BMA Concise Guide to Medicine & Drugs

Sertraline

Brand name Lustral

Used in the following combined preparations None

QUICK REFERENCE

Drug group Antidepressant drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Sertraline is a member of the group of antidepressants called selective serotonin re-uptake inhibitors (SSRIs). These drugs tend to cause less sedation and have different side effects from older types of antidepressants. Sertraline elevates mood, increases physical activity, and restores interest in everyday activities. It is used to treat depression, including accompanying anxiety, and obsessive-compulsive disorder (OCD). Sertraline is also prescribed for post-traumatic stress disorder (PTSD) in women; it has not been shown to work in men with this condition.

Treatment is usually stopped gradually over at least four weeks because symptoms such as headache, nausea, and dizziness may occur if the drug is withdrawn suddenly.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets.

Frequency and timing of doses Once daily, usually in the morning.

Adult dosage range 50–200mg daily.

Onset of effect Some benefits may appear within 14 days, but full effects may take another 6 weeks; anxiety disorders may take longer.

Duration of action Antidepressant effect may continue for some weeks following prolonged use.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 8 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor, who may supervise a gradual reduction in dosage.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause adverse effects. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Common adverse effects of sertraline include gastrointestinal problems (such as nausea, indigestion, and diarrhoea/loose stools), insomnia or sleepiness, anxiety, and sexual dysfunction. Discuss with your doctor if these are severe. Less commonly, a rash, itching, or skin eruptions may occur; if so, you should stop taking the drug and contact your doctor immediately. Rarely, sertraline may cause suicidal thoughts or attempts (mainly in children and adolescents); if they occur, you should stop the drug and seek immediate medical attention.

INTERACTIONS

St John’s wort There is a danger of increasing the side effects of both substances.

Monoamine oxidase inhibitors (MAOIs) Sertraline’s effects and toxicity are greatly increased by MAOIs.

Tramadol and 5HT1 agonists (e.g. sumatriptan) There is an increased risk of adverse effects if these drugs are taken with sertraline.

Antipsychotics Sertraline may increase the levels and effects of some antipsychotics.

Anticoagulants The effects of these may be increased by sertraline.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You have had epileptic seizures.

· You have heart problems.

· You have a history of bleeding disorders.

· You have a history of mania.

· You are taking other medicines.

Pregnancy Safety not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not generally recommended under 18 years.

Over 60 No special problems.

Driving and hazardous work Avoid such activities until you know how sertraline affects you because the drug can cause drowsiness and visual disturbances.

Alcohol Avoid excessive intake. SSRIs may increase the sedative effects of alcohol.

PROLONGED USE

No known problems in adults. There is a small risk of suicidal thoughts and self-harm in children and adolescents, although the drug is rarely used for this age group.

Monitoring Any person experiencing drowsiness, confusion, muscle cramps, or seizures should be monitored for low sodium levels in the blood. Under-18s should be monitored for suicidal thoughts and self-harm.