Sertraline: Difference between revisions
From Pharmacopedia
More actions
| [checked revision] | [checked revision] |
MDElliottMD (talk | contribs) No edit summary |
MDElliottMD (talk | contribs) Migrated 15 effect tag(s) to global ref= |
||
| 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 = | ||
* <effect | * <effect ref="mood-improvement">Onset typically 2–4 weeks.</effect> | ||
* <effect | * <effect ref="anxiolysis">Onset typically 2–4 weeks.</effect> | ||
* <effect | * <effect ref="ocd-improvement">Delayed onset; full benefit often takes 4+ weeks.</effect> | ||
* <effect | * <effect ref="nausea">Often improves over the first 1–2 weeks.</effect> | ||
* <effect | * <effect ref="diarrhea"/> | ||
* <effect | * <effect ref="sexual-dysfunction">Decreased libido, delayed orgasm, anorgasmia. Can persist long-term in some patients (PSSD).</effect> | ||
* <effect | * <effect ref="insomnia"/> | ||
* <effect | * <effect ref="somnolence"/> | ||
* <effect | * <effect ref="sweating"/> | ||
* <effect | * <effect ref="serotonin-syndrome">Especially with other serotonergic agents (triptans, tramadol, MAOIs, linezolid).</effect> | ||
* <effect | * <effect ref="qt-prolongation">Dose-dependent; check ECG in cardiac risk.</effect> | ||
* <effect | * <effect ref="hyponatremia">Especially in elderly patients.</effect> | ||
* <effect | * <effect ref="bleeding-risk">Particularly with concurrent NSAIDs or anticoagulants.</effect> | ||
* <effect | * <effect ref="suicidality">Black box warning in patients under 25; close monitoring in first 4 weeks.</effect> | ||
* <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. | ||