Pharm
Sertraline
search
Sertraline
, Zoloft
Mechanism
Selective Serotonin Reuptake Inhibitor
(
SSRI
)
Indications
Major Depression
Obsessive Compulsive Disorder
Panic Disorder
Post-Traumatic Stress Disorder
(
PTSD
)
Premenstrual Dysphoric Disorder
Background
Cost: $75 per month
Preparations
Tablets (Scored): 25, 50, 100 mg
Oral concentrate: 20 mg/ml (60 ml bottle)
Dosing
Start
Children (ages 6-12 years of age): 25 mg PO qAM
Adults (and children over age 12): 50 mg PO qAM
Elderly: 25 mg PO qAM
Titrate
Adults: Increase by 50 mg every 2 weeks
Maximum: 200 mg per day
Drug Interactions
Significantly raises Pimozide levels
Concurrent use with Pimozide is contraindicated
Inhibits
Cytochrome P450
-2C and P450-3A4
Clinically Significant
interactions are uncommon
Highly protein bound
Interacts with other protein bound medications
Absorption affected by food intake
Raises
Tricyclic Antidepressant
levels
Allow two week wash-out prior to starting
MAO inhibitor
Pharmacokinetics
Half Life: 1 to 4 days
Therapeutic Blood level 9.5 to 56 ng/ml
Adverse Effects
Neutral on the sedation to excitation continuum
Less sedating than
Paxil
or
Luvox
Anxiety,
Insomnia
or other sleep disturbance
Less stimulating than
Prozac
Consider
Trazodone
(
Desyrel
) at bedtime
Diarrhea
or gastrointestinal upset
Diarrhea
more common than with
Fluoxetine
Usually resolves within 2 weeks
Sexual Dysfunction
may be more common
Includes decreased libido
See
Antidepressant Induced Sexual Dysfunction
Antidepressant Withdrawal
symptoms on stopping
Taper 50 mg per every 5-7 days
Taper to 25-50 mg daily before stopping
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