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Generic Name: Sertraline Hydrochloride
Class: Selective Serotonin-reuptake Inhibitors
VA Class: CN609
Molecular Formula: C17H17C12N•ClH
CAS Number: 79559-97-0

Warning(s)

  • Suicidality
  • Antidepressants increased risk of suicidal thinking and behavior (suicidality) compared with placebo in children, adolescents, and young adults (18–24 years of age) with major depressive disorder and other psychiatric disorders; balance this risk with clinical need.1 304 305 344 Sertraline is not approved for use in pediatric patients except for patients with obsessive-compulsive disorder.1 235 (See Pediatric Use under Cautions.)

  • In pooled data analyses, risk of suicidality was not increased in adults >24 years of age and was reduced in adults ≥65 years of age with antidepressants compared with placebo.1 304 305 344

  • Depression and certain other psychiatric disorders are themselves associated with an increased risk of suicide.1 304 305 310 344

  • Appropriately monitor and closely observe all patients who are started on sertraline therapy for clinical worsening, suicidality, or unusual changes in behavior; involve family members and/or caregivers in this process.1 304 305 310 344 (See Worsening of Depression and Suicidality Risk under Cautions.)

Introduction

Antidepressant; selective serotonin-reuptake inhibitor (SSRI).1 2 3

Uses for Zoloft

Major Depressive Disorder

Management of major depressive disorder.1 3 4 5 10 11 33 59 62 148 149 150 151 152 158 159 339 341

Efficacy in hospital settings not established.1

APA states that effectiveness of antidepressants is generally comparable between and within classes of medications, including SSRIs, SNRIs, TCAs, MAOIs, and other antidepressants (e.g., bupropion, mirtazapine, trazodone).a Choose antidepressant based mainly on patient preference; nature of prior response to medication; safety, tolerability, and anticipated adverse effects; concurrent psychiatric and medical conditions; and specific properties of the medication (e.g., half-life, actions on CYP450 enzymes, other drug interactions).a For most patients, an SSRI, SNRI, mirtazapine, or bupropion is considered optimal.a Consult APA’s Practice Guidelines for the Treatment of Patients with Major Depressive Disorder for additional information.a

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Obsessive-Compulsive Disorder (OCD)

Management of OCD; reduces but does not completely eliminate obsessions and compulsions.1 29 156 235 236

Panic Disorder

Management of panic disorder with or without agoraphobia.1

Posttraumatic Stress Disorder (PTSD)

Management of PTSD;1 2 268 270 more effective in women than in men.1

Not effective for combat- or war-related PTSD.2 255

Premenstrual Dysphoric Disorder (PMDD)

Management of PMDD; improves symptoms (e.g., depressed mood, premenstrual anger/irritability) and functional impairment (e.g., difficulty in concentrating, lethargy) associated with this disorder.1 140 160

Efficacy when used in conjunction with oral contraceptives for the treatment of PMDD is unknown.1 140

Social Phobia

Management of social phobia (social anxiety disorder).1 281 282

Premature Ejaculation

Has been used in the management of premature ejaculation.67 217 218 219

Vascular Headaches

Has been used in the management of vascular headaches with equivocal efficacy.220 221

Zoloft Dosage and Administration

General

  • Allow at least 2 weeks to elapse between discontinuance of an MAO inhibitor and initiation of sertraline and vice versa.1 207 A washout period also is advisable when transferring from another antidepressant (e.g., fluoxetine) to sertraline.104 105 111 157 229 (See Contraindicationsand Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions and see also Interactions.)

  • Monitor for possible worsening of depression, suicidality, or unusual changes in behavior, especially at the beginning of therapy or during periods of dosage adjustments.1 34 304 305 310 (See Worsening of Depression and Suicidality Risk under Cautions.)

  • Sustained therapy may be required; monitor periodically for need for continued therapy.1

  • Avoid abrupt discontinuance.59 108 110 208 601 Taper dosage gradually and monitor for withdrawal symptoms.59 108 351 601 If intolerable symptoms occur following dosage reduction or discontinuance, consider reinstituting previously prescribed dosage, then resume more gradual dosage reductions.601 (See Withdrawal of Therapy under Cautions.)

  • Consider cautiously tapering dosage during third trimester of pregnancy prior to delivery.1 301 302 316 317 (See Pregnancy under Cautions.)

Administration

Oral Administration

Administer orally once daily (morning or evening).1 3 4 5

With oral concentrate solution, measure doses carefully using the calibrated dropper provided by the manufacturer.1 (See Sensitivity Reactions under Cautions.) Oral concentrate solution must be diluted just prior to administration.1 Dilute in 120 mL of water, ginger ale, lemon/lime soda, lemonade, or orange juice just prior to administration; do not mix in advance or use anything other than these liquids.1

Dosage

Available as sertraline hydrochloride; dosage is expressed in terms of sertraline.1

Pediatric Patients

OCD
Oral

Children 6–12 years of age: Initially, 25 mg once daily.1

Adolescents 13–17 years of age: Initially, 50 mg once daily.1

Dosage may be increased at weekly intervals according to clinical response.1 3 5 235

Avoid excessive dosages in children.1

Optimum duration not established; may require several months of therapy or longer.1

Adults

Major Depressive Disorder
Oral

Initially, 50–100 mg once daily.1 3 4 5 59 239 Dosage may be increased at weekly intervals according to clinical response.1 3 5 239

Optimum duration not established; may require several months of therapy or longer.1

OCD
Oral

Initially, 50 mg once daily.1 Dosage may be increased at weekly intervals according to clinical response.1 3 5 235

Optimum duration not established; may require several months of therapy or longer.1

Panic Disorder
Oral

Initially, 25 mg once daily.1 After 1 week, increase to 50 mg once daily.1 Dosage may be increased at weekly intervals according to clinical response.1

Optimum duration not established; may require several months of therapy or longer.1

PTSD
Oral

Initially, 25 mg once daily.1 After 1 week, increase to 50 mg once daily.1 Dosage may then be increased at weekly intervals according to clinical response.1

Optimum duration not established; may require several months of therapy or longer.1

PMDD
Oral

Initially, 50 mg once daily given continuously throughout the menstrual cycle or just during the luteal phase (i.e., starting 2 weeks prior to the anticipated onset of menstruation and continuing through the first full day of menses).1

Dosage may be increased in 50-mg increments at the onset of each new menstrual cycle.1

If a dosage of 100 mg daily has been established with luteal phase dosing, titrate dosage using a 50 mg daily dosage for the first 3 days of each luteal phase dosing period.1

Optimum duration not established; periodically assess need for dosage adjustment and continued therapy.1

Social Phobia
Oral

Initially, 25 mg once daily.304 After 1 week, increase to 50 mg once daily.304 Dosage may be increased at weekly intervals according to clinical response.304

Optimum duration not established; may require several months of therapy or longer.1

Premature Ejaculation
Oral

25–50 mg daily.272 Alternatively, 25–50 mg daily on an “as needed” basis.272

Prescribing Limits

Pediatric Patients

OCD
Oral

Maximum 200 mg daily.1 3 5

Adults

Major Depressive Disorder
Oral

Maximum 200 mg daily.1

OCD
Oral

Maximum 200 mg daily.1 3 5

Panic Disorder
Oral

Maximum 200 mg daily.1

PTSD
Oral

Maximum 200 mg daily.1

PMDD
Oral

Maximum 150 mg daily when administered continuously or 100 mg daily when administered during the luteal phase only.1

Social Phobia
Oral

Maximum 200 mg daily.1

Special Populations

Hepatic Impairment

Decreased clearance;1 83 137 lower dosages or less frequent administration recommended.1

Renal Impairment

No dosage adjustments needed.1 Not substantially removed by dialysis; supplemental doses may be unnecessary after dialysis.1 83 185

Cautions for Zoloft

Contraindications

  • Concomitant use with pimozide or an MAO inhibitor.1 35 207 322 (See Contraindications and Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions and see also Interactions.)

  • Concomitant use of sertraline oral concentrate solution (contains alcohol 12%) and disulfiram or other agents likely to produce disulfiram-like reactions (e.g., metronidazole).1

  • Known hypersensitivity to sertraline or any ingredient in the formulation.1

Warnings/Precautions

Warnings

Worsening of Depression and Suicidality Risk

Possible worsening of depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior in both adult and pediatric patients with major depressive disorder, whether or not they are taking antidepressants; may persist until clinically important remission occurs.1 304 305 310 344 345 However, suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide.1 304 305 310 344

Appropriately monitor and closely observe patients receiving sertraline for any reason, particularly during initiation of therapy (i.e., the first few months) and during periods of dosage adjustments.1 304 305 310 344 (See Boxed Warning and also see Pediatric Use under Cautions.)

Anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and/or mania may be precursors to emerging suicidality.1 304 310 344 Consider changing or discontinuing therapy in patients whose depression is persistently worse or in those with emerging suicidality or symptoms that might be precursors to worsening depression or suicidality, particularly if severe, abrupt in onset, or not part of patient’s presenting symptoms.1 304 344 If decision is made to discontinue therapy, taper sertraline dosage as rapidly as is feasible but consider risks of abrupt discontinuance.1 304 344 (See General under Dosage and Administration.)

Prescribe in smallest quantity consistent with good patient management to reduce risk of overdosage.1 304 344

Observe these precautions for patients with psychiatric (e.g., major depressive disorder, OCD) and nonpsychiatric disorders.1 304 344

Bipolar Disorder

May unmask bipolar disorder.304 601 (See Activation of Mania/Hypomania under Cautions.) Sertraline is not approved for use in treating bipolar depression.601

Screen for risk of bipolar disorder by obtaining detailed psychiatric history (e.g., family history of suicide, bipolar disorder, depression) prior to initiating therapy.1 304 601

MAO Inhibitors Interaction

Concomitant use of SSRIs and MAO inhibitors associated with serious, sometimes fatal reactions, including hyperthermia, rigidity, myoclonus, autonomic instability, and mental status changes; these reactions have resembled serotonin syndrome or neuroleptic malignant syndrome (NMS).601 (See Contraindications and Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions and also see Interactions.)

Serotonin Syndrome or Neuroleptic Malignant Syndrome (NMS)-like Reactions

Potentially life-threatening serotonin syndrome or NMS-like reactions reported with SSRIs and SNRIs, including sertraline, but particularly with concurrent administration of other serotonergic drugs (e.g., 5-HT1 receptor agonists [triptans]), drugs that impair serotonin metabolism (e.g., MAO inhibitors), or antipsychotics or other dopamine antagonists.174 177 178 179 189 198 323 348 349 350 (See Contraindications under Cautions and also see Interactions.)

Symptoms of serotonin syndrome may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile BP, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or GI symptoms (e.g., nausea, vomiting, diarrhea).323 348 349 350

Severe serotonin syndrome may resemble NMS, which is characterized by hyperthermia, muscle rigidity, autonomic instability with possible rapid fluctuations in vital signs, and mental status changes.348 349 350

Monitor patients receiving sertraline for the development of serotonin syndrome or NMS-like signs and symptoms.348 If such signs and symptoms occur, immediately discontinue treatment with sertraline and any concurrently administered serotonergic or antidopaminergic agents, including antipsychotic agents, and initiate supportive and symptomatic treatment.348

Sensitivity Reactions

Latex Sensitivity

Dropper dispenser provided with Zoloft oral concentrate solution contains natural latex proteins in the form of dry natural rubber; possible sensitivity reactions in susceptible individuals.1

General Precautions

Activation of Mania/Hypomania

Possible activation of mania or hypomania.1 7 12 28 34 35 59 167 Use with caution in patients with history of mania or hypomania.1 4 59 60 (See Bipolar Disorder under Cautions.)

Weight Loss

Possible anorexia and weight loss.1 8 10 11 33 35 Use with caution in patients who may be adversely affected (e.g., underweight patients).1

Seizures

Limited experience in patients with a history of seizures; use with caution in such patients.1

Withdrawal of Therapy

Withdrawal effects (e.g., dysphoric mood, irritability, agitation, dizziness, sensory disturbances [e.g., paresthesias, such as electric shock sensations], anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania) reported following discontinuance of serotonergic antidepressants, particularly when discontinuance was abrupt.59 108 110 208 601 Events generally self-limiting, but serious cases reported.601

Taper dosage gradually; monitor patients for withdrawal symptoms when discontinuing therapy.59 108 110 208 351 601 If intolerable symptoms occur following dosage reduction or discontinuance, consider reinstituting previously prescribed dosage then resume more gradual dosage reductions.601

Abnormal Bleeding

Possible increased risk of bleeding with SSRIs, including sertraline, and SNRIs; events ranged from ecchymoses, hematomas, epistaxis, and petechiae to life-threatening hemorrhages.289 311 312 601 Concomitant use of aspirin, NSAIAs, warfarin, or other anticoagulants may increase risk.83 289 311 312 601 (See Drugs Affecting Hemostasis and Specific Drugs under Interactions.)

Uricosuric Effect

Decrease in serum uric acid concentrations possible.1 Use with caution in patients who may be adversely affected (e.g., those at risk for acute renal failure).60

Concomitant Illnesses

Experience in patients with concomitant diseases is limited.1 Patients with recent history of MI or unstable heart disease generally were excluded from premarketing clinical studies, but a postmarketing controlled study suggests that sertraline therapy is well tolerated in these patients.1 313

Use with caution in patients with altered metabolism or hemodynamics.1

Hyponatremia or SIADH

Possible hyponatremia during treatment with SSRIs, including sertraline, and SNRIs; in many cases, hyponatremia appears to be due to SIADH.23 27 69 125 126 127 128 129 131 132 133 363 601 Increased risk in patients who are volume depleted, elderly, or taking diuretics.23 69 125 126 128 363 601 Initiate appropriate medical intervention and consider drug discontinuance in patients with symptomatic hyponatremia.601

Angle-Closure Glaucoma

SSRIs, including sertraline, may affect pupil size resulting in mydriasis; this effect may narrow the eye angle resulting in increased IOP and angle-closure glaucoma.601 Use with caution in patients with angle-closure glaucoma or history of glaucoma.601

Endocrine Effects

Possible hypothyroidism, elevated serum thyrotropin, and/or reduced serum thyroxine concentrations.81 96 97 Monitor thyroid function periodically in patients with thyroid disease.97

Electroconvulsive Therapy (ECT)

Effects of concomitant use with ECT have not been systematically evaluated.1

Specific Populations

Pregnancy

Category C.1

Possible complications, sometimes severe and requiring prolonged hospitalization, respiratory support, enteral nutrition, and other forms of supportive care, reported in neonates exposed to sertraline, other SSRIs, or SNRIs late in the third trimester; may arise immediately upon delivery.1 301 302 314 315 316 317 318 (See General under Dosage and Administration.)

Conflicting findings from available studies evaluating possible risk of persistent pulmonary hypertension of the newborn (PPHN) following in utero exposure to SSRIs; currently unclear whether SSRI use during pregnancy can cause PPHN.600 601 602 603 604 605 606 610

Consult joint APA and ACOG guidelines (at ) for additional information on management of depression in women prior to conception and during pregnancy, including treatment algorithms.600 608

Effect on labor and delivery unknown.601

Lactation

Distributed into milk;99 216 use with caution.1

Pediatric Use

Safety and efficacy for OCD not established in children <6 years of age.1 235

Safety and efficacy for other disorders (e.g., major depressive disorder, panic disorder, PTSD, PMDD, social phobia) not established in pediatric patients.1 304 Results of 2 placebo-controlled trials in children and adolescents with major depressive disorder did not support a claim of efficacy for use of sertraline in pediatric patients with this condition.1

Adverse effect profile generally similar to that seen in adults.1 Decreased appetite and weight loss observed with use of SSRIs; monitor weight and growth regularly during long-term sertraline therapy.601

FDA warns that a greater risk of suicidal thinking or behavior (suicidality) occurred during the first few months of antidepressant treatment compared with placebo in children and adolescents with major depressive disorder, OCD, or other psychiatric disorders based on pooled analyses of 24 short-term, placebo-controlled trials of 9 antidepressant drugs (SSRIs and others).1 304 344 However, a more recent meta-analysis of 27 placebo-controlled trials of 9 antidepressants (SSRIs and others) in patients <19 years of age with major depressive disorder, OCD, or non-OCD anxiety disorders suggests that the benefits of antidepressant therapy in treating these conditions may outweigh the risks of suicidal behavior or suicidal ideation.345 No suicides occurred in these pediatric trials.1 304 344

Carefully consider these findings when assessing potential benefits and risks of sertraline for any clinical use.1 304 305 310 345 (See Suicidality in the Boxed Warning and also see Worsening of Depression and Suicidality Risk under Cautions.)

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.1 10 12

Clinically important hyponatremia reported in geriatric patients, who may be at increased risk for this adverse effect.23 69 125 126 128 348 363 Some clinicians recommend periodic monitoring (especially during the first several months) of serum sodium concentrations in geriatric patients receiving SSRIs.128 229 359 360 361 (See Hyponatremia or SIADH under Cautions.)

In pooled data analyses, a reduced risk of suicidality was observed in adults ≥65 years of age with antidepressant therapy compared with placebo.1 304 305 (See Boxed Warning and also see Worsening of Depression and Suicidality Risk under Cautions.)

Hepatic Impairment

Decreased clearance; use with caution.1 137 (See Hepatic Impairment under Dosage and Administration.)

Common Adverse Effects

Nausea, diarrhea/loose stools, dyspepsia, dry mouth, somnolence, dizziness, insomnia, tremor, ejaculatory delay, sweating.1 3 4 5 12

Adverse effects in children are similar to those reported in adults.1 (See Pediatric Use under Cautions.)

Interactions for Zoloft

Apparently metabolized by multiple CYP isoenzymes, with none contributing more than 40% to overall metabolism.358 Inhibits CYP2D6 and 3A4, but less potent as an inhibitor than many other drugs.1

Drugs Metabolized by Hepatic Microsomal Enzymes

Potential pharmacokinetic interactions (increased plasma concentrations of CYP2D6 substrates).1

Clinically important pharmacokinetic interactions with substrates of 3A4 unlikely.1 100

Drugs Affecting Hepatic Microsomal Enzymes

Clinically important pharmacokinetic interactions with inhibitors or inducers of CYP2D6 or 3A4 unlikely.1 100

Drugs Affecting Hemostasis

Potential pharmacologic interaction (increased risk of bleeding) with concomitant use of drugs that affect hemostasis.1 83 289 311 312 Use with caution.1 (See Abnormal Bleeding under Cautions.)

Protein-bound Drugs

Potential for displacement of sertraline or other protein-bound drugs from binding sites.1 Monitor patients for potential adverse effects.1

Drugs Associated with Serotonin Syndrome

Potential pharmacologic interaction (potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions) with serotonergic agents.173 174 175 176 177 189 207 323 601 Avoid such use, or use with caution.179 198 323 601 (See Contraindications and see Serotonin Syndrome or Neuroleptic Malignant Syndrome [NMS]-like Reactions under Cautions.) If serotonin syndrome or NMS occurs, immediately discontinue sertraline and any concurrently administered serotonergic or antidopaminergic agents and initiate supportive and symptomatic treatment.601

Specific Drugs

Drug

Interaction

Comments

Alcohol

Does not potentiate cognitive and motor effects of alcohol1 3 19 34 35 83 146

Concomitant use not recommended1

Antiarrhythmic agents (e.g., encainide, flecainide, propafenone)

Potential for increased plasma antiarrhythmic concentrations; may result in increased risk of serious, potentially fatal, adverse cardiac effects (e.g., cardiac arrhythmias)1 100

Adjust dosages as needed1

Antidepressants, other SSRIs (e.g., citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine) or SNRIs (e.g., desvenlafaxine, duloxetine, milnacipran, venlafaxine)

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions601

Concomitant use not recommended601

Antidepressants, tricyclic (TCAs) (e.g., desipramine, imipramine)

Decreased TCA metabolism1 186

Monitor plasma TCA concentrations and adjust dosage as needed1

Antipsychotic agents

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions350 601

Clozapine: Increased plasma clozapine concentrations278

Pimozide: Increased plasma pimozide concentrations; risk of QT prolongation1 322

Thioridazine: Increased plasma thioridazine concentrations; risk of serious, potentially fatal, adverse cardiac effects (e.g., cardiac arrhythmias)269

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

Clozapine: Monitor closely; consider reduction in clozapine dosage278

Pimozide: Concomitant use contraindicated1 322

Thioridazine: Concomitant use not recommended269

Atenolol

β-adrenergic blocking activity not affected by sertraline1 83 84

Benzodiazepines (e.g., diazepam)

Decreased diazepam clearance1 136

Carbamazepine

Pharmacokinetic interaction unlikely1

Cimetidine

Increased AUC, peak concentration, and elimination half-life of sertraline1

Cisapride

Increased cisapride metabolism1

Clinical importance unlikely 1

Digoxin

No change in digoxin pharmacokinetics1 83 172

Disulfiram or other agents likely to produce disulfiram-like reactions (e.g., metronidazole)

Possible disulfiram reaction due to alcohol content in sertraline oral concentrate solution1

Concomitant use with sertraline oral concentrate contraindicated1

Dopamine antagonists

Potentially life-threatening serotonin syndrome or NMS-like reactions350 601

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

5-HT1 receptor agonists (triptans; e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan)

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions174 240 323 601

Observe carefully if used concomitantly, particularly during treatment initiation, dosage increases, or when another serotonergic agent is initiated323 601

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

Isoniazid

Potentially life-threatening serotonin syndrome204

Linezolid

Potentially serious, sometimes fatal serotonin syndrome324 325 342 364 365 366 367 368 369 601

Do not use concurrently;324 consider availability of alternative anti-infectives and weigh benefit of linezolid against risk of serotonin syndrome324

If emergency use of linezolid is considered necessary, immediately discontinue sertraline; monitor closely for symptoms of CNS toxicity for 2 weeks or until 24 hours after the last linezolid dose, whichever comes first324

If nonemergency use of linezolid is planned, withhold sertraline for at least 2 weeks prior to initiating linezolid;324 sertraline may be resumed 24 hours after last linezolid dose324

Do not initiate sertraline in patients receiving linezolid; when necessary, initiate 24 hours after last linezolid dose324

Lithium

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions1 174 175 177

Pharmacokinetic interaction unlikely1

Use with caution1

Monitor serum lithium concentrations; adjust dosage accordingly1

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

MAO inhibitors (e.g., moclobemide [not commercially available in the US], selegiline)

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions1 174 177 189 192 208

Concomitant use contraindicated1

Allow at least 2 weeks to elapse between discontinuance of MAO inhibitor and initiation of sertraline and vice versa1 189 207

Methylene blue

Increased risk of serotonin syndrome370 371

Generally avoid concurrent use370

In emergencies necessitating immediate use of methylene blue, consider availability of alternative interventions and weigh benefits of methylene blue against risk of serotonin syndrome370

If emergency use of methylene blue is considered necessary, immediately discontinue sertraline and monitor closely for symptoms of CNS toxicity for 2 weeks or until 24 hours after last methylene blue dose, whichever comes first370

If nonemergency use of methylene blue is planned, withhold sertraline for at least 2 weeks prior to administering methylene blue;370 sertraline may be resumed 24 hours after last methylene blue dose370

Do not initiate sertraline in patient receiving methylene blue; when necessary, initiate 24 hours after last methylene blue dose370

NSAIAs (e.g., aspirin)

Increased risk of bleeding1 289 311 312

Use with caution1

Phenytoin

No change in phenytoin pharmacokinetics or pharmacodynamics observed in one study1 135

However, potential increase in plasma phenytoin concentrations and subsequent toxicity reported with sertraline and other SSRIs336

Decreased plasma sertraline concentrations reported during concurrent phenytoin therapy337

Monitor plasma phenytoin concentrations and adjust phenytoin dosage as necessary, particularly in patients with multiple medical conditions and/or those receiving multiple medications concomitantly 1 336

Propranolol

Pharmacokinetic interaction unlikely1 83

Sibutramine (no longer commercially available in US)

Potentially life-threatening serotonin syndrome or NMS-like reactions177 196 323 330 331

Use with caution323 348 356

St. John's Wort (Hypericum perforatum)

Potentially life-threatening serotonin syndrome or NMS-like reactions601

Avoid concomitant use, or use with caution601

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

Tolbutamide

Decreased tolbutamide clearance1 138

Clinical importance unknown1

Tramadol

Potentially life-threatening serotonin syndrome or NMS-like reactions601

Use concomitantly with caution601

If serotonin syndrome or NMS signs and symptoms occur, immediately discontinue sertraline and any concurrently administered antidopaminergic or serotonergic agents; initiate supportive and symptomatic treatment601

Tryptophan and other serotonin precursors

Potentially serious, sometimes fatal serotonin syndrome or NMS-like reactions601

Concomitant use not recommended601

Valproic acid

Possible interaction not systematically evaluated1

Monitor plasma valproate concentrations and adjust valproic acid dosage accordingly1

Warfarin

Possible increased PT and risk of bleeding1 83

Use with caution1

Monitor PT whenever sertraline is initiated or discontinued1 83

Zoloft Pharmacokinetics

Absorption

Bioavailability

Oral bioavailability in humans has not been fully elucidated to date,1 4 but ranges from 22–36% in animals.4 95

Commercially available tablets and oral concentrate solution are bioequivalent.1

Food

Food increases the extent of absorption.1 3

Distribution

Extent

Crosses the blood-brain barrier.3

Distributes into breast milk.1 99 216

Plasma Protein Binding

Approximately 98% bound to plasma proteins, principally to albumin and α1-acid glycoprotein.1 3 4 5 95

Elimination

Metabolism

Extensively metabolized, probably in the liver to N-desmethylsertraline and several other metabolites.1 3 5 19 100 225 Apparently metabolized by multiple CYP isoenzymes, with none contributing more than 40% to overall metabolism.358

N-Desmethylsertraline is approximately 5–10 times less potent an inhibitor of serotonin reuptake than sertraline.1 76 100

Elimination Route

Excreted in both urine and feces.1 5

Half-life

Averages approximately 25–26 hours for sertraline and 62–104 hours for N-desmethylsertraline.1 3 5

Special Populations

Because sertraline is extensively metabolized by the liver, hepatic impairment can affect the elimination of the drug.1 83 137

No clinically important decreases in sertraline clearance observed in patients with renal impairment.1

Geriatric patients may have reduced sertraline plasma clearance.1

Stability

Storage

Oral

Concentrate Solution or Tablets

25°C (may be exposed to 15–30°C).1

Actions

  • Mechanism of action as an antidepressant is presumed to be linked to potentiation of serotonergic activity in the CNS resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).1 3 19 59 62 75 76 82 88 93

  • Has very weak effects on the reuptake of norepinephrine or dopamine1 3 76 and does not exhibit clinically important anticholinergic, antihistaminic, or adrenergic (α1, α2, β) blocking activity at usual therapeutic dosages.1 3 82 88

Advice to Patients

  • Importance of providing copy of written patient information (medication guide) each time sertraline is dispensed.304 305 310 601 Importance of advising patients to read the patient information before taking sertraline and each time the prescription is filled.601

  • Risk of suicidality; importance of patients, family, and caregivers being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment.304 305 310 601 (See Worsening of Depression and Suicidality Risk under Cautions.)

  • Importance of instructing patients not to take sertraline with an MAO inhibitor or within 14 days of stopping the drug, and vice versa.601

  • Importance of informing patients of potential risk of serotonin syndrome and neuroleptic malignant syndrome (NMS)-like reactions, particularly with concurrent use of sertraline and 5-HT1 receptor agonists (also called triptans), tramadol, tryptophan, other serotonergic agents, or antipsychotic agents.323 601 Importance of immediately contacting clinician if signs and symptoms of these syndromes develop (e.g., agitation, hallucinations, coma, mental status changes, loss of coordination, muscle twitching, fast heart beat, increased or decreased BP, sweating, increased body temperature, muscle rigidity, diarrhea, nausea, vomiting, confusion).323 601

  • Risk of cognitive and motor impairment, importance of exercising caution while operating hazardous machinery, including automobile driving, until patients gain experience with the drug’s effects.601

  • Importance of patients being aware that withdrawal effects may occur when stopping sertraline, especially with abrupt discontinuance of the drug.601

  • Importance of informing patients that if they receive diuretics, or are otherwise volume-depleted, or are elderly, that they may be at greater risk of developing hyponatremia during sertraline therapy.601

  • Risks associated with concomitant use with alcohol; concomitant use not recommended.601

  • Importance of continuing sertraline therapy even if improvement is evident within 1–4 weeks, unless directed otherwise by their clinician.1

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1

  • Importance of advising patients, their families, and caregivers to observe sertraline-treated patients for signs of activation of mania/hypomania.601

  • Importance of diluting oral concentrate solution with appropriate liquid just prior to administration.1

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription (e.g., pimozide, MAO inhibitors) and OTC drugs or herbal supplements, as well as any concomitant illnesses or personal or family history of suicidality or bipolar disorder.601 Importance of advising patients about the risk of bleeding associated with concomitant use of sertraline with aspirin or other NSAIAs, warfarin, or other drugs that affect coagulation.601

  • Importance of informing patients of other important precautionary information.1 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Sertraline Hydrochloride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

For solution, concentrate

20 mg (of sertraline) per mL*

Sertraline Hydrochloride Oral Solution

Zoloft (with calibrated dropper dispenser containing latex rubber)

Pfizer

Tablets, film-coated

25 mg (of sertraline)*

Sertraline Hydrochloride Tablets

Zoloft (scored)

Pfizer

50 mg (of sertraline)*

Sertraline Hydrochloride Tablets

Zoloft (scored)

Pfizer

100 mg (of sertraline)*

Sertraline Hydrochloride Tablets

Zoloft (scored)

Pfizer

150 mg (of sertraline)*

Sertraline Hydrochloride Tablets

Ranbaxy

200 mg (of sertraline)*

Sertraline Hydrochloride Tablets

Ranbaxy

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2014. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Sertraline HCl 100MG Tablets (GREENSTONE): 30/$15.99 or 90/$29.97

Sertraline HCl 20MG/ML Concentrate (GREENSTONE): 60/$62.99 or 180/$165.98

Sertraline HCl 25MG Tablets (CAMBER PHARMACEUTICALS): 30/$19.99 or 90/$35.98

Sertraline HCl 50MG Tablets (CAMBER PHARMACEUTICALS): 30/$12.99 or 60/$25.98

Zoloft 100MG Tablets (PFIZER U.S.): 30/$143.99 or 90/$400.97

Zoloft 20MG/ML Concentrate (PFIZER U.S.): 60/$113.85 or 180/$326.27

Zoloft 25MG Tablets (PFIZER U.S.): 30/$137.99 or 90/$403.98

Zoloft 50MG Tablets (PFIZER U.S.): 30/$134.99 or 90/$391.98

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions February 15, 2013. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

References

1. Pfizer Roerig. Zoloft (sertraline hydrochloride) tablets and oral concentrate prescribing information. New York; 2006 Sep.

2. Roerig, New York, NY: Personal communication.

3. Murdoch D, McTavish D. Sertraline: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depression and obsessive-compulsive disorder. Drugs. 1992; 44:604-24. [PubMed 1281075]

4. Guthrie SK. Sertraline: a new specific serotonin reuptake blocker. DICP. 1991; 25:952-61. [IDIS 285275] [PubMed 1949975]

5. Anon. Sertraline for treatment of depression. Med Lett Drugs Ther. 1992; 34:47-8. [PubMed 1533440]

6. Tucker GJ. Psychiatric disorders in medical practice. In: Wyngaarden JB, Smith LH Jr, Bennett JC. Cecil textbook of medicine. 19th ed. Philadelphia; 1992:2079-90.

7. Laporta M, Chouinard G, Goldbloom D et al. Hypomania induced by sertraline, a new serotonin reuptake inhibitor. Am J Psychiatry. 1987; 144:1513-4. [IDIS 235146] [PubMed 3674240]

8. Mattila MJ, Saarialho-Kere U, Mattila M. Acute effects of sertraline, amitriptyline, and placebo on the psychomotor performance of healthy subjects over 50 years of age. J Clin Psychiatry. 1988; 49(8 Suppl):52-8. [IDIS 246664] [PubMed 3045113]

9. Hindmarch I, Bhatti JZ. Psychopharmacological effects of sertraline in normal, healthy volunteers. Eur J Clin Pharmacol. 1988; 35:221-3. [IDIS 246710] [PubMed 3191944]

10. Cohn CK, Shrivastava R, Mendels J et al. Double-blind, multicenter comparison of sertraline and amitriptyline in elderly depressed patients. J Clin Psychiatry. 1990; 51(12 Suppl B):28-33. [IDIS 276047] [PubMed 2258379]

11. Reimherr FW, Chouinard G, Cohn CK et al. Antidepressant efficacy of sertraline: a double-blind, placebo- and amitriptyline-controlled, multicenter comparison study in outpatients with major depression. J Clin Psychiatry. 1990; 51(12 Suppl B):18-27. [IDIS 276046] [PubMed 2258378]

12. Doogan DP. Toleration and safety of sertraline: experience worldwide. Int Clin Psychopharmacol. 1991; 6(Suppl 2):47-56. [PubMed 1806630]

13. Gales BJ, Gales MA. Erythema multiforme and angioedema with indapamide and sertraline. Am J Hosp Pharm. 1994; 51:118-9. [IDIS 323704] [PubMed 8135249]

14. Shihabuddin L, Rapport D. Sertraline and extrapyramidal side effects. Am J Psychiatry. 1994; 151:288. [IDIS 325218] [PubMed 8296906]

15. Bronzo MR, Stahl SM. Galactorrhea induced by sertraline. Am J Psychiatry. 1993; 150:1269-70. [IDIS 318140] [PubMed 8093119]

16. Iruela LM. Sudden chest pain with sertraline. Lancet. 1994; 343:1106. [IDIS 330003] [PubMed 7909131]

17. Anon. Epileptics, antidepressants and seizures. Int Drug Ther Newsl. 1993; 28(1):1-3.

18. Hall MJ. Breast tenderness and enlargement induced by sertraline. Am J Psychiatry. 1994; 151:1395-6. [IDIS 334966] [PubMed 8067502]

19. Doogan DP, Caillard V. Sertraline: a new antidepressant. J Clin Psychiatry. 1988; 49(8 Suppl):46-51. [IDIS 246663] [PubMed 2842321]

20. Jenike MA, Baer L, Summergrad P et al. Sertraline in obsessive-compulsive disorder: a double-blind comparison with placebo. Am J Psychiatry. 1990; 147:923-8. [IDIS 269577] [PubMed 2192564]

21. Klee B, Kronig MH. Case report of probable sertraline-induced akathisia. Am J Psychiatry. 1993; 150:986-7. [IDIS 314769] [PubMed 8494087]

22. Gupta S, Freimer M, Popli A. Paradoxical sedation with sertraline. Am J Psychiatry. 1993; 150:1427-8. [IDIS 319637] [PubMed 8352358]

23. Crews JR, Potts NLS, Schreiber J et al. Hyponatremia in a patient treated with sertraline. Am J Psychiatry. 1993; 150:1564. [IDIS 321770] [PubMed 8379571]

24. Caracci G. Unsuccessful suicide attempt by sertraline overdose. Am J Psychiatry. 1994; 151:147. [IDIS 323845] [PubMed 8267114]

25. Zinner SH. Panic attacks precipitated by sertraline. Am J Psychiatry. 1994; 151:147-8. [IDIS 323846] [PubMed 8267115]

26. Opler LA. Sertraline and akathisia. Am J Psychiatry. 1994; 151:620-1. [IDIS 328010] [PubMed 8147471]

27. Doshi D, Borison R. Association of transient SIADH with sertraline. Am J Psychiatry. 1994; 151:779-80. [IDIS 329222] [PubMed 8166325]

28. Ghaziuddin M. Mania induced by sertraline in a prepubertal child. Am J Psychiatry. 1994; 151:944. [IDIS 330434] [PubMed 8185011]

29. Chouinard G, Goodman W, Greist J et al. Results of a double-blind placebo controlled trial of a new serotonin uptake inhibitor, sertraline, in the treatment of obsessive-compulsive disorder. Psychopharmacol Bull. 1990; 26:279-84. [PubMed 2274626]

30. LaPorta LD. Sertraline-induced akathisia. J Clin Psychopharmacol. 1993; 13:219-20. [IDIS 315642] [PubMed 8354739]

31. Settle EC Jr. Akathisia and sertraline. J Clin Psychiatry. 1993; 54:321. [IDIS 319740] [PubMed 8253701]

32. Ellison JM, Stanziani P. SSRI-associated nocturnal bruxism in four patients. J Clin Psychiatry. 1993; 54:432-4. [IDIS 323510] [PubMed 8270587]

33. Doogan DP, Caillard V. Sertraline in the prevention of depression. Br J Psychiatry. 1992; 160:217-22. [PubMed 1540762]

34. Grimsley SR, Jann MW. Paroxetine, sertraline, and fluvoxamine: new selective serotonin reuptake inhibitors. Clin Pharm. 1992; 11:930-57. [IDIS 303853] [PubMed 1464219]

35. Ayd FJ. Sertraline: the latest FDA-approved serotonin uptake inhibitor antidepressant. Int Drug Ther Newsl. 1992; 27:9-12.

36. Choo V. Paroxetine and extrapyramidal reactions. Lancet. 1993; 341:624. [PubMed 8094844]

37. Guy S, Silke B. The electrocardiogram as a tool for therapeutic monitoring: a critical analysis. J Clin Psychiatry. 1990; 51:37-9. [IDIS 276049] [PubMed 2258381]

38. Fisch C. Effects of sertraline on the ECG in non-elderly and elderly patients with major depression Biol Psychiatry. 1991; 29:353S. Abstract.

39. Goddard C, Paton C. Hyponatremia associated with paroxetine. BMJ. 1992; 305:1332. [IDIS 307374] [PubMed 1483080]

40. Chua TP, Vong SK. Hyponatraemia associated with paroxetine. BMJ. 1993; 306:143. [IDIS 308078] [PubMed 8435627]

41. Chua TP, Vong SK. Paroxetine and hyponatraemia. Br J Clin Pract. 1994; 48:49. [IDIS 325386] [PubMed 8179984]

42. Berh CA, Doogan DP. Sudden chest pain with sertraline. Lancet. 1994; 343:1510-1. [IDIS 330928] [PubMed 7911215]

43. Dista Products Company. Prozac (fluoxetine hydrochloride) prescribing information. Indianapolis, IN; 1999 Mar.

44. Teicher MH, Glod C, Cole JO. Emergence of intense suicidal preoccupation during fluoxetine treatment. Am J Psychiatry. 1990; 147:207-10. [IDIS 262670] [PubMed 2301661]

45. Masand P, Gupta S, Dewan M. Suicidal ideation related to fluoxetine treatment. N Engl J Med. 1991; 324:420. [IDIS 277090] [PubMed 1987466]

46. Anon. In defense of fluoxetine. Int Drug Ther News. 1990; 25:29-30.

47. Teicher MH, Glod CA, Cole JO. Discussion of fluoxetine and suicidal tendencies. Am J Psychiatry. 1990; 147:1572. [PubMed 2221177]

48. Dista Products Company. Dear doctor letter regarding possible relationship between therapy with Prozac and suicidal ideation. Indianapolis, IN: Eli Lilly and Company; 1990 Sep 7.

49. Miller RA. Discussion of fluoxetine and suicidal tendencies. Am J Psychiatry. 1990; 147:1571. [IDIS 273455] [PubMed 2221176]

50. Tollefson GD. Fluoxetine and suicidal ideation. Am J Psychiatry. 1990; 147:1691-2. [IDIS 275575] [PubMed 2244652]

51. Teicher MH, Glod CA, Cole JO. Fluoxetine and suicidal ideation. Am J Psychiatry. 1990; 147:1692-3.

52. FDA Press Office. Talk paper: FDA denies Scientology petition against Prozac. [T91-46.] Rockville, MD: Food and Drug Administration; 1991 Aug 1.

53. Wolfe SM, Hellander I. Citizen’s petition for revision of fluoxetine (Prozac) labeling to Dr. David Kessler, Commissioner, Food and Drug Administration. Washington, DC: Public Citizen; 1991 May 23.

54. Anon. No “credible evidence” to conclude that Lilly’s Prozac or other anti-depressants cause or intensify suicidality, FDA advisory committee determines. FDA Rep Prescrip OTC Pharmaceut. 1991; 53(Sep 23):3-4.

55. Teicher MH, Glod CA, Cole JO. Preoccupation with suicide in patients treated with fluoxetine. Am J Psychiatry. 1991; 148:1091-2. [IDIS 285633] [PubMed 1898490]

56. Hoover CE. Suicidal ideation not associated with fluoxetine. Am J Psychiatry. 1991; 148:543-4. [IDIS 279721] [PubMed 2006704]

57. Teicher MH, Glod CA, Cole JO. Fluoxetine and preoccupation with suicide. Am J Psychiatry. 1991; 148:1260-2.

58. McGrath BJ, Stoukides CA. Fluoxetine and suicidal ideation. DICP. 1991; 25:607-9. [IDIS 281943] [PubMed 1877271]

59. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry. 2000; 150(Suppl 4):1-45.

60. Pfizer Pharmaceuticals, New York; Personal communication.

62. Anon. Drugs for psychiatric disorders. Med Lett Drugs Ther. 1994; 36:89-96. [PubMed 7935156]

63. Louie AK, Lannon RA, Ajari LT. Withdrawal reaction after sertraline discontinuation. Am J Psychiatry. 1994; 151:450-1.

64. Anon. Sertraline and chest pain. Int Drug Ther Newsl. 1994; 29:31.

65. Anon. Sertraline and chest pain. Int Drug Ther Newsl. 1994; 29:38-9.

66. Krivy J, Wiener J. Sertraline and platelet counts in idiopathic thrombocytopenia purpura. Lancet. 1995; 345:132. [IDIS 341322] [PubMed 7815874]

67. Wise TN. Sertraline as a treatment for premature ejaculation. J Clin Psychiatry. 1994; 55:417. [IDIS 338337] [PubMed 7929026]

68. Barrett J. Anisocoria associated with selective serotonin reuptake inhibitors. BMJ. 1994; 309:1620. [IDIS 340042] [PubMed 7819940]

69. Llorente MD, Gorelick M, Silverman MA. Sertraline as the cause of inappropriate antidiuretic hormone secretion. J Clin Psychiatry. 1994; 55:543-4. [IDIS 341208] [PubMed 7814351]

70. Altshuler LL, Pierre JM, Wishing WC et al. Sertraline and akathisia. J Clin Psychopharmacol. 1994; 14:278-9. [IDIS 333003] [PubMed 7962686]

71. McCall WV. Sertraline-induced stuttering. J Clin Psychiatry. 1994; 55:316-7. [IDIS 335017] [PubMed 8071298]

72. Friedman EH. Fluoxetine and stuttering. J Clin Psychiatry. 1990; 51:310. [IDIS 330705] [PubMed 2365670]

73. Markel H, Lee A, Holmes RD et al. LSD flashback syndrome exacerbated by selective serotonin reuptake inhibitor antidepressants in adolescents. J Pediatr. 1994; 125:817-9. [IDIS 337830] [PubMed 7965440]

74. Pigott TA. OCD: where the serotonin selectivity story begins. J Clin Psychiatr. 1996; 57(Suppl. 6):11-20.

75. Koe BK, Weissman A, Welch WM et al. Sertraline, 1S,4S-N-Methyl-4-(3,4-dichlorophenyl-1,2,3,4-tetrahydro-1-naphthylam ine, a new uptake inhibitor with selectivity for serotonin. J Pharmacol Exp Ther. 1983; 226:686-700. [PubMed 6310078]

76. Heym J, Koe BK. Pharmacology of sertraline. J Clin Psychiatr. 1988; 49(Suppl.):40-45.

77. Saletu B, Gr(nberger J, Linzmayer L. On central effects of serotonin re-uptake inhibitors: quantitative EEG and psychometric studies with sertraline and zimelidine. J Neural Transm. 1986; 67:3-4,241-266.

78. Saletu B, Gr(nberger J. Drug profiling by computed electroencephalography and brain maps, with special consideration of sertraline and its psychometric effects. J Clin Psychiatry. 1988; 49(Suppl.):59-71. [IDIS 246665] [PubMed 2970456]

79. Kasper S, Fuger J, M(ller HJ. Comparative efficacy of antidepressants. Drugs. 1992; 43(Suppl. 2):11-22; discussion 22-3.

80. Ross RJ, Ball WA, Gresch PJ et al. REM sleep suppression by monoamine reuptake blockade: development of tolerance with repeated drug administration. Biol Psychiatry. 1990; 28:231-239. [PubMed 2165825]

81. Harel Z, Biro FM, Tedford WL. Effects of long term treatment with sertraline (Zoloft) simulating hypothyroidism in an adolescent. J Adolesc Health. 1995; 16:232-234. [PubMed 7779834]

82. Pfizer Roerig Pratt Pharmaceuticals. Zoloft (sertraline hydrochloride scored tablets product monograph. 1992 Feb.

83. Warrington SJ. Clinical implications of the pharmacology of sertraline. Int Clin Psychopharmacol. 1991; 6(Suppl. 2):11-21. [PubMed 1806626]

84. Ziegler MG, Wilner KD. Sertraline does not alter the beta-adrenergic blocking activity of atenolol in healthy male volunteers. J Clin Psychiatr. 1996; 57(Suppl. 1):12-15.

85. Fuller RW. Serotonin uptake inhibitors: uses in clinical therapy and in laboratory research. Prog Drug Res. 1995; 45:167-204.

86. Myers RD, Quarfordt SD. Alcohol drinking attenuated by sertraline in rats with 6-OHDA or 5,7-DHT lesions of N. accumbens: a caloric response. Pharmacol Biochem Behav. 1991; 40:923-8.

87. Gill K, Amit Z, Koe BK. Treatment with sertraline, a new serotonin uptake inhibitor, reduces voluntary ethanol consumption in rats. Alcohol. 1988; 5:349-54.

88. Koe BK. Preclinical pharmacology of sertraline: a potent and specific inhibitor of serotonin reuptake. J Clin Psychiatry. 1990; 51(Suppl. B):13-7. [PubMed 2175308]

89. Sanders-Bush E, Breeding M, Knoth K et al. Sertraline-induced desensitization of the serotonin 5HT-2m receptor tranmembrane signaling system. Psychopharmacol (Berlin). 1989; 99:1,64-9.

90. Garattini S. An update on the pharmacology of serotoninergic appetite-suppressive drugs. Int J Obes Relat Metab Disord. 1992; 16(Suppl. 4):S41-8.

91. Leonard BE. Pharmacological differences of serotonin reuptake inhibitors and possible clinical relevance. Drugs. 1992; 43(Suppl. 2):3-10. [PubMed 1378371]

92. Simansky KJ. Serotonergic control of the organization of feeding and satiety. Behav Brain Res. 1996; 73:1-2,37-42. [PubMed 8788468]

93. Doogan DP, Caillard V. Sertraline: a new antidepressant. J Clin Psychiatry. 1988; 49(Suppl.):46-51. [IDIS 246663] [PubMed 2842321]

94. O’Donnell JM, Grealy M. Neuroendocrine response to clonidine and 8-OH-DPAT in rats following chronic administration of desipramine or sertraline. Br J Pharmacol. 1992; 105:863-868. [PubMed 1387021]

95. Tremaine LM, Stroh JG, Ronfeld RA. Metabolism and disposition of the 5-hydroxytryptamine uptake blocker sertraline in the rat and dog. Drug Metab Dispos. 1989; 17:542-550. [PubMed 2573498]

96. McCowen KC, Garber JR, Spark R. Elevated serum thyrotropin in thyroxine-treated patients with hypothyroidism given sertraline. New Engl J Med. 1997; 337:1010-1011. [IDIS 392016] [PubMed 9312673]

97. Clary CM, Harrison WM. Elevated serum thyrotropin in thyroxine-treated patients with hypothyroidism given sertraline. New Engl J Med. 1997; 337:1011. [IDIS 392017] [PubMed 9312674]

98. Kaminski CA, Robbins MS, Weibley RE. Sertraline intoxication in a child. Ann Emerg Med. 1994; 23:1371-4. [IDIS 330839] [PubMed 8198316]

99. Altshuler LL, Burt VK, McMullen et al. Breastfeeding and sertraline: a 24-hour analysis. J Clin Psychiatry. 1995; 56:243-245. [IDIS 348974] [PubMed 7775366]

100. Preskorn SH. Clinically relevant pharmacology of selective serotonin reuptake inhibitors: an overview with emphasis on pharmacokinetics and effects on oxidative drug metabolism. Clin Pharmacokinet. 1997; 32(Suppl. 1):1-21. [PubMed 9068931]

101. Joblin M. Possible interaction of sertraline with carbamazepine. New Zealand Medical Journal. 1994; 107:43. [IDIS 325658] [PubMed 8043067]

102. Kavoussi RJ, Liu J, Coccaro EF. An open trial of sertraline in personality disordered patient with impulsive aggression. J Clin Psychiatry. 1994; 55:137-141. [IDIS 329463] [PubMed 8071257]

103. Brown DF, Kerr HD. Sertraline overdose. Ann Pharmacother. 1994; 28:1307. [IDIS 339216] [PubMed 7849356]

104. Stock AJ, Kofoed L. Therapeutic interchange of fluoxetine and sertraline: experience in the clinical setting. Am J Hosp Pharm. 1994; 51:2279-2281. [PubMed 7801990]

105. Schleis T. Realities of the fluoxetine-to-sertraline switch. Am J Health-Syst Pharm. 1995; 52:423. [IDIS 342146] [PubMed 7757876]

108. Lazowick AL, Levin GM. Potential withdrawal syndrome associated with SSRI discontinuation. Ann Pharmacother. 1995; 29:1284-5. [IDIS 357519] [PubMed 8672834]

110. Frost L, Lal S. Shock-like sensations after discontinuance of SSRIs. Am J Psychiatry. 1995; 152:810. [IDIS 346934] [PubMed 7726327]

111. Rosenblatt JE, Rosenblatt NC. How long a hiatus between discontinuing fluoxetine and beginning sertraline? Curr Affect Illness. 1992; 11(8):2. Abstract.

113. Katzelnick DJ, Kobak KA, Griest JH et al. Sertraline for social phobia: a double-blind, placebo-controlled crossover study. Am J Psychiatry. 1995; 152:1368-71. [IDIS 353718] [PubMed 7653696]

118. American Psychiatric Association. DSM-IV™: diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994:394-403,411-29,715-8.

119. Reviewers’ comments (personal observations) on clomipramine 28:16.04.

120. Munjack DJ, Flowers C, Eagan TV. Sertraline in social phobia. Anxiety. 1994-1995; 1:196-8.

121. Van Ameringen M. Sertraline in social phobia. J Affect Disord. 1994; 31:141-5. [PubMed 8071477]

122. Jefferson JW. Social phobia: a pharmacological treatment overview. J Clin Psychiatry. 1995; 56(Suppl. 5):18-24. [IDIS 349662] [PubMed 7782272]

123. Fisch C, Knoebel SB. Electrocardiographic findings in sertraline depression trials. Drug Invest. 1992; 4:305-12.

124. Makela EH, Sullivan P, Taylor M. Sertraline and speech blockage. J Clin Psychopharmacol. 1994; 14:432-3. [IDIS 340031] [PubMed 7884029]

125. Liu BA, Mittmann N, Knowles SR et al. Hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone associated with the use of selective serotonin reuptake inhibitors: a review of spontaneous reports. CMAJ. 1996; 155:519-27. [IDIS 371725] [PubMed 8804257]

126. Bradley ME, Foote EF, Lee EN et al. Sertraline-associated syndrome of inapproproate antidiuretic hormone: case report and review of the literature. Pharmacotherapy. 1996; 16:680-3. [IDIS 370978] [PubMed 8840376]

127. Goldstein L, Barker M, Segall F et al. Seizure and transient SIADH associated with sertraline. Am J Psychiatry. 1996; 153:732. [IDIS 368977] [PubMed 8615425]

128. Kessler J, Samuels SC. Sertraline and hyponatremia. New Engl J Med. 1996; 335:524. [IDIS 370059] [PubMed 8676965]

129. Bouman WP, Johnson H, Trescoli-Serrano C et al. Recurrent hyponatremia associated with sertraline and lofepramine. Am J Psychiatry. 1997; 154:580. [IDIS 384231] [PubMed 9090354]

130. Anonymous. Selective serotonin reuptake inhibitors and SIADH: Adverse Drug Reactions Advisory Committee. Med J Austr. 1996; 164:562.

131. Thornton SL, Resch DS. SIADH associated with sertraline therapy. Am J Psychiatry. 1995; 152:809. [IDIS 346932] [PubMed 7726325]

132. Bluff DD, Oji N. SIADH in a patient receiving sertraline. Ann Intern Med. 1995; 123:811. [IDIS 356257] [PubMed 7574211]

133. Jackson C, Carson W, Markowitz J et al. SIADH associated with fluoxetine and sertraline therapy. Am J Psychiatry. 1995; 123:811.

134. DeVane CL, Gill HS, Markowitz JS et al. Awareness of potential drug interactions may aid avoidance. Ther Drug Monit. 1997; 19:366-7. [IDIS 394375] [PubMed 9200782]

135. Rapeport WG, Muirhead DC, Williams SA et al. Absence of effect of sertraline on the pharmacokinetics and pharmacodynamics of phenytoin. J Clin Psychiatry. 1996; 57(Suppl. 1):24-8. [IDIS 366736] [PubMed 8617708]

136. Gardner MJ, Baris BA, Wilner KD et al. Effect of sertraline on the pharmacokinetics and protein binding of diazepam in healthy volunteers. Clin Pharmacokinet. 1997; 32(Suppl. 1):43-9. [PubMed 9068935]

137. Demolis JL, Angebaud P, Grange JD et al. Influence of liver cirrhosis on sertraline pharmacokinetics. Br J Clin Pharmacol. 1996; 42:394-7. [IDIS 373423] [PubMed 8877033]

138. Tremaine LM, Wilner KD, Preskorn SH. A study of the potential effect of sertraline on the pharmacokinetics and protein binding of tolbutamide. Clin Pharmacokinet. 1997; 32(Suppl. 1):31-6. [PubMed 9068933]

139. Brady KT, Sonne SC, Roberts JM. Sertraline treatment of comorbid posttraumatic stress disorder and alcohol dependence. J Clin Psychiatry. 1995; 56:502-5. [IDIS 358475] [PubMed 7592501]

140. Yonkers KA, Halbreich U, Freeman E et al. Symptomatic improvement of premenstrual dysphoric disorder with sertraline treatment: a randomized controlled trial. JAMA. 1997; 278:983-8. [IDIS 391778] [PubMed 9307345]

141. Montgomery SA, Doogan DP, Burnside R. The influence of different relapse criteria on the assessment of long-term efficacy of sertraline. Int Clin Psychopharmacol. 1991; 6(Suppl. 2):37-46. [PubMed 1806629]

142. Franchini L, Gasperini M, Perez J et al. A double-blind study of long-term treatment with sertraline or fluvoxamine for prevention of highly recurrent unipolar depression. J Clin Psychiatry. 1997; 58:104-7. [IDIS 384090] [PubMed 9108811]

143. Montgomery SA. Efficacy in long-term treatment of depression. J Clin Psychiatry. 1996; 57(Suppl. 2):24-30. [IDIS 367836] [PubMed 8626360]

144. Montgomery SA. Long-term managment of obsessive-compulsive disorder. Int Clin Psychopharmacol. 1996; 11(Suppl. 5):23-9. [PubMed 9032001]

145. Greist JH, Jefferson JW, Kobak KA et al. A 1 year double-blind placebo controlled fixed dose study of sertraline in the treatment of obsessive-compulsive disorder. Int Clin Psychopharmacol. 1995; 10:57-65. [PubMed 7673657]

146. Hindmarch I, Shillingford J, Shillingford C. The effects of sertralinie on psychomotor perforamce in elderly volunteers. J Clin Psychiatry. 1990; 51(Suppl. B):34-36. [IDIS 276048] [PubMed 2258380]

147. Small GW, Rabins PV, Barry PB et al. Diagnosis and treatment of Alzheimer disease and related disorders: consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer’s Association, and the American Geriatrics Society. JAMA. 1997; 278:1363-1371. [IDIS 393115] [PubMed 9343469]

148. Aguglia E, Cassacchia M, Cassano GB et al. Double-blind study of the efficacy and safety of sertraline versus fluoxetine in major depression. Int Clin Psychopharmacol. 1993; 8:197-202. [PubMed 8263318]

149. Feiger A, Kiev A, Shrivastava RK et al. Nefazodone versus sertraline in outpatients with major depression: focus on efficacy, tolerability, and effects on sexual function and satisfaction. J Clin Psychiatry. 1996; 57(Suppl. 2):53-62. [IDIS 367840] [PubMed 8626364]

150. Bennie EH, Mullin JM, Martindale JJ. A double-blind multicenter trial comparing sertraline and fluoxetine in outpatients with major depression. J Clin Psychiatry. 1995; 56:229-237. [IDIS 348972] [PubMed 7775364]

151. Fabre LF, Abuzzahab FS, Amin M et al. Sertraline safety and efficacy in major depression: a double-blind fixed dose comparison with placebo. Biol Psychiatry. 1995; 38:592-602. [PubMed 8573661]

152. Lapierre YD. Controlling acute episodes of depression. Int Clin Psychopharmacol. 1991; 6(Suppl. 2):23-35. [PubMed 1806627]

153. Fava M, Nierenberg AA, Quitkin FM et al. A preliminary study on the efficacy of sertraline and imipramine on anger attacks in atypical depression and dysthymia. Psychopharmacol Bull. 1997; 33:101-103. [PubMed 9133758]

154. Thase ME, Fava M, Halbreich U et al. A placebo-controlled, randomized clinical trial comparing sertraline and imipramine for the treatment of dysthymia. Arch Gen Psychiatry. 1996; 53:777-784. [IDIS 373032] [PubMed 8792754]

155. Rabkin JG, Wagner G, Rabkin R. Effects of sertraline on mood and immune status in patients with major depression and HIV illness: an open trial. J Clin Psychiatry. 1994; 55:433-439. [IDIS 380019] [PubMed 7961520]

156. Chouinard G. Sertraline in the treatment of obsessive compulsive disorder: two double-blind, placebo-controlled studies. Int Clin Psychopharmacol. 1992; 7(Suppl. 2):37-41. [PubMed 1484177]

157. Brown WA, Harrison W. Are patients who are intolerant to one SSRI intolerant to another? Psychopharmacol Bull. 1992; 28:253-256.

158. Thompson C. Management of depression in real-life settings: knowledge gained from large-scale clinical trials. Int Clin Psychophamracol. 1994; 9(Suppl. 3):21-25.

159. Doogan DP, Langdon CJ. A double-blind, placebo-controlled comparison of sertraline and dothiepin in the treatment of major depression in general practice. Int Clin Psychopharmacol. 1994; 9:95-100. [PubMed 8057000]

160. Freeman EW, Rickels K, Sondheimer SJ et al. Sertraline versus desipramine in the treatment of premenstrual syndrome: an open-label trial. J Clin Psychiatry. 1996; 57:7-11. [IDIS 360763] [PubMed 8543554]

161. Butler J, Leonard BE. The platelet serotonergic system in depression and following sertraline treatment. Int Clin Psychopharmacol. 1988; 35:343-347.

162. Wernicke JF. The side effect profile and safety of fluoxetine. J Clin Psychiatry. 1985; 46:59-67. [IDIS 197277] [PubMed 3156126]

163. Settle EC Jr, Puzzuoli Settle G. A case of mania associated with fluoxetine. Am J Psychiatry. 1984; 141:280-1. [IDIS 180957] [PubMed 6362443]

164. Bunney WE Jr, Goodwin FK, Murphy DL et al. The “switch process” in manic-depressive illness. II. Relationship to catecholamines, REM sleep, and drugs. Arch Gen Psychiatry. 1974; 27:304-9.

165. Lebegue B. Mania precipitated by fluoxetine. Am J Psychiatry. 1987; 144:1620. [IDIS 237173] [PubMed 3500651]

166. Turner SM, Jacob RG, Beidel DC et al. A second case of mania associated with fluoxetine. Am J Psychiatry. 1985; 142:274-5. [IDIS 195897] [PubMed 3871593]

167. Peet M. Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants. Br J Psychiatry. 1994; 164:549-50. [IDIS 328227] [PubMed 8038948]

168. Chinchilla A, Cebollada A, Vega M et al. Treatment of dysthymia with sertraline. Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1997; 25:3-9. [PubMed 9133155]

169. Kocsis JH, Zisook S, Davidson J et al. Double-blind comparison of sertraline, imipramine, and placebo in the treatment of dysthymia: psychosocial outcomes. Am J Psychiatry. 1997; 154:390-5. [IDIS 383117] [PubMed 9054788]

170. Shelton RC, Davidson J, Yonkers KA et al. The undertreatment of dysthymia. J Clin Psychiatry. 1997; 58:59-65. [IDIS 383349] [PubMed 9062374]

171. Bourgeois JA. Review of clinical use of sertraline by family practice physicians in a small Air Force hospital. Mil Med. 1996; 161:425-7. [IDIS 370118] [PubMed 8754718]

172. Rapeport WG, Coates PE, Dewland PM et al. Absence of a sertraline-mediated effect on digoxin pharmacokinetics and electrocardiographic findings. J Clin Psychiatry. 1996; 57(Suppl. 1):16-9. [IDIS 366734] [PubMed 8617706]

173. Mandalos GE, Szarek BL. Dose-related paranoid reaction associated with fluoxetine. J Nerv Ment Dis. 1990; 178:57-8. [PubMed 2295892]

174. Mills KC. Serotonin syndrome. Am Fam Physician. 1995; 52:1475-82. [IDIS 354648] [PubMed 7572570]

175. Reynolds RD. Serotonin syndrome: what family physicians need to know. Am Fam Physician. 1995; 52:1263-71. [IDIS 354637] [PubMed 7572545]

176. Lappin RI, Auchincloss EL. Treatment of the serotonin syndrome with cyproheptadine. N Engl J Med. 1994; 330:1021-2. [PubMed 8121457]

177. Sporer KA. The serotonin syndrome. Implicated drugs, pathophysiology and management. Drug Saf. 1995; 13:94-104. [PubMed 7576268]

178. Sternbach H. The serotonin syndrome. Am J Psychiatry. 1991; 148:705-13. [IDIS 282914] [PubMed 2035713]

179. Nierenberg DW, Semprebon M. The central nervous system serotonin syndrome. Clin Pharmacol Ther. 1993; 53:84-8. [IDIS 308978] [PubMed 8257462]

180. Brodribb TR, Downey M, Gilbar PJ. Efficacy and adverse effects of moclobemide. Lancet. 1994; 343:475. [IDIS 325641] [PubMed 7905962]

181. Wyeth-Ayerst. Redux (dexfenfluramine hydrochloride) capsules prescribing information. Philadelphia, PA; 1996 April 29.

182. Somerset Pharmaceuticals. Eldepryl (selegiline) tablets prescribing information (dated 1993 Jan). In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995:2430-2.

183. Sternbach H. Danger of MAOI therapy after fluoxetine withdrawal. Lancet. 1988; 2:850-1. [IDIS 246846] [PubMed 2902292]

184. Feighner JP, Boyer WF, Tyler DL et al. Adverse consequences of fluoxetine-MAOI combination. J Clin Psychiatry. 1990; 51:222-5. [IDIS 267347] [PubMed 2347858]

185. Schwenk MH, Verga MA, Wagner JD. Hemodialyzability of sertraline. Clin Nephrol. 1995; 44:121-4. [IDIS 352357] [PubMed 8529300]

186. Kurtz DL, Bergstrom RF, Goldberg MJ et al. The effect of sertraline on the pharmacokinetics of desipramine and imipramine. Clin Pharmacol Ther. 1997; 62:145-56. [IDIS 393499] [PubMed 9284850]

187. Rapeport WG, Williams SA, Muirhead DC et al. Absence of a sertraline-mediated effect on the pharmacokinetics and pharmacodynamics of carbamazepine. J Clin Psychiatry. 1996; 57(Suppl. 1):20-3. [IDIS 366735] [PubMed 8617707]

188. Neuvonen PJ, Pohjola-Sintonen S, Tacke U. Five fatal cases of serotonin syndrome after moclobemide-citalopram or moclobemide-clomipramine overdoses. Lancet. 1993; 342:1419. [IDIS 322746] [PubMed 7901695]

189. Graber MA, Hoehns TB, Perry PJ. Sertraline-phenelzine drug interaction: a serotonin syndrome reaction. Ann Pharmacother. 1994; 28:732-5. [IDIS 332591] [PubMed 7919561]

190. Brannan SK, Talley BJ, Bowden CL. Sertraline and isocarboxazid cause a serotonin syndrome. J Clin Psychopharmacol. 1994; 14:144-5. [IDIS 327530] [PubMed 8195456]

191. Bhatara VS, Bandettini FC. Possible interaction between sertraline and tranylcypromine. Clin Pharm. 1993; 12:222-5. [IDIS 310301] [PubMed 8491079]

192. Coplan JD, Gorman JM. Detectable levels of fluoxetine metabolites after discontinuation: an unexpected serotonin syndrome. Am J Psychiatry. 1993; 150:837. [IDIS 314308] [PubMed 8480837]

193. Beasley CM, Masica DN, Heiligenstein JH et al. Possible monoamine oxidase inhibitor–serotonin uptake inhibitor interaction: fluoxetine clinical data and preclinical findings. J Clin Psychopharmacol. 1993; 13:312-20. [IDIS 320450] [PubMed 8227489]

194. Miller F, Friedman R, Tanenbaum J et al. Disseminated intravascular coagulation and acute myoglobinuric renal failure: A consequence of the serotonin syndrome. J Clin Psychopharmacol. 1991; 11:277-9. [IDIS 286360] [PubMed 1918432]

195. Jermaine DM. Potential fluoxetine-selegiline interaction. Ann Pharmacother. 1992; 26:1300.

196. Somerset Pharmaceuticals. Eldepryl (selegiline) tablets prescribing information (dated 1994 Sep). In: Physicians’ desk reference. 49th ed. Montvale, NJ: Medical Economics Company Inc; 1995(Supp A):A157-8.

197. Chouinard G. Fluoxetine and preoccupation with suicide. Am J Psychiatry. 1991; 148:1258-9. [IDIS 287951] [PubMed 1679300]

198. Kline SS, Mauro LS, Scala-Barnett DM et al. Serotonin syndrome versus neuroleptic malignant syndrome as a cause of death. Clin Pharm. 1989; 8:510-4. [IDIS 257026] [PubMed 2568897]

200. Solvay. Luvox (fluvoxamine maleate) tablets prescribing information (dated 1996 Aug). In: Physicians’ desk reference. 51st ed. Montvale, NJ: Medical Economics Company Inc; 1997:2723-7.

201. SmithKline Beecham. Paxil (paroxetine hydrochloride) tablets and oral suspension prescribing information. Philadelphia, PA; 1999 May.

202. Spigset O, Mjorndal T, Lovhelm O. Serotonin syndrome caused by a moclobemide-clomipramine interaction. BMJ. 1993; 306:248.

203. Blume CD. Dear doctor letter regarding use of Eldepryl. Tampa, FL: Somerset Pharmaceuticals; 1994 Nov 14.

204. Evans ML, Kortas KJ. Potential interaction between isoniazid and selective serotonin reuptake inhibitors. Am J Health-Syst Pharm. 1995; 52:2135-6. [IDIS 354730] [PubMed 8535949]

205. Mathew NT, Tietjen GE, Lucker C. Serotonin syndrome complicating migraine pharmacotherapy. Cephalalgia. 1996; 16:323-7. [PubMed 8869767]

206. Laird LK. Issues in the monopharmacotherapy and polypharmacotherapy of obsessive-compulsive disorder. Psychopharmacol Bull. 1996; 32:569-78. [PubMed 8993077]

207. Steinberg H. Dear doctor letter regarding use of Zoloft (sertraline hydrochloride). New York, New York: Pfizer Inc, U.S. Pharmaceuticals Group; 1995 Aug 1.

208. Price JS, Waller PC, Wood SM. A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms upon withdrawal. Br J Clin Pharmacol. 1996; 42:757-63. [IDIS 378467] [PubMed 8971432]

209. Gupta MA, Gupta AK. Chronic idiopathic urticaria associated with panic disorder: a syndrome responsive to selective serotonin reuptake inhibitor antidepressants. Cutis. 1995; 56:53-4. [PubMed 7555104]

210. Sheehan DV, Harnett-Sheehan K. The role of SSRIs in panic disorder. J Clin Psychiatry. 1996; 57(Suppl. 10):51-8; discussion 59-60. [IDIS 377784] [PubMed 8917132]

211. Sanders-Bush E, Mayer SE. 5-Hydroxytryptamine (serotonin) receptor agonists and antagonists. In: Hardman JG, Limbird LE, Molinoff PB et al, eds. Goodman and Gilman’s the pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill; 1996:249-63.

212. Reviewers’ comments (personal observations) on fluoxetine hydrochloride 28:16.04.

213. Leonard BE. The comparative pharmacology of new antidepressants. J Clin Psychiatry. 1993; 54(Suppl):3-15. [IDIS 320053] [PubMed 8253704]

214. Kupfer DJ, Spiker DG, Coble PA et al. Sleep and treatment prediction in endogenous depression. Am J Psychiatry. 1981; 138:429-34. [IDIS 176783] [PubMed 7212100]

215. Vogel GW, Vogel F, McAbee RS et al. Improvement of depression by REM sleep deprivation: new findings and a theory. Arch Gen Psychiatry. 1980; 37:247-53. [PubMed 7362414]

216. Stowe ZN, Owens MJ, Landry JC et al. Sertraline and desmethylsertraline in human breast milk and nursing infants. Am J Psychiatry. 1997; 154:1255-60. [IDIS 392586] [PubMed 9286185]

217. Balon R. Antidepressants in the treatment of premature ejaculation. J Sex Marital Ther. 1996; 22:85-96. [PubMed 8743620]

218. Mendels J, Camera A, Sikes C. Sertraline treatment for premature ejaculation. J Clin Psychopharmacol. 1995; 15:341-6. [IDIS 354601] [PubMed 8830065]

219. Swartz DA. Sertraline hydrochloride for premature ejaculation. J Urol (Baltimore). 1994; 151(Suppl):345A.

220. Sosin D. Clinical efficacy of fluoxetine vs. sertraline in a headache clinic population. Headache. 1993; 33:284.

221. Solomon GD, Pearson E. Sertraline in the management of headache. Clin Pharmacol Ther. 1994; 55:130.

222. Fouda HG, Ronfeld RA, Weidler DJ. Gas chromatographic-mass spectrometric analysis and preliminary human pharmacokinetics of sertraline, a new antidepressant drug. J Chromatography. 1987; 417:197-202.

223. Carpenter LL, McDougle CJ, Epperson CN et al. A risk-benefit assessment of drugs used in the management of obsessive-compulsive disorder. Drug Saf. 1996; 15:116-34. [PubMed 8884163]

224. Harris MG, Benfield P. Fluoxetine: a review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in older patients with depressive illness. Drugs Aging. 1995; 6:64-84. [PubMed 7696780]

225. Ronfield RA, Shaw GL, Tremaine LM. Distribution and pharmacokinetics of the selective 5-HT uptake blocker sertraline in man, rat and dog. Psychopharmacology. 1988; 96(Suppl):269.

226. Bersani G, Bertolino A, Ciani N et al. Sertraline in the treatment of major depression: an open clinical stratification study in Italian outpatients. Eur Neuropsychopharmacol. 1991; 1:444.

227. Greist JH, Jefferson JW, Kobak KA et al. Efficacy and tolerability of serotonin transport inhibitors in obsessive-compulsive disorder: a meta-analysis. Arch Gen Psychiatry. 1995; 52:53-60. [IDIS 341152] [PubMed 7811162]

228. American Psychiatric Association. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. Am J Psychiatry. 1997; 154(Suppl):1-39.

229. Reviewers’ comments (personal observations).

230. Calhoun, JW. Prolonged bleeding time in a patient treated with sertraline. Am J Psychiatry. 1996; 153:443.

231. Trescoli-Serrano C. Sertraline-induced agranulocytosis. Postgrad Med J. 1996; 72:446. [PubMed 8935613]

232. Mendelson WB, Franko T. Priapism with sertraline and lithium. J Clin Psychopharmacol. 1994; 14:434-5. [IDIS 340033] [PubMed 7884031]

233. Grubb BG, Samoil D, Kosinski D et al. Use of sertraline in the treatment of refractory neurocardiogenic syncope in children and adolescents. Am Coll Cardiol. 1994; 24:490-4.

234. Rasmussen BB, Mäenpää J, Pelkonen O et al. Selective serotonin reuptake inhibitors and theophylline metabolism in human liver microsomes: potent inhibition by fluvoxamine. Br J Clin Pharmac. 1995; 39:151-9.

235. Pfizer, New York, NY: Personal communication.

236. Wolkow R, March JS, Safferrman AZ et al. A placebo-controlled trial of sertraline treatment for pediatric OCD. Paper presented at the Annual Meeting of the American Psychiatric Association, San Diego, CA; 1997 May 17–22. Abstract.

237. Johnston HF. The efficacy of sertraline and behavior therapy in adolescents with treatment resistant OCD. Paper presented at the 146th Annual Meeting of the American Psychiatric Association. San Francisco, CA; 1993 May 23–26. Abstract.

238. Wolkow R, Alderman J, Johnston J et al. Sertraline treatment of children and adolescents with obsessive-compulsive disorder or depression. Paper presented at the World Congress of Psychiatry, Madrid, Spain; 1996 Aug 23–28. Abstract.

239. Preskorn SH, Lane RM. Sertraline 50 mg daily: the optimal dose in the treatment of depression. Int Clin Psychopharmacol. 1995; 10:129-41. [PubMed 8675965]

240. Glaxo Wellcome. Imitrex (sumatriptan succinate) injection prescribing information. Research Triangle Park, NC; 1996 May.

241. Blier P, Bergeron R. The safety of concomitant use of sumatriptan and antidepressant treatments. J Clin Psychopharmacol. 1995; 15:106-9. [IDIS 345845] [PubMed 7782482]

242. Diamond S. The use of sumatriptan in patients on monoamine oxidase inhibitors. Neurology. 1995; 45:1039-40. [IDIS 348476] [PubMed 7783861]

243. Wing Y-K, Clifford EM, Sheehan BD et al. Paroxetine treatment and the prolactin response to sumatriptan. Psychopharmacology. 1996; 124:377-9. [PubMed 8739554]

244. Szabo CP. Fluoxetine and sumatriptan: possibly a counterproductive combination. J Clin Psychiatry. 1995; 56:37-8. [IDIS 342757] [PubMed 7836342]

245. Glaxo Wellcome, Research Triangle Park, NC: Personal communication.

246. Reviewers’ comments (personal observations) on sumatriptan succinate 28:92.

247. Janssen Pharmaceutica. Hismanal (astemizole tablets) prescribing information. Titusville, NJ. 1998 Feb.

248. Klausner MA. Dear doctor letter regarding important drug warning of Hismanal (astemizole). Titusville, NJ: Janssen Pharmaceutica; 1998 Feb.

249. Hoechst Marion Roussel. Seldane-D (terfenadine and pseudoephedrine hydrochloride) extended-release tablets prescribing information. Kansas City, MO; 1997 Sep.

250. Keller MB, Kocsis JH, Thase ME et al. Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. JAMA. 1998; 280:1665-72. [IDIS 414396] [PubMed 9831997]

251. Liu B, Anderson G, Mittmann N et al. Use of selective serotonin-reuptake inhibitors or tricyclic antidepressants and risk of hip fractures in elderly people. Lancet. 1998; 351:1303-7. [IDIS 406796] [PubMed 9643791]

252. Thapa PB, Gideon P, Cost TW et al. Antidepressants and the risk of falls among nursing home residents. New Engl J Med. 1998; 339:875-82. [IDIS 411481] [PubMed 9744971]

253. Ballenger MC, Davison JRT, Lucribier Y et al. Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety. J Clin Psychiatry. 1998; 59(Suppl 8):47-54.

254. National Institutes of Health Office of Medical Applications of Research. NIH consensus statement: diagnosis and treatment of depression in late life. 1991; 9;1-27.

255. Lebowitz BD, Pearson JL, Schneider LS et al. Diagnosis and treatment of depression in late life. Consensus statement update. JAMA. 1997; 278:1186-90. [IDIS 392714] [PubMed 9326481]

256. Davidson JR. The long-term treatment of panic disorder. J Clin Psychiatry. 1998; 59(Suppl. 8):17-21; discussion: 22-3. [IDIS 408262] [PubMed 9707158]

257. Baldwin DS, Birttwwistle J. The side effect burden associated with drug treatment of panic disorder. J Clin Psychiatry. 1998; 59(Suppl. 8):39-44; discussion: 45-6.

258. Gorman JM. The use of newer antidepressants for panic disorder. J Clin Psychiatry. 1997; 58(Suppl. 14):54-8; discussion 59. [IDIS 398618] [PubMed 9418747]

259. Lecrubier Y, Bakker A, Dunbar G et al. A comparison of paroxetine, clomipramine and placebo in the treatment of panic disorder: Collaborative Paroxetine Panic Study Investigators. Acta Psychiatr Scand. 1997; 95:145-52. [PubMed 9065680]

260. Westenberg HG. Developments in the drug treatment of panic disorder: what is the place of the selective serotonin reuptake inhibitors? J Affect Dis. 1996; 40:85-93.

261. deh Boer JA. Pharmacotherapy of panic disorder: differential efficacy from a clinical standpoint. J Clin Psychiatry. 1998; 59:30-6; discussion 37-8.

262. Fava M. New approaches to treatment of refractory depression. J Clin Psychiatry. 2000:61 (Suppl 1):26-32.

263. Nelson JC. Augmentation strategies in depression 2000. J Clin Psychiatry. 2000:61(Suppl 2):13-9.

264. Food and Drug Administration. Psychopharmacologic Drugs Advisory Committee consideration of NDA 19-839(S). Zoloft (sertraline hydrochloride) proposed indication: treatment of PTSD. Rockville, MD; October 1999. From FDA web site.

265. Turner S. Place of pharmacotherapy in post-traumatic stress disorder. Lancet. 1999; 354:1404-5. [IDIS 435452] [PubMed 10543663]

266. The Expert Consensus Panels for PTSD. The expert consensus guideline series: treatment of posttraumatic stress disorder. J Clin Psychiatry. 1999; 60(Suppl 16):3-76.

267. Van Etten ML, Taylor S. Comparative efficacy of treatments for post-traumatic stress disorder: a meta-analysis. Clin Psychol Psychother. 1998; 5:126-44.

268. International Society for Traumatic Stress Studies. Practice guideline for the treatment of post-traumatic stress disorder. Northbrook, IL; March 2000. From the International society for traumatic stress studies website.

269. Novartis Pharmaceuticals. Mellaril (thioridazine hydrochloride) tablets and oral solution and Mellaril-S (thioridazine hydrochloride) oral suspension prescribing information. 2000 June.

270. Brady K, Pearlstein T, Asnis GM et al. Efficacy and safety of sertraline treatment of posttraumatic stress disorder. JAMA. 2000; 283:1837- 44. [IDIS 443532] [PubMed 10770145]

271. Kennedy SH, Eisfeld BS, Dickens SE et al. Antidepressant-induced sexual dysfunction during treatment with moclobemide, paroxetine, sertraline, and venlafaxine. J Clin Psychiatry. 2000;61:276-81.

272. Rosen RC, Lane RM, and Menza M. Effects of SSRIs on sexual function: a critical review. Journal of Clinical Psychopharmacology. 1999; 19:67-85. [IDIS 421736] [PubMed 9934946]

273. Ambrosini PJ. A review of pharmacotherapy of major depression in children and adolescents. Pschiatric Ser. 2000; 51:627-33.

274. Pliszka SR, Greenhill LL, Crismon ML et al. The Texas Children’s Medication Algorithm Project: Report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Attention-deficit/Hyperactivity Disorder. Part II. Tactics. J Am Acad Child Adolesc Psychiatry. 2000; 39:920-7. [IDIS 449215] [PubMed 10892235]

275. Hughes CW, Emslie GJ, Crismon ML et al. The Texas children’s medication algorithm project: report of the Texas Consensus Conference Panel on Medication Treatment of Childhood Major Depressive Disorder. J Am Acad child Adolesc Psychiatry. 1999; 38:1442-54. [IDIS 439422] [PubMed 10560232]

276. American Academy of Child and Adolescent Psychiatry. Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 1998; 37(Suppl 10):63S-83S. [IDIS 415552] [PubMed 9785729]

277. Emslie GJ, Rush J, Weinberg WA et al. A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry. 1997; 54:1031-7. [IDIS 396287] [PubMed 9366660]

278. Novartis. Clozaril (clozapine) tablets prescribing information. East Hanover, NJ; 1999 Sept.

279. Ellingrod VL. Pharmacotherapy of primary obsessive-compulsive disorder: review of the literature. Pharmacotherapy. 1998; 18:936-60. [IDIS 416228] [PubMed 9758307]

280. Griest JH, Jefferson JW. Pharmacotherapy for obsessive-compulsive disorder. Br J Psychiatry. 1998; 35:64-70.

281. Van Ameringen MA, Lane RM, Walker JR et al. Sertraline treatment of generalized social phobia: a 20-week, double-blind, placebo-controlled study. Am J Psychiatry. 2001; 158:275-81. [PubMed 11156811]

282. Walker JR, Van Ameringen MA, Swinson R et al. Prevention of relapse in generalized social phobia: results of a 24-week study in responders to 20 weeks of sertraline treatment. J Clin Psychopharmacol. 2000; 20:636-44. [IDIS 456036] [PubMed 11106135]

283. Anon. FDA statement regarding the anti-depressant Paxil for pediatric population. FDA Talk Paper. Rockville, MD: Food and Drug Administration; 2003 Jun 19. From the FDA website.

284. Anon. Questions and answers on Paxil (paroxetine hydrochloride). Rockville, MD: Food and Drug Administration; 2003 Jun 19. From the FDA website.

285. Calabrese JR, Londborg PD, Shelton MD et al. Citalopram treatment of fluoxetine-intolerant patients. J Clin Psychiatry. 2003; 64:562-7. [IDIS 497988] [PubMed 12755660]

286. Anon. FDA issues public health advisory entitled: Reports of suicidality in pediatric patients being treated with antidepressant medications for major depressive disorder (MDD). FDA Talk Paper. Rockville, MD: Food and Drug Administration; 2003 Oct 27. From the FDA website.

287. Anon. Reports of suicidality in pediatric patients being treated with antidepressant medications for major depressive disorder (MDD). FDA Public Health Advisory. Rockville, MD: Food and Drug Administration; 2003 Oct 27. From the FDA website.

288. Anon. SSRIs safe for children? Med Lett Drugs Ther.2003; 45:53-4.

289. de Abajo FJ, García Rodríguez LA, Montero D. Association between selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: population based case control study. BMJ. 1999; 319:1106-9. [PubMed 10531103]

290. Shuster J. SSRIs and upper gastrointestinal bleeding? Cutaneous reactions to psychotropic drugs; atrial fibrillation and anabolic steroids; accidental olanzapine overdose in a child. Hosp Pharm. 2000; 35:29-30,32.

291. SmithKlineBeecham Pharmaceuticals. Paxil (paroxetine hydrochloride) tablets and oral suspension prescribing information. 2001 Apr.

292. Skop BP, Brown TM. Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors. Psychosomatics. 1996; 37:12-6. [PubMed 8600488]

293. Boettcher M, Peoples J, Proujansky R et al. Rectal bleeding with use of selective serotonin reuptake inhibitors. J Pediatr Gastroenterol. 1999; 29:522.

294. Goldberg RJ. Selective serotonin reuptake inhibitors: infrequent medical adverse effects. Arch Fam Med. 1998; 7:78-84. [PubMed 9443704]

295. Tielens JA. Vitamin C for paroxetine- and fluvoxamine-associated bleeding. Am J Psychiatr. 1997; 154:883-4. [IDIS 386903] [PubMed 9167526]

296. Alderman CP, Seshadri P, Ben Tovim DI. Effects of serotonin reuptake inhibitors on hemostasis. Ann Pharmacother. 1996; 30:1232-4. [IDIS 375311] [PubMed 8913401]

297. Waldinger MD, Zwinderman AH, Olivier B. SSRIs and ejaculation: a double-blind, randomized, fixed-dose study with paroxetine and citalopram. J Clin Psychopharmacol. 2001; 21:556-60. [IDIS 474020] [PubMed 11763001]

298. Montejo AL, Llorca G, Izquierdo JA et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the Study of Psychotropic-Related Sexual Dysfunction. J Clin Psychiatr.2001;62(Suppl 3):10-21.

299. Landen M, Eriksson E, Agren H et al. Effect of buspirone on sexual dysfunction in depressed patients treated with selective serotonin reuptake inhibitors. J Clin Psychopharmacol. 1999; 19:268-71. [IDIS 428398] [PubMed 10350034]

300. Ekselius L, von Knorring L. Effect on sexual function of long-term treatment with selective serotonin reuptake inhibitors in depressed patients treated in primary care. J Clin Psychopharmacol. 2001; 21:154-60. [IDIS 461299] [PubMed 11270911]

301. Nordeng H, Lindemann R, Perminov KV et al. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr. 2001; 90:288-91. [PubMed 11332169]

302. Dahl ML, Olhager E, Ahlner J. Paroxetine withdrawal syndrome in a neonate. Br J Psychiatr. 1997; 171:391-2.

303. Kulin NA, Pastuszak A, Sage SR et al. Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA. 1998; 279:609-10. [IDIS 400524] [PubMed 9486756]

304. Food and Drug Administration. Antidepressant use in children, adolescents, and adults: class revisions to product labeling. Rockville, MD; 2007 May 2. From the FDA web site.

305. Food and Drug Administration. FDA news: FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. Rockville, MD; 2007 May 2. From the FDA web site.

306. Anon. FDA statement on recommendations of the psychopharmacologic drugs and pediatric advisory committees. Rockville, MD; 2004 Sep 16. From the FDA website.

307. American Psychiatric Association (APA). APA responds to FDA’s new warning on antidepressants. Arlington, VA; 2004 Oct. 15. From the APA website.

308. American Academy of Child and Adolescent Psychiatry (AACAP). AACAP responds to the new FDA warnings on pediatric antidepressant medications. Washington, D.C; 2004 Oct 15. From the AACAP website.

309. American Academy of Pediatrics (AAP). Children, antidepressants and a black box warning. Washington, D.C; 2004 Oct. 15. From the AAP website.

310. Food and Drug Administration. Revisions to medication guide: antidepressant medicines, depression and other serious mental illnesses and suicidal thoughts or actions. Rockville, MD; 2007 May 2. From the FDA web site.

311. Dalton SO, Johansen C, Mellemkjaer L et al. Use of selective serotonin reuptake inhibitors and risk of upper gastrointestinal tract bleeding: a population-based cohort study. Arch Intern Med. 2003; 163:59-64.

312. van Walraven C, Mamdani MM, Wells PS et al. Inhibition of serotonin reuptake by antidepressants and upper gastrointestinal bleeding in elderly patients: retrospective cohort study. Br Med J. 2001; 323:655-8.

313. Glassman AH, O’Connor CM, Califf RM et al. and the Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) Group. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002; 288:701-9.

314. Morag I, Batash D, Keidar R et al. Paroxetine use throughout pregnancy: does it pose any risk to the neonate? J Toxicol Clin Toxicol. 2004; 42:97-100.

315. Haddad PM, Pal BR, Clarke P et al. Neonatal symptoms following maternal paroxetine treatment: serotonin toxicity or paroxetine discontinuation syndrome? J Psychopharmacol. 2005; 19:554-7.

316. Moses-Kolko EL, Bogen D, Perel J et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA. 2005; 293:2372-85.

317. Sanz EJ, De-Las-Cuevas C, Kiuru A et al. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet. 2005; 365:482-7.

318. Santos RP, Pergolizzi JJ. Transient neonatal jitteriness due to maternal use of sertraline (Zoloft). J Perinatol. 2004; 24:392-4.

319. Dear healthcare professional letter regarding changing the Pregnancy subsection of the Precautions section in the labels for Paxil (paroxetine HCl) and Paxil (paroxetine HCl) CR. Philadelphia, PA: GlaxoSmithKline; 2005 Sep.

320. Hendrick V, Smith LM, Suri R et al. Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol. 2003; 188:812-5.

321. SmithKlineBeecham Pharmaceuticals. Paxil (paroxetine hydrochloride) tablets and oral suspension prescribing information. 2005 Sep.

322. Gate Pharmaceuticals. Orap (pimozide) tablets prescribing information. 2004 Jun.

323. Food and Drug Administration. Public health advisory: combined use of 5-hydroxytryptamine receptor agonists (triptans), selective serotonin reuptake inhibitors (SSRIs) or selective serotonin/norepinephirne reuptake inhibitors (SNRIs) may result in life-threatening serotonin syndrome. Rockville, MD; 2006 Jul 19. From the FDA website.

324. US Food and Drug Administration. Drug Safety Communication: Serious CNS reactions possible when linezolid (Zyvox) is given to patients taking certain psychiatric medications. 2011 Jul 26. From FDA website.

325. US Food and Drug Administration. Drug Safety Communication: Updated information about the drug interaction between linezolid (Zyvox) and serotonergic psychiatric medications. 2011 Oct 20. From FDA website.

327. Dear healthcare professional letter regarding further revisions to the labels for Paxil (paroxetine HCl) and Paxil (paroxetine HCl) CR in the pregnancy precautions and warnings section. Philadelphia, PA: GlaxoSmithKline; 2005 Dec.

328. Heikkinen T, Ekblad U, Kero P et al. Citalopram in pregnancy and lactation. Clin Pharmacol Ther. 2002; 72:184-91. [IDIS 486091] [PubMed 12189365]

329. Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002:277-81.

330. Benazzi F. Organic hypomania secondary to sibutramine-citalopram interaction. J Clin Psychiatr. 2002; 63:165.

331. Abbott Laboratories. Meridia (sibutramine hydrochloride monohydrate) capsules prescribing information. North Chicago, IL; 2006 Aug.

332. Lowenstein L, Mueller ER, Sharma S et al. Urinary hesitancy and retention during treatment with sertraline. Int Urogynecol J Pelvic Floor Dysfunct. 2006; Nov 7:epub ahead of print.

333. Movig KL, Leufkens HG, Belitser SV et al. Selective serotonin reuptake inhibitor-induced urinary incontinence. Pharmacoepidemiol Drug Saf. 2002; 11:271-9. [PubMed 12138594]

334. Votolato NA, Stern S, Caputo RM. Serotonergic antidepressants and urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2000; 11:386-8. [PubMed 11147747]

335. Apseloff G, Wilner KD, von Deutsch DA et al. Sertraline does not alter steady-state concentrations or renal clearance of lithium in healthy volunteers. J Clin Pharmacol. 1992; 32:643-6. [PubMed 1640004]

336. Haselberger MB, Freedman LS, Tolbert S. Elevated serum phenytoin concentrations associated with coadministration of sertraline. J Clin Psychopharmacol. 1997; 17:107-9. [PubMed 10950473]

337. Pihlsgard M, Eliasson E. Significant reduction of sertraline plasma levels by carbamazepine and phenytoin. Eur J Clin Pharmacol. 2002; 57:915-6. [PubMed 11936714]

338. Trivedi MH, Fava M, Wisniewski SR et al. for the STAR*D Study Team. Medication augmentation after the failure of SSRIs for depression. N Engl J Med. 2006; 354:1243-52. [PubMed 16554526]

339. Rush AJ, Trivedi MH, Wisniewski SR et al. for the STAR*D Study Team. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression. N Engl J Med. 2006; 354:1231-42. [PubMed 16554525]

340. Rubinow DR. Treatment strategies after SSRI failure—good news and bad news. N Engl J Med. 2006; 354:1305-7. [PubMed 16554533]

341. Lepine JP, Goger J, Blashko C et al. A double-blind study of the efficacy and safety of sertraline and clomipramine in outpatients with severe major depression. Int Clin Psychopharmacol. 2000; 15:263-71. [PubMed 10993128]

342. Clark DB, Andrus MR, Byrd DC. Drug interactions between linezolid and selective serotonin reuptake inhibitors: case report involving sertraline and review of the literature. Pharmacotherapy. 2006; 26:269-76. [PubMed 16466332]

344. Watson Laboratories, Inc. Sertraline hydrochloride tablets prescribing information. Corona, CA; 2007 May.

345. Bridge JA, Iyengar S, Salary CB. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007; 297:1683-96. [PubMed 17440145]

346. Forest Pharmaceuticals, Inc. Lexapro (escitalopram oxalate) tablets/oral solution prescribing information. St. Louis, MO; 2007 May.

347. Forest Pharmaceuticals, Inc. Celexa (citalopram hydrobromide) tablets/oral solution prescribing information. St. Louis, MO; 2007 May.

348. Pfizer Roerig. Zoloft (sertraline hydrochloride) tablets and oral concentrate prescribing information. New York; 2009 Jan.

349. Boyer EW, Shannon M. The serotonin syndrome. N Engl J Med. 2005; 352:1112-20. [PubMed 15784664]

350. Stevens DL. Association between selective serotonin-reuptake inhibitors, second-generation antipsychotics, and neuroleptic malignant syndrome. Ann Pharmacother. 2008; 42:1290-7. [PubMed 18628446]

351. Rabins PV, Blacker D, Rovner BW et al. and the APA Work Group on Alzheimer’s Disease and other Dementias. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias, second edition. Am J Psychiatry. 2007; 164(Suppl 12):5-56.

352. Raskind MA, Peskind ER. Alzheimer’s disease and related disorders. Med Clin North Am. 2001; 85:803-17. [PubMed 11349485]

353. Flint AJ, van Reekum R. The pharmacologic treatment of Alzheimer’s disease: a guide for the general psychiatrist. Can J Psychiatry. 1998; 43:689-97. [PubMed 9773218]

354. Ames D, Wirshing WC. Ecstasy, the serotonin syndrome, and neuroleptic malignant syndrome--a possible link?. JAMA. 1993; 269:869-70. [PubMed 8426445]

355. Wyeth Pharmaceuticals Inc. Pristiq (desvenlafaxine succinate) extended-release tablets prescribing information. Philadelphia, PA; 2009 Aug.

356. Müller D, Weinmann W, Hermanns-Clausen M. Chinese slimming capsules containing sibutramine sold over the Internet: a case series. Dtsch Arztebl Int. 2009; 106:218-22. [PubMed 19471631]

358. Kobayashi K, Ishizuka T, Shimada N et al. Sertraline N-demethylation is catalyzed by multiple isoforms of human cytochrome P-450 in vitro. Drug Metab Dispos. 1999; 27(7):763-6. [PubMed 10383917]

359. Hull M, Kottlors M, Braune S. Prolonged coma caused by low sodium and hypo-osmolarity during treatment with citalopram. J Clin Psychopharmacol. 2002; 22:337-8. [IDIS 481146] [PubMed 12006908]

360. Odeh M, Beny A, Oliven A. Severe symptomatic hyponatremia during citalopram therapy. Am J Med Sci. 2001; 321:159-60. [IDIS 459269] [PubMed 11217819]

361. Wilkinson TJ, Begg EJ, Winter AC et al. Incidence and risk factors for hyponatremia following treatment with fluoxetine or paroxetine in elderly people. Br J Clin Pharmacol. 1999; 47:211-7. [IDIS 424778] [PubMed 10190657]

362. Lyketsos CG, DelCampo L, Steinberg M et al. Treating depression in Alzheimer disease: efficacy and safety of sertraline therapy, and the benefits of depression reduction: the DIADS. Arch Gen Psychiatry. 2003; 60:737-46. [PubMed 12860778]

363. Forest Pharmaceuticals, Inc. Celexa (citalopram hydrobromide) tablets and oral solution prescribing information. St. Louis, MO; 2009 Jan.

364. Pfizer. Zyvox (linezolid) injection, tablets, and for oral suspension prescribing information. New York, NY: 2008 Jul.

365. Steinberg M, Morin AK. Mild serotonin syndrome associated with concurrent linezolid and fluoxetine. Am J Health-Syst Pharm. 2007; 264:59-62.

366. Taylor JJ, Wilson JW, Estes LL et al. Linezolid and serotonergic drug interactions: a retrospective survey. Clin Infect Dis. 2006; 43:180-7. [PubMed 16779744]

367. Sola CL, Bostwick JM, Hart DA et al. Anticipating linezolid-SSRI interactions in the general hospital setting: an MAOI in disguise. Mayo Clin Proc. 2006; 81:330-4. [PubMed 16529136]

368. Hachem RY, Hicks K, Huen A et al. Myelosuppression and serotonin syndrome associated with concurrent use of linezolid and selective serotonin reuptake inhibitors in bone marrow transplant recipients. Clin Infect Dis. 2003; 37:e8-11. [IDIS 512019] [PubMed 12830431]

369. Teva Pharmaceuticals USA. Sertraline hydrochloride tablets prescribing information. Sellersville, PA: 2008 May.

370. US Food and Drug Administration. Drug Safety Communication: Serious CNS reactions possible when methylene blue is given to patients taking certain psychiatric medications. 2011 Jul 26. From FDA website.

371. US Food and Drug Administration. Drug Safety Communication: Updated information about the drug interaction between methylene blue (methylthioninium chloride) and serotonergic psychiatric medications. 2011 Oct 20. From FDA website.

372. Forest Pharmaceuticals, Inc. Viibryd (vilazodone hydrochloride) tablets prescribing information. St Louis, MO; 2011 Mar.

373. Forest Pharmaceuticals, Inc. Celexa (citalopram hydrobromide) tablets and oral solution prescribing information. St. Louis, MO; 2012 Mar.

600. Food and Drug Administration. FDA drug safety communication: Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies. 2011 Dec 14. From the FDA website.

601. Pfizer Roerig, Zoloft (sertraline hydrochloride) film-coated tablets and solution concentrate prescribing information. New York; 2012 May

602. Chambers CD, Hernandez-Diaz S, Van Marter LJ et al. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. New Engl J Med. 2006; 354:579-87. [PubMed 16467545]

603. Källén B, Olausson PO. Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2008; 17:801-6. [PubMed 18314924]

604. Wichman CL, Moore KM, Lang TR et al. Congenital heart disease associated with selective serotonin reuptake inhibitor use during pregnancy. Mayo Clin Proc. 2009; 84:23-7. [PubMed 19121250]

605. Andrade SE, McPhillips H, Loren D et al. Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2009; 18:246-52. [PubMed 19148882]

606. Wilson KL, Zelig CM, Harvey JP et al. Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol. 2011; 28:19-24Note:r607 had been r324; changed to r607 to match boilerplate wording in other SSRIs. [PubMed 20607643]

607. US Food and Drug Administration. Public health advisory: treatment challenges of depression in pregnancy and the possibility of persistent pulmonary hypertension in newborns. Rockville, MD; 2006 Jul 19. From the FDA website.

608. Yonkers KA, Wisner KL, Stewart DE et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Obstet Gynecol. 2009; 114:703-13. [PubMed 19701065]

609. Cohen LS, Altshuler LL, Harlow BL et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA. 2006; 295:499-507. [PubMed 16449615]

610. Kieler H, Artama M, Engeland A et al. Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. Br Med J. 2012; 344:d8012.

a. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatr. 2010; 157(Suppl 4):1-45.

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