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Sertraline

    Brands

    DEA Class;  Rx

    Common Brand Names; Zoloft

    • Antidepressants, SSRIs

    Oral selective serotonin reuptake inhibitor (SSRI) antidepressant
    Indicated for depression, OCD, panic disorder, PTSD, social anxiety disorder, and PMDD in adults; used for OCD in children 6 years and older
    Increased risk of suicidality during treatment initiation in pediatric and young adult patients

    Indicated for major depressive disorder (MDD)

    Indicated for obsessive-compulsive disorder (OCD)

    Indicated for panic disorder (PD)

    Indicated posttraumatic stress disorder (PTSD)

    Indicated for social anxiety disorder (SAD)

    Indicated for premenstrual dysphoric disorder (PMDD)

    Hypersensitivity

    Do not use disulfiram concomitantly with oral solution due to alcohol in preparation

    Concomitant pimozide: Risk of long QT syndrome

    • Nausea (15-24%)
    • Insomnia (11-24%)
    • Dry mouth (9-18%)
    • Headache (17%)
    • Asthenia (10-15%)
    • Constipation (10-15%)
    • Diarrhea (9-12%)
    • Dizziness (6-14%)
    • Ejaculation disorder (10-15%)
    • Tremor (4-11%)
    • Anxiety (5-10%)
    • Blurred vision (5-10%)
    • Decreased appetite (5-10%)
    • Impotence (2-9%)
    • Nervousness (2-5%)
    • Paresthesia (2-5%)
    • Hypomania (0.3 to 2.2%)
    • Hypertension
    • Tachycardia
    • Emotional lability
    • Pruritus
    • Weight gain
    • Arthralgia
    • Tinnitus
    • Vertigo
    • Angle clossure glaucoma

    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)

    Overall, available published epidemiologic studies of pregnant women exposed to sertraline in the first trimester suggest no difference in major birth defect risk compared to the background rate for major birth defects in comparator populations

    Available data from published literature demonstrate low levels of sertraline and its metabolites in human milk

    There are no data on the effects of sertraline on milk production

    Adults

    200 mg/day PO.

    Geriatric

    200 mg/day PO; however, lower dosages may be effective/better tolerated.

    Adolescents

    200 mg/day PO.

    Children

    6 to 12 years: 200 mg/day PO.
    1 to 5 years: Safety and efficacy have not been established.

    Infants

    Not indicated.

    Neonates

    Not indicated.

    Sertraline hydrochloride

    tablets (Zoloft, generic)

    • 25mg
    • 50mg
    • 100mg

    capsules (generic)

    • 150mg
    • 200mg

    oral solution (Zoloft, generic)

    • 20mg/mL