What it's for (Indications)
- Sertraline is indicated for the treatment of Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-traumatic Stress Disorder (PTSD), Premenstrual Dysphoric Disorder (PMDD), and Social Anxiety Disorder.
- It can be used in adults and pediatric patients (from age 6 to 17) for certain indications, but caution and close monitoring are advised.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Sertraline is for oral administration, taken once daily either in the evening or morning, with or without meals. **Adults - Initial Treatment:** * For Major Depressive Disorder (MDD) and Obsessive-Compulsive Disorder (OCD): Initiate at 50 mg once daily. * For Panic Disorder, Post-traumatic Stress Disorder (PTSD), and Social Anxiety Disorder: Initiate at 25 mg once daily for one week, then increase to 50 mg once daily. **Dose Adjustment:** While a relationship between dose and effect has not been definitively established for all indications, patients not responding to a 50 mg dose may benefit from dose increases up to a maximum of 200 mg/day. Given the 24-hour elimination half-life of sertraline, dose changes should be considered carefully. Dosage therapy may differ for various depression states. **Pediatric Patients:** For pediatric patients (from age 6 to 17), caution and close monitoring are advised. |
Safety & Warnings
Common Side Effects
- Commonly reported side effects include upset stomach, anorexia (eating disorder), sexual problems, tremor (unintentional muscle movement), increased sweating, pharyngitis (inflammation of throat), nightmares, agitation, bruxism (teeth grinding), tinnitus (ringing in ear), palpitations (increased heartbeat), insomnia, malaise (feeling ill), myalgia (muscle pain), rash, urinary retention (unable to urinate), seizures, or psychosis.
- Patients are advised to consult their doctor if they experience any of these symptoms.
Serious Warnings
- Black Box Warning: Suicidality and Antidepressant Drugs Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of sertraline or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality w
- For oral use only.
- Patients should inform their doctor about any allergies or past medical history and should not self-medicate.
- Do not stop taking the medication without informing your doctor and complete the whole prescribed therapy.
- Caution is advised in patients with low blood sodium, an increased risk of bleeding, manic behavior, or manic-depression.
- **Pregnancy:** Pregnant females are advised to consult their doctors before taking this medicine, as there is no definite data regarding its use.
- **Lactation:** Lactating females should be cautioned against the use of this medicine as its effects are undetermined; consultation with a doctor is advised.
- **Driving:** It is advised not to drive after taking this medicine due to potential impairment.
- **Liver & Kidney Impairment:** Caution is advised for patients with liver or kidney impairment; consult a doctor before use.
- **Alcohol:** Avoid consuming alcohol while using this medicine.
- **Storage:** Store tablets at room temperature between 20 to 25 degrees C.
- Keep the bottle tightly closed, away from direct heat and sunlight, and out of the reach of children and pets.
How it Works (Mechanism of Action)
Sertraline operates primarily as a potent and highly selective inhibitor of serotonin (5-hydroxytryptamine or 5-HT) reuptake into presynaptic neurons within the central nervous system. By blocking the serotonin transporter (SERT), sertraline effectively prevents the reabsorption of serotonin from the synaptic cleft back into the presynaptic neuron. This action leads to an elevated and sustained concentration of serotonin in the synapse, thereby enhancing serotonergic neurotransmission and increasing the activation of postsynaptic serotonin receptors. Unlike older antidepressant classes, sertraline exhibits negligible affinity for muscarinic cholinergic, histaminergic, alpha-1 adrenergic, and dopamine receptors, which contributes to its improved tolerability profile and reduced incidence of anticholinergic, sedative, and cardiovascular side effects. The sustained increase in synaptic serotonin is believed to induce adaptive changes in neuronal receptor sensitivity and gene expression over several weeks, ultimately leading to the observed therapeutic effects in mood and anxiety disorders. Furthermore, sertraline possesses a weak, clinically less significant, inhibitory effect on dopamine reuptake, which distinguishes it slightly from other SSRIs.