8-hydroxymirtazapine and demethylmirtazapine

Mirtazapine is an antidepressant that acts specifically on noradrenergic and sertonergic receptors. A LC-MS method was developed that allows the simultaneous analysis of the R-(-)- and S-(+)-enantiomers of mirtazapine (MIR), demethylmirtazapine (DMIR), and 8-hydroxymirtazapine (8-OH-MIR) in plasma of MIR-treated patients. The method involves a 3-step liquid-liquid extraction, an HPLC separation on a Chirobiotic V column, and MS detection in electrospray mode. The limit of quantification (LOQ) for all enantiomers was 0.5 ng/mL, and the intra- and interday CVs were within 3.3% to 11.7% (concentration ranges 5-50 ng/mL). A method is also presented for the quantitative analysis of glucuroconjugated MIR and 8-OH-MIR. S-(+)-8-OH-MIR is present in plasma mainly as its glucuronide. Preliminary data suggest that in all patients, except in those comedicated with CYP2D6 inhibitors such as fluoxetine and thioridazine, R-(-)-MIR concentrations were higher than those of S-(+)MIR. Moreover, fluvoxamine seems also to inhibit the metabolism of MIR. Therefore, this method seems to be suitable for the stereoselective assay of MIR and its metabolites in plasma of patients comedicated with MIR and other drugs for routine and research purposes.

Topics: Adult; Aged; Aged, 80 and over; Antidepressive Agents, Tricyclic; Chromatography, High Pressure Liquid; Chromatography, Liquid; Female; Humans; Male; Mass Spectrometry; Mianserin; Middle Aged; Mirtazapine; Reproducibility of Results; Sensitivity and Specificity; Stereoisomerism

A simple, rapid and sensitive chiral capillary zone electrophoresis coupled with acetonitrile-field-amplified sample stacking method was developed that allows the simultaneous enantioselective separation of the mirtazapine, N-demethylmirtazapine, 8-hydroxymirtazapine and mirtazapine-N-oxide. The separation was achieved on an uncoated 40.2 cm×75 μM fused silica capillary with an applied voltage of 16 kV. The electrophoretic analyses were carried out in 6.25 mM borate-25 mM phosphate solution at pH 2.8 containing 5.5 mg/mL carboxymethyl-β-cyclodextrin. The detection wavelength was 200 nm. Under these optimized conditions, satisfactory chiral separations of four pair enantiomers were achieved in less than 7 min in vitro. After one step clean-up liquid-liquid extraction using 96-well format, sample was introduced capillary zone electrophoresis with acetonitrile-field-amplified sample stacking to enhance the sensitivity of enantiomers. The method was validated with respect to specificity, linearity, lower limit of quantitation, accuracy, precision, extraction recovery and stability. The lower limit of quantification was 0.5 ng/mL with linear response over the 0.5-50 ng/mL concentration range for each mirtazapine, N-demethylmirtazapine and 8-hydroxymirtazapine enantiomer. The developed and validated method has been successfully applied to the enantioselective pharmacokinetic studies in 12 healthy volunteers after oral administration of rac- mirtazapine.

Topics: Acetonitriles; Administration, Oral; Antidepressive Agents, Tricyclic; beta-Cyclodextrins; Biotransformation; Buffers; Chemical Fractionation; Cyclic N-Oxides; Electrophoresis, Capillary; Humans; Limit of Detection; Male; Mianserin; Mirtazapine; Reproducibility of Results; Stereoisomerism

Mirtazapine (MRT) is a human antidepressant drug mainly metabolised by the cytochrome P450 enzyme system to 8-OH mirtazapine (8-OH) and dimetilmirtazapine (DMR). The drug is usually administered to dogs with anorexia according to doses extrapolated from humans, although it could also have applications as an antidepressant and analgesic in this species. The aim of this study was to assess the pharmacokinetics of MRT and its metabolites, DMT and 8-OH. Six healthy male Beagle dogs were administered MRT orally (20 mg/dog) and plasma MRT and metabolite concentrations were evaluated by high performance liquid chromatography with fluorescence detection. The pharmacokinetic profiles of MRT and DMR were similar (detected from 0.25 up to 10 h), while 8-OH (detected from 0.50 up to 10 h) attained the highest concentrations. The mean half-life of MRT was 6.17 h with a clearance of 1193 mL/h/kg. The study showed that MRT has a different pharmacokinetic profile in the dog compared to other species.

Topics: Administration, Oral; Animals; Antidepressive Agents, Tricyclic; Chromatography, High Pressure Liquid; Dogs; Half-Life; Male; Metabolic Clearance Rate; Mianserin; Mirtazapine; Pilot Projects

A selective and reproducible off-line solid-phase microextraction procedure was developed for the simultaneous enantioselective determination of mirtazapine (MRT), demethylmirtazapine and 8-hydroxymirtazapine in human urine. CE was used for optimization of the extraction procedure whereas LC-MS was used for method validation and application. The influence of important factors in the solid-phase microextraction efficiency is discussed, such as the fiber coatings, extraction time, pH, ionic strength, temperature and desorption time. Before extraction, human urine samples were submitted to enzymatic hydrolysis at 37 degrees C for 16 h. Then, the enzyme was precipitated with trichloroacetic acid and the pH was adjusted to 8 with 1 mol/L pH 11 phosphate buffer solution. In the extraction, the analytes were transferred from the aqueous solution to the polydimethylsiloxane-divinylbenzene fiber coating and then desorbed in methanol. The mean recoveries were 5.4, 1.7 and 1.0% for MRT, demethylmirtazapine and 8-hydroxymirtazapine enantiomers, respectively. The method was linear over the concentration range of 62-1250 ng/mL. The within-day and between-day assay precision and accuracy were lower than 15%. The method was successfully employed in a preliminary cumulative urinary excretion study after administration of racemic MRT to a healthy volunteer.

Topics: Antidepressive Agents, Tricyclic; Buffers; Chromatography, Liquid; Humans; Hydrogen-Ion Concentration; Mianserin; Mirtazapine; Osmolar Concentration; Reproducibility of Results; Solid Phase Microextraction; Stereoisomerism; Tandem Mass Spectrometry

Capillary electrophoresis and liquid-phase microextraction using porous polypropylene hollow fibers were employed for the enantioselective analyses of mirtazapine and its metabolites demethylmirtazapine and 8-hydroxymirtazapine in human urine. Before the extraction, urine samples (1.0 mL) were submitted to enzymatic hydrolysis at 37 degrees C for 16 h. Then, the enzyme was precipitated with trichloroacetic acid, the pH was adjusted to 8 with 0.5 mol/L phosphate buffer solution (pH 11) and 15% sodium chloride was further added. The analytes were transferred from the aqueous donor phase, through n-hexyl ether (organic solvent immobilized in the fiber), into 0.01 moL/L acetic acid solution (acceptor phase). The electrophoretic analyses were carried out in 50 mmol/L phosphate buffer solution (pH 2.5) containing 0.55% w/v carboxymethyl-beta-cyclodextrin. The method was linear over the concentration range of 62.5-2500 ng/mL for each mirtazapine and 8-hydroxymirtazapine enantiomer and 62.5-1250 ng/mL for each demethylmirtazapine enantiomer. The quantification limit was 62.5 ng/mL for all the enantiomers. Within-day and between-day assay precision and accuracy were lower than 15% for all the enantiomers. Finally, the method proved to be suitable for pharmacokinetic studies.

Topics: Electrophoresis, Capillary; Humans; Hydrolysis; Mianserin; Mirtazapine; Temperature

Little information exists on the concentrations of recent antidepressants and their metabolites in cerebrospinal fluid (CSF). Using a stereoselective method, we measured plasma and CSF levels of mirtazapine (MIR), N-demethylmirtazapine and 8-OH-MIR in 3 depressed patients treated with racemic MIR (45 mg/day) for 4 weeks. S-(+)-MIR is considered to be the antidepressant enantiomer, but only R-(-)-MIR reached measurable concentrations in CSF. For R-(-)-MIR, the CSF/plasma ratio varied between 0.08 and 0.31. Further studies are needed to test the hypothesis that there are possible differences in the transport mechanisms of the enantiomers of MIR at the blood-CSF barrier.

Topics: Adult; Antidepressive Agents, Tricyclic; Depressive Disorder; Drug Administration Schedule; Humans; Male; Mianserin; Mirtazapine; Severity of Illness Index; Stereoisomerism