Sertraline is used for a number of conditions, including major depressive disorder (MDD), obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder (SAD). The comparative efficacy of sertraline and TCAs for melancholic depression has not been studied. A 1998 review suggested that, due to its pharmacology, sertraline may be more efficacious than other SSRIs and equal to TCAs for the treatment of melancholic depression. A meta-analysis of 12 new-generation antidepressants showed that sertraline and escitalopram are the best in terms of efficacy and acceptability in the acute-phase treatment of adults with unipolar MDD. Sertraline used for the treatment of depression in elderly (older than 60) patients was superior to placebo and comparable to another SSRI fluoxetine, and TCAs amitriptyline, nortriptyline (Pamelor) and imipramine. Sertraline had much lower rates of adverse effects than these TCAs, with the exception of nausea, which occurred more frequently with sertraline. In addition, sertraline appeared to be more effective than fluoxetine or nortriptyline in the older-than-70 subgroup. placebo in elderly patients showed a statistically significant (that is, unlikely to occur by chance), but clinically very modest improvement in depression and no improvement in quality of life. A meta-analysis on SSRIs and SNRIs that look at partial response (defined as at least a 50% reduction in depression score from baseline) found that sertraline, paroxetine and duloxetine were better than placebo. amoxicillin reaction rash The NICE British National Formulary (BNF) and British National Formulary for Children (BNFc) sites are only available to users in the UK, Crown Dependencies and British Overseas Territories. If you believe you are seeing this page in error please contact us. Zithromax peds dosing Cipro expired Medscape - Depression, OCD, panic disorder, PTSD, PMDD-specific dosing for Zoloft sertraline, frequency-based adverse effects. Black Box Warnings. metformin tiredness Sertraline By mouth SER-tra-leen. Treats depression, obsessive-compulsive disorder OCD. Warnings. Tell your doctor if you are pregnant or breastfeeding, or if you have liver disease, bleeding problems, glaucoma, heart disease, or a seizure disorder. Even if you don’t take Zoloft, you should not drink alcohol if you have depression. This is because alcohol is a depressant. Drinking it may make your symptoms of depression worse. Initial: 50 mg q Day PO given continuously throughout menstrual cycle or given during luteal phase only May increase by 50 mg at the onset of each new menstrual cycle; no more than 150 mg q Day when administered continuously or 100 mg q Day when administered during luteal phase only 25 mg PO q Day initially; may increase by 25 mg every 2-3 days; not to exceed 200 mg q Day Alzheimer dementia related depression: Start at 12.5 mg/day and titrate every 1-2 weeks to response; not to exceed 150-200 mg Renal impairment: Dose adjustment not necessary Mild hepatic impairment (Child-Pugh 5-6): Decrease recommended starting dose and therapeutic dose by 50% Moderate-to-severe hepatic impairment (Child-Pugh 7-15): Not recommended; sertraline is extensively metabolized, and the effects in patients with moderate and severe hepatic impairment have not been studied Clinical worsening and suicide ideation may occur despite medication Use caution in patients with seizure disorders May worsen mania symptoms or precipitate mania in patients with bipolar disorder Increases risk of hyponatremia and impairment of cognitive/motor functions in the elderly Increases risk of bleeding in patients taking anticoagulants/antiplatelets concomitantly Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy Pregnancy: Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn (see Pregnancy) In neonates exposed to SNRIs/SSRIs late in third trimester: Risk of complications such as feeding difficulties, irritability, and respiratory problems Avoid abrupt withdrawal Bone fractures reported with antidepressant therapy; consider the possibility if patient presents with bone pain, bruising, or point of tenderness Coadministration with other drugs that enhance the effects of serotonergic neurotransmission (eg, tryptophan, fenfluramine, fentanyl, 5-HT agonists, St. John’s Wort) should be undertaken with caution and avoided whenever possible due to the potential for pharmacodynamic interaction (see Contraindications) May cause false-positive urine immunoassay screening tests for benzodiazepines SSRIs and SNRIs are associated with development of SIADH; hyponatremia reported Several SSRIs (eg, fluoxetine, fluvoxamine, paroxetine, sertraline) are metabolized by CYP2D6 CYP2D6 is involved in the metabolism of approximately 20% of drugs in clinical use and displays large individual-to-individual variability in activity due to genetic polymorphisms More than 80 CYP2D6 variant alleles have been identified; however, 4 of the most prevalent alleles, CYP2D6*3, *4, *5, and *6, account for 93-97% of CYP2D6 poor metabolizers CYP2D6*4, the most common variant (~25% frequency in whites), causes a splicing defect; CYP2D6*3 (2.7% frequency) causes a frameshift mutation; and CYP3D6*5 (2.6%) is an entire deletion of the CYP2D6 gene; individuals homozygous for these alleles have no CYP2D6 activity The impact of CYP2D6 activity is further complicated in some SSRIs (eg, fluoxetine, fluvoxamine, paroxetine, sertraline) because in addition to being substrates for CYP2D6, they are also known to moderately inhibit CYP2D6 activity The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Sertraline is indicated for the treatment of: Major depressive episodes. Prevention of recurrence of major depressive episodes. Obsessive compulsive disorder (OCD) in adults and paediatric patients aged 6-17 years. Post traumatic stress disorder (PTSD) Depression and OCD Sertraline treatment should be started at a dose of 50 mg/day. Panic Disorder, PTSD, and Social Anxiety Disorder Therapy should be initiated at 25 mg/day. After one week, the dose should be increased to 50 mg once daily. This dosage regimen has been shown to reduce the frequency of early treatment emergent side effects characteristic of panic disorder. Depression, OCD, Panic Disorder, Social Anxiety Disorder and PTSD Patients not responding to a 50 mg dose may benefit from dose increases. Dose changes should be made in steps of 50 mg at intervals of at least one week, up to a maximum of 200 mg/day. Sertraline warnings Sertraline 50mg tablets - Summary of Product Characteristics., Sertraline By mouth - National Library of Medicine. Canadian prescription drugstore Clonidine opiate withdrawal Do viagra pills have a shelf life Sertraline hydrochloride Tablets and Oral Concentrate 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. Tablets and Oral Concentrate - Food and Drug Administration Can I Mix Zoloft and Alcohol? - Healthline SSRI Antidepressants - Uses, Types, Side Effects, Lawsuits. Medscape - Depression, OCD, panic disorder, PTSD, PMDD-specific dosing for Zoloft sertraline, frequency-based adverse effects, comprehensive interactions. ciprofloxacin cell culture Warnings and Precautions before Taking Zoloft Read warnings and precautions about Zoloft. Always consult your physician before starting, stopping or switching from a prescribed medication. The FDA has issued multiple warnings about Zoloft and has required changes to its prescribing information and Pfizer, Zoloft’s manufacturer, has faced lawsuits for injuries caused by the medication. Zoloft. Zoloft is the brand name of the generic medication, sertraline.