Sertraline; Uses, Dosage, Side Effects, Drug Interactions

Sertraline
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Sertraline is a selective serotonin reuptake inhibitor (SSRI) used in the therapy of depression, anxiety disorders, and obsessive-compulsive disorder. Sertraline therapy can be associated with transient asymptomatic elevations in serum aminotransferase levels and has been linked to rare instances of clinically apparent acute liver injury.

Sertraline is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is primarily used for the major depressive disorder, obsessive-compulsive disorder, panic disorder, and social anxiety disorder. Effectiveness is similar to other antidepressants. Sertraline is taken by mouth. Sertraline affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.

Mechanism of Action of Sertraline

The exact mechanism of action sertraline is not fully known, but the drug appears to selectively inhibit the reuptake of serotonin at the presynaptic membrane. This results in an increased synaptic concentration of serotonin in the CNS, which leads to numerous functional changes associated with enhanced serotonergic neurotransmission. It is suggested that these modifications are responsible for the antidepressant action observed during long term administration of antidepressants. It has also been hypothesized that obsessive-compulsive disorder is caused by the dysregulation of serotonin, as it is treated by sertraline, and the drug corrects this imbalance.As with other antidepressant agents, several weeks of therapy may be required before a clinical effect is seen. SSRIs are potent inhibitors of neuronal serotonin reuptake. They have little to no effect on norepinephrine or dopamine reuptake and do not antagonize α- or β-adrenergic, dopamine D2 or histamine H1 receptors. During acute use, SSRIs block serotonin reuptake and increase serotonin stimulation of somatodendritic 5-HT1A and terminal autoreceptors. Chronic use leads to desensitization of somatodendritic 5-HT1A and terminal autoreceptors. The overall clinical effect of increased mood and decreased anxiety is thought to be due to adaptive changes in neuronal function that leads to enhanced serotonergic neurotransmission.

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Indications of Sertraline

Contra Indications of Sertraline

  • Syndrome of inappropriate antidiuretic hormone secretion
  • Low amount of sodium in the blood
  • Increased risk of bleeding
  • Behaving with excessive cheerfulness and activity
  • Mild degree of mania
  • Manic-depression
  • Having thoughts of suicide
  • Serotonin syndrome – adverse drug interaction
  • Closed angle glaucoma
  • Liver problems
  • Bleeding from stomach
  • Esophagus or duodenum
  • Seizures
  • Weight loss
  • Risk of angle-closure glaucoma due to narrow angle of anterior chamber of eye

Dosage of Sertraline

Strengths: 25 mg;  50 mg; 100 mg; 20 mg/mL;

Depression

  • Initial dose: 50 mg orally once a day
  • Maintenance Dose: 50 to 200 mg orally once a day

Obsessive Compulsive Disorder

  • Initial dose: 50 mg orally once a day
  • Maintenance Dose: 50 to 200 mg orally once a day

Panic Disorder

  • Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
  • Maintenance dose: 50 to 200 mg orally once a day

Post Traumatic Stress Disorder

  • Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
  • Maintenance dose: 50 to 200 mg orally once a day

Social Anxiety Disorder

  • Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
  • Maintenance dose: 50 to 200 mg orally once a day

Premenstrual Dysphoric Disorder

Continuous regimen

  • Initial dose: 50 mg orally once a day during the menstrual cycle
  • Maintenance dose: 50 to 150 mg orally once a day during the menstrual cycle

Cyclic regimen

  • Initial dose: 50 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
  • Maintenance dose: 50 to 100 mg orally once a day
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Pediatric Obsessive Compulsive Disorder

6 to 12 years

  • Initial dose: 25 mg orally once a day
  • Maintenance dose: 25 to 200 mg orally once a day

13 to 17 years

  • Initial dose: 50 mg orally once a day
  • Maintenance dose: 50 to 200 mg orally once a day

Side Effects of Sertraline

The most common

More common

Less common

Drug Interactions of Sertraline

Sertraline may interact with following drugs, supplements & may decrease the efficacy of the drug

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Pregnancy & Lactation of Sertraline

FDA Pregnancy Category C 

Pregnancy

This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. There have been some reports that women taking SSRIs such as sertraline during the second half of pregnancy may be associated with lung disorders in newborns. Talk to your doctor if you have any concerns.

Breast-feeding

It is not known if sertraline passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

References

 

Sertraline

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