Sertraline: 7 things you should know
Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 5, 2020.
1. How it works
- Sertraline is a medicine that may be used in the treatment of depression and other mood disorders.
- Experts believe sertraline's effects are due to its ability to rebalance chemicals in the brain, such as serotonin, that are imbalanced in people with anxiety, depression, and other disorders.
- Its activity against other neurotransmitters is much less potent than other antidepressants.
- Sertraline belongs to a group of medicines called Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are thought to work by preventing the reuptake of serotonin by nerves, leading to an increase in serotonin concentrations within the nerve synapse (space between two nerves).
- May be used for the treatment of moderate-to-severe depression (Major Depressive Disorder).
- May reduce feelings of anxiety in people with obsessive-compulsive disorder (OCD), panic disorder, or social anxiety disorder.
- May relieve intrusion and avoidance symptoms associated with post-traumatic stress disorder (PTSD).
- May help mood swings associated with premenstrual dysphoric disorder (PDD).
- Generic sertraline is available.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- A headache, nausea, diarrhea, weight loss, insomnia, tremors, and sexual dysfunction are the most common side effects.
- May cause drowsiness, but is less likely than many other antidepressants to do so. However, caution should still be used when driving or operating machinery until the full effects of the drug are known.
- May increase the risk of suicidal thoughts or behavior in young adults (similar to other antidepressants).
- Discontinuation symptoms (including dissatisfied mood, irritability, agitation, diarrhea, dizziness, electric shock sensations, muscle tremor, sweating, confusion, headache, vivid dreams) may occur with abrupt discontinuation; taper off slowly under medical advice.
- Interaction or overdosage may cause serotonin syndrome (symptoms include agitation, hallucinations, fast heart rate, dizziness, muscle tremor, nausea, vomiting, diarrhea).
- Investigate any unexplained bone pain, tenderness, swelling, or bruising since bone fragility fractures have been associated with antidepressant treatment.
Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here.
- May be taken with or without food; however, this needs to be consistent.
- Administer once daily either morning or evening. If drowsiness is experienced, administer at bedtime.
- Report to your doctor any signs of worsening of depression or suicidal thoughts particularly during the first few months of therapy.
- Seek urgent medical advice if symptoms consistent with serotonin syndrome (such as agitation, hallucinations, fast heart rate, dizziness, flushing, nausea, diarrhea) develop.
- Do not stop suddenly as withdrawal symptoms may occur.
- Dilute oral concentrate immediately before use with either water, ginger ale, lemon/lime soda, lemonade, or orange juice. Take immediately after mixing.
- For people who are allergic to latex, note that the oral concentrate dropper dispenser contains dry natural rubber.
6. Response and Effectiveness
- The peak effects of sertraline are seen within 4.5 to 8 hours. Some antidepressant action may be experienced within a week; however, the full effects of sertraline may take eight to 12 weeks to develop.
Medicines that interact with sertraline may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with sertraline. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with sertraline include:
- anticoagulants (blood thinners), such as warfarin, or other drugs that have blood-thinning effects such as aspirin or NSAIDs
- anticonvulsants, such as phenytoin, phenobarbital, or primidone
- antipsychotics (such as butyrophenones, phenothiazines, or thioxanthenes) and atypical antipsychotics (eg, olanzapine, quetiapine, ziprasidone)
- any medication that may cause drowsiness, such as benzodiazepines (eg, diazepam, lorazepam), first-generation antihistamines (such as doxylamine or promethazine), metoclopramide, or opioids (such as codeine, morphine)
- diuretics, such as furosemide
- medications that may affect the heartbeat by prolonging the QT interval, such as amiodarone, encainide, flecainide, or pimozide
- other antidepressants, such as tricyclic antidepressants (eg, amitriptyline), monoamine oxidase inhibitors (eg, isocarboxazid, phenelzine, and tranylcypromine), venlafaxine, and SSRIs (eg, paroxetine, sertraline)
- other medications that affect serotonin, such as amphetamines, fentanyl, lithium, tramadol, triptans (eg, almotriptan, eletriptan, or sumatriptan), or St. John's Wort
- other medications that are metabolized by the same enzymes such as cimetidine, most antipsychotics, flecainide, propafenone, or vinblastine
- others, such as HIV medications (fosamprenavir, ritonavir), or procyclidine.
Avoid drinking alcohol or taking illegal or recreational drugs while taking sertraline.
Note that this list is not all-inclusive and includes only common medications that may interact with sertraline. You should refer to the prescribing information for sertraline for a complete list of interactions.
Sertraline. Revised 08/2020. Drugs.com https://www.drugs.com/ppa/sertraline.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use sertraline only for the indication prescribed.
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- Drug class: selective serotonin reuptake inhibitors
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