Sertraline

Antidepressant Drug

Drug class: Selective Serotonin Reuptake Inhibitor

Sertraline (ZOLOFT)（中文：舍曲林）

Common Strengths of Sertraline

Sertraline are available in the following strengths:

• Tablets: 25 mg, 50 mg, 100 mg
• Capsules: 150 mg, 200 mg
• Oral solution: 20 mg/mL

Drug Trade Names of Sertraline

Zoloft

Drug Usage

• Major depressive disorder
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Social anxiety disorder
• Generalized anxiety disorder
• Post-traumatic stree disorder (PTSD)

Mechanism of Action

Sertraline is a selective serotonin reuptake inhibitor (SSRI). It works by increaasing serotonin levels in the brain by inhibiting its reuptake into presynaptic neurons, thereby enhancing serotonergic activity.

Route of Administration

Oral

Dosages

• Depression: 50 mg/day initially, may increase to 200 mg/day maximum
• Obsessive-compulsive disorder (OCD): 50 mg/day initially, may increase to 200 mg/day maximum
• Panic disorder: 25 mg/day initially, may increase to 200 mg/day maximum

Renal dose based on eGFR:

• For severe renal impairment (eGFR <30 mL/min): 25 mg/day initially, may titrate up to 200 mg/day maximum

Side Effects

Frequency	Adverse reactions
Common	Nausea: Often mitiagated by taking the medication with food
	Headaches: Drinking plenty of fluids and resting can help; avoid excessive alcohol consumption
	Insomnia: Taking fluoxetine in the morming may reduce sleep disurbances
	Fatigue or Weakness: Resting and avoiding activities that require alertness, such as driving
	Sexual Dysfunction: This includes decreased libido and difficulty achieving orgasm
	Diarrhoea
	Dry Mouth: Staying hydrated and using sugar-free gum or candy can help alleviate dry mouth
	Dizziness: Moving slowly when changing positions can help reduce dizziness
	Sweating
	Anxiety
	Tremor/shaking
	Indigestion/heratburn
Serious	Suicidal Thoughts or Actions: Especially in the first few months of treatment or when the dose is changed. Symptoms include new or worsening depression, anxiety, or unusua changes in mood or behavior.
	Serotonin Syndrome: This potentially life-threatening condition can occur when there is too much serotonin in the body. Symptoms include agitation, hallucinations, rapid heart rate, fever, nausea, vomiting, diarrhea, and muscle twitching.
	Severe Allergic Reactions: These include symptoms like difficulty breathing, swelling of the face, lips, tongue, or throat, and severe rash or hives.
	Abnormal Bleeding: Can manifest as unusual bruising or bleeding
	Low Sodium Levels: Particularly in older adults, symptoms include headache, confusion, weakness, and difficulty concentrating.
	Mania: Symptoms include excessively high energy, severe trouble sleeping, racing thoughts, reckless behavior, and unusually grand ideas.
	Seizures
	Angle-closure glaucoma (eye pain, vision changes)
	QT interval prolongation may lead to heart arrhythmias

Pharmacokinetics

• Metabolism: Hepatic via CYP2D6, CYP3A4, and others
• Elimination: Primarily renal
• Half-life: Approximately 26 hours
• Onset: 4 to 6 weeks for full antidepressant effect

Drug Precautions

Pregnancy

Use only if the potential benefit justifies the risk to the fetus

Breastfeeding

Present in breast milk, use with caution

Children and Elderly

Not approved for use in pediatric patients with depression. Lower doses are recommended for the elderly due to increased sensitivity to side effects

Monitoring Requirements

• Monitor for suicidal thoughts, especially in young adults
• Monitor for serotonin syndrome, especially when combined with other serotonergic drugs
• Regularly assess liver function and electrolyte levels

Drug Interactions

• Contraindicated with thioridazine due to risk of serotonin syndrome and QT prolongation
• Caution with other serotonergic drugs, NSAIDs, anticoagulants, and drugs affecting CYP2D6 metabolism

FAQ

How Should I Take the Tablet?

Take orally with or without food, usually once daily in the morning

What Should I Avoid While Taking?

Avoid alcohol and activities requiring mental alertness until you know how the tablet affects you.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember unless it is almost time form your next dose. Do not double doses.