joon (Department of Physiology and Department of Biomedical Sciences, Seoul National University College of Medicine)
Publication Information
The Korean Journal of Physiology and Pharmacology / v.16, no.5, 2012 , pp. 327-332 More about this Journal
Abstract
Sertraline is a commonly used antidepressant of the selective serotonin reuptake inhibitors (SSRIs) class. In these experiments, we have used the whole cell patch clamp technique to examine the effects of sertraline on the major cardiac ion channels expressed in HEK293 cells and the native voltage-gated $Ca^{2+}$ channels in rat ventricular myocytes. According to the results, sertraline is a potent blocker of cardiac $K^+$ channels, such as hERG, $I_{Ks}$ and $I_{K1}$. The rank order of inhibitory potency was hERG > $I_{K1}$ > $I_{Ks}$ with $IC_{50}$ values of 0.7, 10.5, and 15.2 ${\mu}M$, respectively. In addition to $K^+$ channels, sertraline also inhibited $I_{Na}$ and $I_{Ca}$, and the $IC_{50}$ values are 6.1 and 2.6 ${\mu}M$, respectively. Modification of these ion channels by sertraline could induce changes of the cardiac action potential duration and QT interval, and might result in cardiac arrhythmia.
Keywords
Antidepressant; Cardiac; Ion channel; Selective serotonin reuptake inhibitor; Sertraline;
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1 Nabauer M, Kaab S. Potassium channel down-regulation in heart failure. Cardiovasc Res. 1998;37:324-334.   DOI   ScienceOn
2 Tsuboi M, Antzelevitch C. Cellular basis for electrocardiographic and arrhythmic manifestations of Andersen-Tawil syndrome (LQT7). Heart Rhythm. 2006;3:328-335.   DOI   ScienceOn
3 Grant AO, Carboni MP, Neplioueva V, Starmer CF, Memmi M, Napolitano C, Priori S. Long QT syndrome, Brugada syndrome, and conduction system disease are linked to a single sodium channel mutation. J Clin Invest. 2002;110:1201-1209.   DOI
4 Splawski I, Timothy KW, Decher N, Kumar P, Sachse FB, Beggs AH, Sanguinetti MC, Keating MT. Severe arrhythmia disorder caused by cardiac L-type calcium channel mutations. Proc Natl Acad Sci USA. 2005;102:8089-8096.   DOI   ScienceOn
5 Pacher P, Ungvari Z, Nanasi PP, Furst S, Kecskemeti V. Speculations on difference between tricyclic and selective serotonin reuptake inhibitor antidepressants on their cardiac effects. Is there any? Curr Med Chem. 1999;6:469-480.
6 De Ponti F, Poluzzi E, Cavalli A, Recanatini M, Montanaro N. Safety of non-antiarrhythmic drugs that prolong the QT interval or induce torsade de pointes: an overview. Drug Saf. 2002;25:263-286.   DOI   ScienceOn
7 Haddad PM, Anderson IM. Antipsychotic-related QTc prolongation, torsade de pointes and sudden death. Drugs. 2002;62: 1649-1671.   DOI   ScienceOn
8 Witchel HJ, Hancox JC, Nutt DJ. Psychotropic drugs, cardiac arrhythmia, and sudden death. J Clin Psychopharmacol. 2003; 23:58-77.   DOI   ScienceOn
9 Li GR, Lau CP, Ducharme A, Tardif JC, Nattel S. Transmural action potential and ionic current remodeling in ventricles of failingcanine hearts. Am J Physiol Heart Circ Physiol. 2002; 283:H1031-1041.   DOI
10 Jiang M, Zhang M, Tang DG, Clemo HF, Liu J, Holwitt D, Kasirajan V, Pond AL, Wettwer E, Tseng GN. KCNE2 protein is expressed in ventricles of different species, and changes in its expression contribute to electrical remodeling in diseased hearts. Circulation. 2004;109:1783-1788.   DOI   ScienceOn
11 Viskin S. Long QT syndromes and torsade de pointes. Lancet. 1999;354:1625-1633.   DOI   ScienceOn
12 Kannankeril PJ, Roden DM. Drug-induced long QT and torsade de pointes: recent advances. Curr Opin Cardiol. 2007;22:39-43.   DOI   ScienceOn
13 Witchel HJ, Hancox JC, Nutt DJ. Psychotropic drugs, cardiac arrhythmia, and sudden death. J Clin Psychopharmacol. 2003;23:58-77.   DOI   ScienceOn
14 Glassman AH, Bigger JT Jr. Cardiovascular effects of therapeutic doses of tricyclic antidepressants. A review. Arch Gen Psychiatry. 1981;38:815-820.   DOI   ScienceOn
15 Yeragani VK, Roose S, Mallavarapu M, Radhakrishna RK, Pesce V. Major depression with ischemic heart disease: effects of paroxetine and nortriptyline on measures of nonlinearity and chaos of heart rate. Neuropsychobiology. 2002;46:125-135.   DOI   ScienceOn
16 Yeragani VK. Major depression and long-term heart period variability. Depress Anxiety. 2000;12:51-52.   DOI   ScienceOn
17 Rodriguez de la Torre B, Dreher J, Malevany I, Bagli M, Kolbinger M, Omran H, Luderitz B, Rao ML. Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients. Ther Drug Monit. 2001;23:435-440.   DOI   ScienceOn
18 de Boer RA, van Dijk TH, Holman ND, van Melle JP. QT interval prolongation after sertraline overdose: a case report. BMC Emerg Med. 2005;5:5.   DOI   ScienceOn
19 Pousti A, Bakhtiarian A, Najafi R, Deemyad T, Brumand K, Hosseini MJ. Effect of sertraline on ouabain-induced arrhythmia in isolated guinea-pig atria. Depress Anxiety. 2009;26: E106-110.   DOI   ScienceOn
20 Amin M, Lehmann H, Mirmiran J. A double-blind, placebocontrolled dose-finding study with sertraline. Psychopharmacol Bull. 198925:164-167.
21 Kocabay G, Yildiz M, Eksi Duran N, Ozkan M. Sinus arrest due to sertraline. Clin Cardiol. 2010;33:E114-115.   DOI   ScienceOn
22 Patel NH, Golwala H, Stavrakis S, Schechter E. Sertraline-Induced Ventricular Tachycardia. Am J Ther. 2011. [Epub ahead of print]
23 Hoehns JD, Fouts MM, Kelly MW, Tu KB. Sudden cardiac death with clozapine and sertraline combination. Ann Pharmacother. 2001;35:862-866.   DOI
24 Keating MT, Sanguinetti MC. Molecular and cellular mechanisms of cardiac arrhythmias. Cell. 2001;104:569-580.   DOI   ScienceOn
25 Tseng GN. I(Kr): the hERG channel. J Mol Cell Cardiol. 2001;33:835-849.   DOI   ScienceOn
26 Saldeen J, Curiel DT, Eizirik DL, Andersson A, Strandell E, Buschard K, Welsh N. Efficient gene transfer to dispersed human pancreatic islet cells in vitro using adenovirus-polylysine/ DNA complexes or polycationic liposomes. Diabetes. 1996; 45:1197-1203.   DOI   ScienceOn
27 Hamill OP, Marty A, Neher E, Sakmann B, Sigworth FJ. Improved patch-clamp techniques for high-resolution current recording from cells and cell-free membrane patches. Pflugers Arch. 1981;391:85-100.   DOI   ScienceOn
28 Fisch C, Knoebel SB. Electrocardiographic findings in sertraline depression trials. Drug Invest. 19924:305-312.   DOI
29 Park KS, Kong ID, Chung HS, Joo NY, Park KC, Lee JW. Effects of antidepressants on cardiac functions in the perfused rat heart. J Wonju Coll Med J. 1996;9:176-181
30 Park KS, Kong ID, Park KC, Lee JW. Fluoxetine inhibits L-type $Ca^{2+}$ and transient outward $K^+$ currents in rat ventricular myocytes. Yonsei Med J. 199940:144-151.   DOI
31 Amin M, Lehmann H, Mirmiran J. A double-blind, placebocontrolled dose-finding study with sertraline. Psychopharmacol Bull. 1989;25:164-167.
32 Wang GK, Mitchell J, Wang SY. Block of persistent late $Na^+$ currents by antidepressant sertraline and paroxetine. J Membr Biol. 2008;222:79-90.   DOI   ScienceOn
33 Meijer WE, Heerdink ER, Leufkens HG, Herings RM, Egberts AC, Nolen WA. Incidence and determinants of long-term use of antidepressants. Eur J Clin Pharmacol. 2004;60:57-61.   DOI   ScienceOn
34 Kelsey JE, Nemeroff CB. Selective serotonin reuptake inhibitors: introduction and overview. In: Sadock BJ, Sadock VA, ed. Philadelphia PA: Lippincott Williams & Willis; 2000. p.2432-2435.
35 Maertens C, Droogmans G, Verbesselt R, Nilius B. Block of volume-regulated anion channels by selective serotonin reuptake inhibitors. Naunyn Schmiedebergs Arch Pharmacol. 2002; 366:158-165.   DOI   ScienceOn
36 Kobayashi T, Washiyama K, Ikeda K. Inhibition of G proteinactivated inwardly rectifying $K^+$ channels by different classes of antidepressants. PLoS One. 2011;6:e28208.   DOI
37 Sanguinetti MC, Jiang C, Curran ME, Keating MT. A mechanistic link between an inherited and an acquired cardiac arrhythmia: HERG encodes the IKr potassium channel. Cell. 1995;81:299-307.   DOI   ScienceOn
38 http://www.pfizer.ca/en/our_products/products/monograph/137/ May 2010
39 Redfern WS, Carlsson L, Davis AS, Lynch WG, MacKenzie I, Palethorpe S, Siegl PK, Strang I, Sullivan AT, Wallis R, Camm AJ, Hammond TG. Relationships between preclinical cardiac electrophysiology, clinical QT interval prolongation and torsade de pointes for a broad range of drugs: evidence for a provisional safety margin in drug development. Cardiovasc Res. 2003;58: 32-45.   DOI   ScienceOn
40 Chen J, Zheng R, Melman YF, McDonald TV. Functional interactions between KCNE1 C-terminus and the KCNQ1 channel. PLoS One. 2009;4:e5143.   DOI   ScienceOn