Table 4.

Specifications and environmental impacts of some antidepressants, sedatives, and antimicrobials.

Category type	Drug name	Drug bank ID	Structure	Impacts on water and the environment	Ref.
Antidepressants and sedatives	Sertraline	DB01104		• Endocrine-disrupting compound • Changes in crucial physiological functions such as behavior, growth, reproduction of aquatic species	[72,85]
	Citalopram	DB00215		• Inducing significant foot detachment from the substrate in two kinds of freshwater snails	[86]
	Carbamazepine	DB00564		• Relatively limited acute toxicity on the studied organisms such as fish, algae, bacteria, and micro-crustaceans.	[87]
	Fluoxetine	DB00472		• Disrupt the endocrine systems of some aquatic creatures	[88]
	Diazepam	DB00829		• Detected in the tissues of some aquatic organisms • Disrupting behavioral traits of animals • Sublethal toxic effects in fish such as gene expression alterations	[89]
Antibiotics	Amoxicillin	DB01060		• Cause antibiotic resistance, decreasing the effectiveness of available antibiotics • Change microbial ecosystems potentially	[76,90]
	Azithromycin	DB00207