Sertraline - Revision history

MDElliottMD: Sertraline: drop the weight-neutral effect entry (a descriptor, not a ratable patient effect, per Mark); tremor effect now registered so the effects list renders complete

2026-05-21T05:23:42Z

Sertraline: drop the weight-neutral effect entry (a descriptor, not a ratable patient effect, per Mark); tremor effect now registered so the effects list renders complete

← Older revision		Revision as of 05:23, 21 May 2026
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	* <effect ref="bruxism" author="MDElliottMD">Recognized association with SSRIs broadly.</effect>		* <effect ref="bruxism" author="MDElliottMD">Recognized association with SSRIs broadly.</effect>
	* <effect ref="restless-legs" author="MDElliottMD"/>		* <effect ref="restless-legs" author="MDElliottMD"/>
	* <effect ref="weight-neutral" author="MDElliottMD">Long-term weight gain on sertraline is minimal in most patients, distinguishing it from paroxetine and citalopram.</effect>

	\| pk_absorption = Oral bioavailability is not precisely characterized in humans (intravenous sertraline has not been administered for absolute bioavailability measurement). Absorption is essentially complete, with extensive first-pass metabolism limiting systemic availability. Peak plasma concentrations occur between 4.5 and 8.4 hours post-dose. Concomitant food modestly increases peak plasma levels and total exposure. Steady-state is reached within approximately one week of continuous dosing.<ref name="zoloft-label">U.S. Food and Drug Administration. Zoloft (sertraline hydrochloride) prescribing information. NDA 019839.</ref>		\| pk_absorption = Oral bioavailability is not precisely characterized in humans (intravenous sertraline has not been administered for absolute bioavailability measurement). Absorption is essentially complete, with extensive first-pass metabolism limiting systemic availability. Peak plasma concentrations occur between 4.5 and 8.4 hours post-dose. Concomitant food modestly increases peak plasma levels and total exposure. Steady-state is reached within approximately one week of continuous dosing.<ref name="zoloft-label">U.S. Food and Drug Administration. Zoloft (sertraline hydrochloride) prescribing information. NDA 019839.</ref>

MDElliottMD: Sertraline: full prescribing-guide page. History-first intro and History (Pfizer discovery 1977-1983, Koe and Welch, FDA approval 1991, the PANDA trial), pharmacokinetics, interactions, dosing, pregnancy. Clinically reviewed by pharmacist-claude; filed Pharmaceutical

2026-05-21T05:00:02Z

Sertraline: full prescribing-guide page. History-first intro and History (Pfizer discovery 1977-1983, Koe and Welch, FDA approval 1991, the PANDA trial), pharmacokinetics, interactions, dosing, pregnancy. Clinically reviewed by pharmacist-claude; filed Pharmaceutical

Show changes

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:11Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

MDElliottMD: Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

2026-05-19T01:37:42Z

Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

← Older revision		Revision as of 01:37, 19 May 2026
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	}}<h2 id="Pharmacokinetics">Pharmacokinetics</h2>		}}<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>		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>		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="Problems">Problems</h2>
	*Major depressive disorder		*Major depressive disorder
	*Generalized anxiety disorder		*Generalized anxiety disorder
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	<h2 id="Pharmacokinetics">Pharmacokinetics</h2>		<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>		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>		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="Problems">Problems</h2>
	*Major depressive disorder		*Major depressive disorder
	*Generalized anxiety disorder		*Generalized anxiety disorder

MediaWiki default: Assign pharmacological categories from List_of_CNS-active_medicines

2026-05-14T15:14:58Z

Assign pharmacological categories from List_of_CNS-active_medicines

← Older revision		Revision as of 15:14, 14 May 2026
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	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>		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]]		[[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]

			[[Category:Antidepressants]]
			[[Category:Selective Serotonin Reuptake Inhibitors (SSRIs)]]
	[[Category:Medicines]]		[[Category:Medicines]]
	<h2 id="Pharmacokinetics">Pharmacokinetics</h2>		<h2 id="Pharmacokinetics">Pharmacokinetics</h2>

MDElliottMD: Pharmacopedia: add

2026-05-14T03:31:09Z

Pharmacopedia: add <pharmaInteractions/>

← Older revision		Revision as of 03:31, 14 May 2026
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	\| 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.		\| 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.
	\| interactions = MAOIs (serotonin syndrome — contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.		\| interactions = MAOIs (serotonin syndrome — contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.
			<pharmaInteractions/>
	\| 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.		\| 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.		\| monitoring = Mood/suicidality (especially first 4 weeks), sodium (elderly), QT in cardiac risk, response and side effects.

MDElliottMD: Pharmacopedia: remove contraindications parameter

2026-05-14T02:40:50Z

Pharmacopedia: remove contraindications parameter

← Older revision		Revision as of 02:40, 14 May 2026
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	* <effect ref="discontinuation-syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>		* <effect ref="discontinuation-syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>
	\| 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.		\| 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.		\| 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.		\| 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.

MDElliottMD: Migrated 15 effect tag(s) to global ref=

2026-05-13T00:51:17Z

Migrated 15 effect tag(s) to global ref=

← Older revision		Revision as of 00:51, 13 May 2026
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	\| 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.		\| 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 =		\| effects =
	* <effect ~~slug~~="mood-improvement~~" label="Improved mood~~">Onset typically 2–4 weeks.</effect>		* <effect ref="mood-improvement">Onset typically 2–4 weeks.</effect>
	* <effect ~~slug~~="anxiolysis~~" label="Anxiolysis~~">Onset typically 2–4 weeks.</effect>		* <effect ref="anxiolysis">Onset typically 2–4 weeks.</effect>
	* <effect ~~slug~~="ocd-improvement~~" label="Reduced obsessive thoughts~~">Delayed onset; full benefit often takes 4+ weeks.</effect>		* <effect ref="ocd-improvement">Delayed onset; full benefit often takes 4+ weeks.</effect>
	* <effect ~~slug~~="nausea~~" label="Nausea~~">Often improves over the first 1–2 weeks.</effect>		* <effect ref="nausea">Often improves over the first 1–2 weeks.</effect>
	* <effect ~~slug~~="diarrhea~~" label="Diarrhea~~"/>		* <effect ref="diarrhea"/>
	* <effect ~~slug~~="sexual-~~dysfunction" label="Sexual~~ dysfunction">Decreased libido, delayed orgasm, anorgasmia. Can persist long-term in some patients (PSSD).</effect>		* <effect ref="sexual-dysfunction">Decreased libido, delayed orgasm, anorgasmia. Can persist long-term in some patients (PSSD).</effect>
	* <effect ~~slug~~="insomnia~~" label="Insomnia~~"/>		* <effect ref="insomnia"/>
	* <effect ~~slug~~="somnolence~~" label="Somnolence / sedation~~"/>		* <effect ref="somnolence"/>
	* <effect ~~slug~~="sweating~~" label="Sweating / diaphoresis~~"/>		* <effect ref="sweating"/>
	* <effect ~~slug~~="serotonin-~~syndrome" label="Serotonin~~ syndrome">Especially with other serotonergic agents (triptans, tramadol, MAOIs, linezolid).</effect>		* <effect ref="serotonin-syndrome">Especially with other serotonergic agents (triptans, tramadol, MAOIs, linezolid).</effect>
	* <effect ~~slug~~="qt-~~prolongation" label="QT~~ prolongation">Dose-dependent; check ECG in cardiac risk.</effect>		* <effect ref="qt-prolongation">Dose-dependent; check ECG in cardiac risk.</effect>
	* <effect ~~slug~~="hyponatremia~~" label="Hyponatremia / SIADH~~">Especially in elderly patients.</effect>		* <effect ref="hyponatremia">Especially in elderly patients.</effect>
	* <effect ~~slug~~="bleeding-~~risk" label="Bleeding~~ risk">Particularly with concurrent NSAIDs or anticoagulants.</effect>		* <effect ref="bleeding-risk">Particularly with concurrent NSAIDs or anticoagulants.</effect>
	* <effect ~~slug~~="suicidality~~" label="Suicidality~~">Black box warning in patients under 25; close monitoring in first 4 weeks.</effect>		* <effect ref="suicidality">Black box warning in patients under 25; close monitoring in first 4 weeks.</effect>
	* <effect ~~slug~~="discontinuation-~~syndrome" label="Discontinuation~~ syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>		* <effect ref="discontinuation-syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>
	\| 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.		\| 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.		\| contraindications = MAOIs (within 14 days), pimozide, severe hepatic impairment. Caution: bipolar disorder (mood switching risk), seizure disorders.

MDElliottMD at 00:31, 12 May 2026

2026-05-12T00:31:23Z

← Older revision		Revision as of 00:31, 12 May 2026
Line 25:		Line 25:
	\| 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.		\| 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 =		\| effects =

	~~==== Therapeutic ====~~
	* <effect slug="mood-improvement" label="Improved mood">Onset typically 2–4 weeks.</effect>		* <effect slug="mood-improvement" label="Improved mood">Onset typically 2–4 weeks.</effect>
	* <effect slug="anxiolysis" label="Anxiolysis">Onset typically 2–4 weeks.</effect>		* <effect slug="anxiolysis" label="Anxiolysis">Onset typically 2–4 weeks.</effect>
	* <effect slug="ocd-improvement" label="Reduced obsessive thoughts">Delayed onset; full benefit often takes 4+ weeks.</effect>		* <effect slug="ocd-improvement" label="Reduced obsessive thoughts">Delayed onset; full benefit often takes 4+ weeks.</effect>

	~~==== Common ====~~
	* <effect slug="nausea" label="Nausea">Often improves over the first 1–2 weeks.</effect>		* <effect slug="nausea" label="Nausea">Often improves over the first 1–2 weeks.</effect>
	* <effect slug="diarrhea" label="Diarrhea"/>		* <effect slug="diarrhea" label="Diarrhea"/>
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	* <effect slug="somnolence" label="Somnolence / sedation"/>		* <effect slug="somnolence" label="Somnolence / sedation"/>
	* <effect slug="sweating" label="Sweating / diaphoresis"/>		* <effect slug="sweating" label="Sweating / diaphoresis"/>

	~~==== Serious ====~~
	* <effect slug="serotonin-syndrome" label="Serotonin syndrome">Especially with other serotonergic agents (triptans, tramadol, MAOIs, linezolid).</effect>		* <effect slug="serotonin-syndrome" label="Serotonin syndrome">Especially with other serotonergic agents (triptans, tramadol, MAOIs, linezolid).</effect>
	* <effect slug="qt-prolongation" label="QT prolongation">Dose-dependent; check ECG in cardiac risk.</effect>		* <effect slug="qt-prolongation" label="QT prolongation">Dose-dependent; check ECG in cardiac risk.</effect>

MDElliottMD at 00:30, 12 May 2026

2026-05-12T00:30:32Z

← Older revision		Revision as of 00:30, 12 May 2026
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	==== Therapeutic ====		==== Therapeutic ====
	* <effect slug="mood-improvement" label="Improved mood">Onset typically 2–4 weeks.</effect>		* <effect slug="mood-improvement" label="Improved mood">Onset typically 2–4 weeks.</effect>
	* <effect slug="~~anxiety-reduction~~" label="~~Reduced anxiety~~">Onset typically 2–4 weeks.</effect>		* <effect slug="anxiolysis" label="Anxiolysis">Onset typically 2–4 weeks.</effect>
	* <effect slug="ocd-improvement" label="Reduced obsessive thoughts">Delayed onset; full benefit often takes 4+ weeks.</effect>		* <effect slug="ocd-improvement" label="Reduced obsessive thoughts">Delayed onset; full benefit often takes 4+ weeks.</effect>

← Older revision		Revision as of 03:16, 19 May 2026
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	\| intro = '''Sertraline''' is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, anxiety disorders, OCD, PTSD, and panic disorder. In the US, it is one of the [https://www.definitivehc.com/resources/healthcare-insights/top-antidepressants-by-prescription-volume most frequently utilized SSRIs at this time].		\| intro = '''Sertraline''' is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed for depression, anxiety disorders, OCD, PTSD, and panic disorder. In the US, 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.		\| 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.		\| 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		\| indications = * Major depressive disorder
	* Generalized anxiety disorder		* Generalized anxiety disorder
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	* <effect ref="discontinuation-syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>		* <effect ref="discontinuation-syndrome">"Brain zaps," dizziness, irritability, flu-like symptoms with abrupt cessation. Taper to avoid.</effect>
	\| 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.		\| 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.
	\| interactions = MAOIs (serotonin syndrome — contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.		\| interactions = MAOIs (serotonin syndrome, contraindicated), triptans, tramadol, linezolid, lithium, NSAIDs/anticoagulants (bleeding), CYP2D6 substrates.
	<pharmaInteractions/>		<pharmaInteractions/>
	\| 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.		\| 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.		\| 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.		\| 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 =		\| anecdotes =
	\| seealso = [[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]		\| seealso = [[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]
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	}}<h2 id="Pharmacokinetics">Pharmacokinetics</h2>		}}<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>		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="Problems">Problems</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="Problems">Problems</h2>
	*Major depressive disorder		*Major depressive disorder
	*Generalized anxiety disorder		*Generalized anxiety disorder
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	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>		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 (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>		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>		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>		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>		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]]		[[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]

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	<h2 id="Pharmacokinetics">Pharmacokinetics</h2>		<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>		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="Problems">Problems</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="Problems">Problems</h2>
	*Major depressive disorder		*Major depressive disorder
	*Generalized anxiety disorder		*Generalized anxiety disorder
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	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>		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 (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>		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>		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>		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>		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]]		[[Fluoxetine]], [[Paroxetine]], [[Citalopram]], [[Escitalopram]]
	[[Category:Medicines]]		[[Category:Medicines]]