GENERIC NAME: sertraline
BRAND NAME: Zoloft
DRUG CLASS AND MECHANISM: Sertraline is a drug that is used to treat psychological illnesses including depression, obsessive-compulsive disorder, panic disorder, and post-traumatic stress disorder. Sertraline belongs to a class of drugs called serotonin uptake inhibitors. Serotonin is a neurotransmitter (a chemical messenger) produced by nerve cells in the brain that is used by the nerves to communicate with one another. A nerve releases the serotonin it produces into the space surrounding it. The serotonin either travels across the space and attaches to receptors on the surface of nearby nerves or it attaches to receptors on the surface of the nerve that produced it to be taken up, recycled and released again (a process referred to as re-uptake) . A balance is reached for serotonin between attachment to the nearby nerves and re-uptake. It is believed that some illnesses, for example, depression, are caused by disturbances in the function of the receptors which alters the balance of serotonin. The leading theory is that drugs such as sertraline alter the receptors in a manner that restores the balance.
GENERIC AVAILABLE: no
PREPARATIONS: Tablets: 25 mg, 50 mg, 100 mg.
STORAGE: Tablets should be stored at room temperature 15-30C (59-86F).
PRESCRIBED FOR: Sertraline is prescribed for the treatment of major depressive disorders. A major depressive episode is characterized by persistent depression that interferes with daily functioning for at least two weeks and includes some of the following symptoms: a change in appetite or sleep, loss of interest in usual activities, a decrease in sexual drive, psychomotor retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, or suicide thoughts or attempts. Sertraline is used for the treatment of obsessive-compulsive disorders. An obsessive-compulsive disorder is characterized by recurrent and persistent ideas, thoughts, impulses or images that are recognized by the person as excessive or unreasonable. Sertraline is used for the treatment of panic attacks. A panic attack is a transient, intense period of fear or discomfort. Symptoms may include sweating, trembling, a sensation of choking, lightheadedness, fear of losing control, fear of dying, or chills. Sertraline also is used to treat post-traumatic stress disorder (PTSD). PTSD is a combination of symptoms that leads to distressing changes in personality and behavior in response to a traumatic event from the past. Symptoms may include flashbacks in which individuals relive the traumatic event and may have intense fear or feelings of separation from the world, their own emotions, and their physical bodies. Drastic attempts may be made to avoid the flashbacks, and hyperactive behavior may cause sleep disturbances, anxiety, and jitteryness.
DOSING: Sertraline usually is taken in the morning with or without meals. Treatment usually is begun at a lower dose, and the dose is steadily increased until the desired effect is achieved or side effects intervene.
DRUG INTERACTIONS: The dose of sertraline should be lowered in patients with liver or kidney disease to avoid build up of drug. Its safety in children has not been established. Simultaneous use of sertraline with a different class of antidepressants known as MAO inhibitors (e.g., phenelzine)can lead to serious reactions (such as confusion, fever, irritability and muscle rigidity), and should be avoided. Sertraline interacts with diazepam (Valium), digoxin (Lanoxin), tolbutamide, and warfarin (Coumadin) to increase the blood levels of these medicines. Cimetidine has been shown to increase the blood levels of sertraline. Sertraline may reactivate mania or hypomania. Sertraline may impair a patients judgment, thinking or motor skills. Patients may want to avoid driving or operating hazardous machinery until they are certain that their performance is not affected. Sertraline should be used with caution in patients with a history of seizures since seizures have occurred in patients taking similar antidepressants. Sertraline has been shown to cause low blood sodium levels. Patients should avoid alcohol while taking sertraline since the alcohol will further impair judgment, thought, and motor skills.
PREGNANCY: Sertraline's safety in pregnancy has not been established.
NURSING MOTHERS: Sertraline's safety in nursing mothers has not been established.
SIDE EFFECTS: The most common side effects are sleepiness, insomnia, dizziness, nausea, skin rash, upset stomach, loss of appetite, headache, loose stools or diarrhea, and or delay of ejaculation. Sertraline should be used cautiously in patients who have a history of seizures, angin or heart attack, cirrhosis, or kidney disease. Sertraline may cause sensitivity to sun (severe sunburn); therefore, avoiding the sun and wearing protective clothing and sunscreen may be necessary. Major side effects are uncommon and include palpitations or irregular heartbeats or anaphylactic reactions involving swelling of the face or airways and hives.
If antidepressants are discontinued abruptly, symptoms may occur such as dizziness, headache, nausea, changes in mood, or changes in the sense of smell, taste, etc. (Such symptoms may occur when even a few doses of antidepressant are missed.) Therefore, it is recommended that the dose of antidepressant be reduced gradually when therapy is discontinued.