Sertraline: Difference between revisions
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* Premenstrual dysphoric 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. | | 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="anxiety-reduction" label="Reduced anxiety">Onset typically 2–4 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="diarrhea" label="Diarrhea"/> | |||
* <effect slug="sexual-dysfunction" label="Sexual dysfunction">Decreased libido, delayed orgasm, anorgasmia. Can persist long-term in some patients (PSSD).</effect> | |||
* <effect slug="insomnia" label="Insomnia"/> | |||
* <effect slug="somnolence" label="Somnolence / sedation"/> | |||
* <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="qt-prolongation" label="QT prolongation">Dose-dependent; check ECG in cardiac risk.</effect> | |||
* <effect slug="hyponatremia" label="Hyponatremia / SIADH">Especially in elderly patients.</effect> | |||
* <effect slug="bleeding-risk" label="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 slug="discontinuation-syndrome" label="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. | ||