Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: sertraline
BRAND NAME: Zoloft
DRUG CLASS AND MECHANISM:
Sertraline belongs to a class of drugs called selective serotonin reuptake
inhibitors (SSRIs). Other drugs in this class are Prozac (fluoxetine), Paxil
(paroxetine), Celexa (citalopram) and Luvox (fluvoxamine). 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 by the nerve and released again (a process referred to as
re-uptake). A balance is reached for serotonin between attachment to the nearby
nerves and reuptake. Selective serotonin inhibitors block the reuptake of
serotonin and therefore change the level of serotonin in the brain.
It is
believed that some illnesses such as depression are caused by disturbances in
the balance between serotonin and other neurotransmitters. The leading theory is
that drugs such as sertraline restore the chemical balance among
neurotransmitters in the brain. The FDA approved sertraline in December 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50, and 100 mg; oral concentrate: 20 mg/ml
STORAGE: Sertraline should be stored at room temperature between
15-30°C (59-86°F).
PRESCRIBED FOR: Sertraline is used for treating depression,
obsessive-compulsive disorder (OCD),
panic disorder, and
post-traumatic stress
disorder (PTSD). Sertraline also is used for treating
social anxiety disorder
and postmenstrual dysphoric disorder (PMDD).
DOSING: The recommended dose of sertraline is 25-200 mg once daily.
Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder
is initiated at 25-50 mg once daily. Doses are increased at weekly intervals
until the desired response is seen.
The recommended dose for PMDD is 50-150 mg
every day of the menstrual cycle or for 14 days before menstruation.
Sertraline
may be taken with or without food.
DRUG INTERACTIONS: Serious reactions such as hyperthermia,
fluctuations in blood pressure and rigidity of muscles may occur when SSRIs are
used in combination with monoamine oxidase inhibitors (MAOI) such as phenelzine,
tranylcypromine (Parnate) and isocarboxazid. Therefore, SSRIs should not be used
in combination with MAOIs. In addition, SSRIs and MAOIs should not be used
within 14 days of each other.
Cimetidine (Tagamet) may increase the levels in blood of sertraline by reducing the
elimination of sertraline by the liver. Increased levels of sertraline may lead
to more side effects.
Sertraline increases the blood level of
pimozide (Orap) by 40%. High levels
of pimozide can affect electrical conduction in the heart and lead to sudden
death. Therefore, patients should not receive treatment with both pimozide and
sertraline.
Through unknown mechanisms, sertraline may increase the blood thinning action
of warfarin (Coumadin). The effect of warfarin should be monitored when sertraline is
started or stopped.
PREGNANCY: Use of sertraline during the 3rd trimester of
pregnancy may
lead to adverse effects in the newborn.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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