Cortisol—the most important steroid hormone with a significant effect on body metabolism—strongly affects peripheral tissues and the central nervous system. Fluctuations in cortisol secretion often accompany psychiatric disorders, and normalization of its levels correlates with improvement in the patient’s health. This indicates that cortisol may be useful as a biological marker that can help determine the likelihood of mental illness, its impending onset, and the severity of symptoms, which is especially important in the face of the increasing prevalence of mental disorders, including those associated with social isolation and anxiety during the COVID-19 pandemic. This publication reviews recent reports on cortisol levels in healthy participants and shows the current state of knowledge on changes in the levels of this hormone in people at risk for depression, bipolar disorder, and psychosis. It shows how people with psychiatric disorders react to stressful situations and how the applied therapies affect cortisol secretion. The influence of antidepressants and antipsychotics on cortisol levels in healthy people and those with mental disorders is also described. Finally, it reviews publications on the patterns of cortisol secretion in patients in remission.

Objectives: The oral cavity constitutes an attractive organ for the local and systemic application of drug substances. Oromucosal tablets, gels, or sprays are examples of the formulations applied. Due to the elution through the saliva, the residence time of the formulation at the application site is relatively short. Medical devices placed in the oral cavity, with a reservoir for an active substance, play an important role in solving this problem. Materials and methods: In this review, we discuss the devices described in the literature that are designed to be used in the oral cavity, highlighting the advantages, disadvantages, and clinical applications of each of them. Results: Among the intraoral medical devices, special types are personalized 3D-printed devices, iontophoretic devices, and microneedle patches. Conclusion: We anticipate that with the development of 3D printing and new polymers, the technology of flexible and comfortable devices for prolonged drug delivery in the oral cavity will develop intensively. Clinical relevance: The presented review is therefore a useful summary of the current technological state, when in fact none of the existing devices has been widely accepted clinically.

Depression is one of the widespread diseases whose etiology is still unclear. Dysregulation of the hypothalamic–pituitary–adrenal axis can be the cause of this illness which is concomitant with a high level of cortisol. For this reason, the purpose of the study was to estimate the influence of the selective serotonin reuptake inhibitors (SSRIs) therapy used in monotherapy and polypragmasy on cortisol level in saliva of depressed women. Cortisol was determined in saliva collected from 40 depressed patients treated with SSRIs. HPLC with UV detection was used for quantification of cortisol after its extraction with dichloromethane. For statistical evaluation of the data, the cluster analysis and principal components analysis were used. Results of the study have shown that the SSRIs treatment reduces the cortisol level in saliva. The therapy with sertraline and polypragmasy had a strong influence on suppressing the cortisol secretion. Besides, the amplitude of changes of the cortisol level during the treatment had an impact on the duration of hospitalization. In conclusion, it can be stet that the process of reduction of the cortisol level is multiphasic and that the combination treatment had a stronger influence on suppressing the cortisol secretion than did antidepressants used in monotherapy.

Neuroleptics and antiepileptics are excreted in saliva, which can, therefore, be very useful in determining their concentration in the body. This study presents a method developed to simultaneously identify five neuroleptics—olanzapine, quetiapine, risperidone, aripiprazole, and clozapine—and the antiepileptic carbamazepine together with their metabolites: N-demethyl olanzapine, norquetiapine, 9-OH-risperidone, dehydroaripiprazole, N-desmethylclozapine, and carbamazepine-10,11 epoxide. Chlordiazepoxide was used as the internal standard. Strata-X-C columns were used for isolation of the compounds. Chromatographic analysis was carried out using UHPLC with a diode array detector (DAD). A mixture of acetonitrile and water with the addition of formic acid and 0.1% triethylamine was used as the mobile phase. The developed method was validated by determining the linearity for all analytes in the range 10–1000 ng/mL and the value of R² > 0.99. Intra- and inter-day precision were also determined, and the relative standard deviation (RSD) value in both cases did not exceed 15%. To determine the usefulness of the developed method, saliva samples were collected from 40 people of both sexes treated with the tested active substances both in monotherapy and in polypragmasy. In all cases, the active substances tested were identified.

Sertralina (SRT) jest nowoczesnym i stosunkowo bezpiecznym selektywnym inhibitorem wychwytu zwrotnego serotoniny często stosowanym w terapii depresji. Monitorowanie poziomu leku i jego aktywnego metabolitu, N-demetylosertraliny (DSRT), w organizmie pacjenta umożliwia optymalizację dawkowania i personalizację leczenia, a ponadto ma szczególne znaczenie w przypadku nasilonych działań niepożądanych lub braku reakcji organizmu na zastosowaną terapię. Z tych powodów istotną kwestią jest dysponowanie szybkimi, czułymi i wiarygodnymi metodami analitycznymi umożliwiającymi oznaczenie SRT i DSRT w materiale diagnostycznym, tj. we krwi, osoczu, moczu i ślinie, a ponadto w materiale biologicznym pochodzącym od osób zmarłych. Pożądana jest duża różnorodność metod analitycznych i materiału diagnostycznego z uwagi na konieczność oznaczenia zarówno całkowitego poziomu leku (analiza krwi), jak również niezwiązanego z białkami (analiza śliny i moczu). Z tego względu dokonano szczegółowego przeglądu piśmiennictwa traktującego o sposobach izolacji SRT i DSRT z materiału biologicznego i technikach analitycznych wykorzystywanych do ich oznaczania. Scharakteryzowano takie procedury ekstrakcyjne, jak ekstrakcja i mikroekstrakcja do fazy stałej oraz ekstrakcja od fazy ciekłej. Zwracano szczególną uwagę na parametry uwzględniane podczas optymalizacji ekstrakcji, tj. wpływ pH, rodzaju rozpuszczalnika oraz składu mieszaniny rozpuszczalników na proces przemywania różnych rodzajów sorbentów (hydrofobowych, hydrofilowo-lipofilowych, jonowymiennych) oraz wymywania analitów. Wskazano na wady i zalety technik ekstrakcyjnych, uwzględniając wydajność i precyzję ekstrakcji. Omówiono też precypitację białek jako jeden z nowszych sposobów oczyszczania próbek. Przedstawiając techniki końcowego oznaczania, tj. HPLC, LC, GC, zwrócono uwagę na znaczenia detektora (UV, azotowo-fosforanowy, MS), jako podstawowego elementu decydującego o czułości wyrażanej jako granice wykrywalności i oznaczalności osiągane daną metodą.