Sertindole
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Sertindole, sold under the brand name Serdolect among others, is an antipsychotic medication. Sertindole was developed by the Danish pharmaceutical company Lundbeck and marketed under license by
Abbott Labs Abbott Laboratories is an American multinational medical devices and health care company with headquarters in Abbott Park, Illinois, United States. The company was founded by Chicago physician Wallace Calvin Abbott in 1888 to formulate known d ...
. Like other atypical antipsychotics, it has activity at
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic compound, organic chemical of the catecholamine and phenethylamine families. Dopamine const ...
and
serotonin Serotonin () or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter. Its biological function is complex and multifaceted, modulating mood, cognition, reward, learning, memory, and numerous physiological processes such as vomiting and vas ...
receptors in the brain. It is used in the treatment of schizophrenia. It is classified chemically as a phenylindole derivative. Sertindole is not approved for use in the United States and was discontinued in Australia in January 2014.


Medical Uses

Sertindole appears effective as an antipsychotic in schizophrenia. In a 2013 study in a comparison of 15 antipsychotic drugs in effectivity in treating schizophrenic symptoms, sertindole was found to be slightly less effective than haloperidol, quetiapine, and aripiprazole, as effective as ziprasidone, approximately as effective as chlorpromazine and asenapine, and slightly more effective than lurasidone and iloperidone.


Adverse effects

Very common (>10% incidence) adverse effects include: * Headache * Ejaculation failure * Insomnia * Dizziness Common (1–10% incidence) adverse effects include: * Urine that tests positive for red and/or white blood cells * Sedation (causes less sedation than most antipsychotic drugs according to a recent meta-analysis of the efficacy and tolerability of 15 antipsychotic drugs. Causes only slightly nd non-significantlymore sedation than amisulpride and paliperidone) * Ejaculation disorder * Erectile dysfunction * Orthostatic hypotension * Weight gain (which it seems to possess a similar propensity for causing as quetiapine) Uncommon (0.1–1% incidence) adverse effects include: * Substernal chest pain * Face oedema *
Influenza-like illness Influenza-like illness (ILI), also known as flu-like syndrome or flu-like symptoms, is a medical diagnosis of possible influenza or other illness causing a set of common symptoms. These include fever, shivering, chills, malaise, dry cough, lo ...
* Neck rigidity * Pallor * Peripheral vascular disorder * syncope * Torsades de pointes * Vasodilation *
Suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
attempt *
Amnesia Amnesia is a deficit in memory caused by brain damage or disease,Gazzaniga, M., Ivry, R., & Mangun, G. (2009) Cognitive Neuroscience: The biology of the mind. New York: W.W. Norton & Company. but it can also be caused temporarily by the use ...
* Anxiety * Ataxia * Confusion * Incoordination * Libido decreased * Libido increased * Miosis * Nystagmus * Personality disorder * Psychosis * Reflexes decreased * Reflexes increased * Stupor * Suicidal tendency * Urinary retention * Vertigo * Diabetes mellitus * Abnormal stools * Gastritis * Gingivitis * Glossitis * Increased appetite * Mouth ulceration * Rectal disorder * Rectal haemorrhage * Stomatitis * Tongue disorder * Ulcerative stomatitis * Anaemia * Ecchymosis * Hypochromic anaemia * Leukopenia * Hyperglycaemia * Hyperlipemia * Oedema * Bone pain * Myasthenia * Twitching * Bronchitis * Hyperventilation * Pneumonia * Sinusitis * Furunculosis * Herpes simplex * Nail disorder * Psoriasis * Pustular Rash * Skin discolouration * Skin hypertrophy * Skin ulcer * Abnormal vision * Keratoconjunctivitis * Lacrimation disorder * Otitis externa * Pupillary disorder * Taste perversion * Anorgasmia * Penis disorder (gs) * Urinary urgency * Hyperprolactinaemia (which it seems to cause with a higher propensity than most other atypical antipsychotics do) * Seizures *
Galactorrhoea Galactorrhea ( also spelled galactorrhoea) ( galacto- + -rrhea) or lactorrhea ( lacto- + -rrhea) is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. Galactorrhea is reported to occur in 5–32% of women. M ...
Rare (<0.1% incidence) adverse effects include: * Neuroleptic malignant syndrome * Tardive dyskinesia Unknown frequency adverse events include: * Extrapyramidal side effects (EPSE; e.g. dystonia, akathisia, muscle rigidity, parkinsonism, etc. These adverse effects are probably uncommon/rare according to a recent meta-analysis of the efficacy and tolerability of 15 antipsychotic drugs which found it had the 2nd lowest effect size for causing EPSE) * Venous thromboembolism * QT interval prolongation (probably common; in a recent meta-analysis of the efficacy and tolerability of 15 antipsychotic drugs it was found to be the most prone to causing QT interval prolongation)


Pharmacology

Sertindole is metabolized in the body to dehydrosertindole.


Safety and status


United States

Abbott Labs Abbott Laboratories is an American multinational medical devices and health care company with headquarters in Abbott Park, Illinois, United States. The company was founded by Chicago physician Wallace Calvin Abbott in 1888 to formulate known d ...
first applied for U.S. Food and Drug Administration (FDA) approval for sertindole in 1996, but withdrew this application in 1998 following concerns over the increased risk of sudden death from
QTc prolongation QT prolongation is a measure of delayed ventricular repolarisation, which means the heart muscle takes longer than normal to recharge between beats. It is an electrical disturbance which can be seen on an electrocardiogram (ECG). Excessive QT prolo ...
.Abbott Labs Withdraws Sertindole NDA Sertindole
- The Pharma Letter, 12 Jan 1998
In a trial of 2000 patients on taking sertindole, 27 patients died unexpectedly, including 13 sudden deaths.{{cite web , url=http://apps.who.int/medicinedocs/en/d/Js2256e/1.12.html#Js2256e.1.12 , archive-url=https://web.archive.org/web/20110622124240/http://apps.who.int/medicinedocs/en/d/Js2256e/1.12.html#Js2256e.1.12 , url-status=dead , archive-date=June 22, 2011 , title=WHO Pharmaceuticals Newsletter 1998, No. 03&04: Regulatory actions: Sertindole - approval application withdrawn Lundbeck cites the results of the Sertindole Cohort Prospective (SCoP) study of 10,000 patients to support its claim that although sertindole does increase the QTc interval, this is not associated with increased rates of cardiac arrhythmias, and that patients on sertindole had the same overall mortality rate as those on risperidone. Nevertheless, in April 2009 an FDA advisory panel voted 13-0 that sertindole was effective in the treatment of schizophrenia but 12-1 that it had not been shown to be acceptably safe. {{Asof, October 2010, the drug has not been approved by the FDA for use in the USA.{{failed verification, date=September 2020


European Union

In the European Union, sertindole was approved and marketed in 19 countries from 1996, but its marketing authorization was suspended by the
European Medicines Agency The European Medicines Agency (EMA) is an agency of the European Union (EU) in charge of the evaluation and supervision of medicinal products. Prior to 2004, it was known as the European Agency for the Evaluation of Medicinal Products or Euro ...
in 1998 and the drug was withdrawn from the market. In 2002, based on new data, the EMA's CHMP suggested that Sertindole could be reintroduced for restricted use in clinical trials, with strong safeguards including extensive contraindications and warnings for patients at risk of cardiac dysrhythmias, a recommended reduction in maximum dose from 24 mg to 20 mg in all but exceptional cases, and extensive ECG monitoring requirement before and during treatment. {{As of, September 2020, sertindole is authorized in several states of the European Union.{{cite report , url=https://www.ema.europa.eu/documents/psusa/sertindole-list-nationally-authorised-medicinal-products-psusa/00002695/202001_en.pdf , title=Sertindole: List of nationally authorised medicinal products - PSUSA/00002695/202001 , date=3 September 2020 , id=EMA/270645/2015 , publisher=
European Medicines Agency The European Medicines Agency (EMA) is an agency of the European Union (EU) in charge of the evaluation and supervision of medicinal products. Prior to 2004, it was known as the European Agency for the Evaluation of Medicinal Products or Euro ...
(EMA)


References

{{reflist


External links

* {{cite web , url = https://druginfo.nlm.nih.gov/drugportal/name/sertindole , publisher = U.S. National Library of Medicine , work = Drug Information Portal , title = Sertindole {{Antipsychotics {{Navboxes , title = Pharmacodynamics , titlestyle = background:#ccccff , list1 = {{Adrenergic receptor modulators {{Dopamine receptor modulators {{Serotonin receptor modulators {{Portal bar , Medicine Atypical antipsychotics Chloroarenes Imidazolidinones HERG blocker Indoles Fluoroarenes Piperidines Withdrawn drugs