Sertraline

2026-05-11T21:27:57Z

Testing234:

{{MedTemplate
| generic = Sertraline
| brand = Zoloft, Lustral
| structure = Sertraline.svg
| classes = SSRI, Antidepressant, Anxiolytic
| mechanism = SSRI; weak DRI
| uses = Depression, anxiety disorders, OCD, PTSD, panic disorder
| formula = C17H17Cl2N
| routes = Oral
| onset = 2–4 weeks for full effect
| duration =
| halflife = 26 hours (parent); norsertraline 62–104 hours
| bioavailability = ~44%
| pregnancy = Category C
| legal = Rx-only
| intro = '''Sertraline''' is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, anxiety disorders, OCD, PTSD, and panic disorder. It is one of the [https://www.definitivehc.com/resources/healthcare-insights/top-antidepressants-by-prescription-volume most frequently utilized SSRIs at this time].
| pharmacokinetics = Well-absorbed orally, ~44% bioavailability. Metabolized hepatically via CYP3A4/CYP2C19/CYP2D6 to N-desmethylsertraline (less active). Half-life ~26h; steady state in ~1 week.
| pharmacodynamics = Highly selective inhibitor of the serotonin reuptake transporter (SERT). Mild dopamine reuptake inhibition at higher doses. Minimal affinity for muscarinic, histaminic, or adrenergic receptors — hence cleaner adverse effect profile than TCAs.
| indications = * Major depressive disorder
* Generalized anxiety disorder
* Obsessive-compulsive disorder
* Post-traumatic stress disorder
* Panic disorder
* Premenstrual dysphoric disorder
| dosing = Start 25–50 mg PO daily. Titrate by 25–50 mg every 1–2 weeks based on response. Typical effective dose 50–200 mg/day; max 200 mg/day.
| effects = ''Therapeutic:'' improved mood, reduced anxiety, fewer obsessive thoughts (delayed 2–4 weeks).
''Common adverse:'' nausea, diarrhea, sexual dysfunction, insomnia, somnolence, sweating.
| adverse = Serotonin syndrome (especially with other serotonergic agents), QT prolongation at high doses, hyponatremia (SIADH, esp. elderly), bleeding risk, suicidality warning in young adults, discontinuation syndrome.
| contraindications = MAOIs (within 14 days), pimozide, severe hepatic impairment. Caution: bipolar disorder (mood switching risk), seizure disorders.
| interactions = MAOIs (serotonin syndrome — contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.
| pregnancy_details = Category C. SSRIs in third trimester associated with persistent pulmonary hypertension of the newborn (PPHN) and neonatal adaptation syndrome. Risk-benefit decision; sertraline often preferred in pregnancy among SSRIs.
| monitoring = Mood/suicidality (especially first 4 weeks), sodium (elderly), QT in cardiac risk, response and side effects.
| counseling = Take with or without food. Effect emerges over 2–4 weeks. Don't stop abruptly — taper to avoid withdrawal. Report serotonin-syndrome symptoms.
| anecdotes =
| seealso = [[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]
| references =
}}<h2 id="Pharmacokinetics">Pharmacokinetics</h2>
Well-absorbed orally, ~44% bioavailability. Metabolized hepatically via CYP3A4/CYP2C19/CYP2D6 to N-desmethylsertraline (less active). Half-life ~26h; steady state in ~1 week.<h2 id="Pharmacodynamics">Pharmacodynamics</h2>
Highly selective inhibitor of the serotonin reuptake transporter (SERT). Mild dopamine reuptake inhibition at higher doses. Minimal affinity for muscarinic, histaminic, or adrenergic receptors — hence cleaner adverse effect profile than TCAs.<h2 id="Indications">Indications</h2>
*Major depressive disorder
*Generalized anxiety disorder
*Obsessive-compulsive disorder
*Post-traumatic stress disorder
*Panic disorder
*Premenstrual dysphoric disorder<h2 id="Dosing">Dosing and titration</h2>
Start 25–50 mg PO daily. Titrate by 25–50 mg every 1–2 weeks based on response. Typical effective dose 50–200 mg/day; max 200 mg/day.<h2 id="Effects">Effects</h2><span></span>
''Therapeutic:'' improved mood, reduced anxiety, fewer obsessive thoughts (delayed 2–4 weeks).

<span></span>

''Common adverse:'' nausea, diarrhea, sexual dysfunction, insomnia, somnolence, sweating.<h2 id="Adverse">Adverse effects</h2>
Serotonin syndrome (especially with other serotonergic agents), QT prolongation at high doses, hyponatremia (SIADH, esp. elderly), bleeding risk, suicidality warning in young adults, discontinuation syndrome.<h2 id="Contraindications">Contraindications</h2>
MAOIs (within 14 days), pimozide, severe hepatic impairment. Caution: bipolar disorder (mood switching risk), seizure disorders.<h2 id="Interactions">Interactions</h2>
MAOIs (serotonin syndrome — contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.<h2 id="Pregnancy">Pregnancy and lactation</h2>
Category C. SSRIs in third trimester associated with persistent pulmonary hypertension of the newborn (PPHN) and neonatal adaptation syndrome. Risk-benefit decision; sertraline often preferred in pregnancy among SSRIs.<h2 id="Monitoring">Monitoring</h2>
Mood/suicidality (especially first 4 weeks), sodium (elderly), QT in cardiac risk, response and side effects.<h2 id="Counseling">Patient counseling</h2>
Take with or without food. Effect emerges over 2–4 weeks. Don't stop abruptly — taper to avoid withdrawal. Report serotonin-syndrome symptoms.<h2 id="SeeAlso">See also</h2><span></span>
[[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]
[[Category:Medicines]]

Pharmacopedia - User contributions [en]

Sertraline