Mental Health Book

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SertralineAka: Zoloft

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  1. Mechanism
    1. Selective Serotonin Reuptake Inhibitor (SSRI)
  2. Indications
    1. Major Depression
    2. Obsessive Compulsive Disorder
    3. Panic Disorder
    4. Post-Traumatic Stress Disorder (PTSD)
    5. Premenstrual Dysphoric Disorder
  3. Background
    1. Cost: $75 per month
  4. Preparations
    1. Tablets (Scored): 25, 50, 100 mg
    2. Oral concentrate: 20 mg/ml (60 ml bottle)
  5. Dosing
    1. Start
      1. Children (ages 6-12 years of age): 25 mg PO qAM
      2. Adults (and children over age 12): 50 mg PO qAM
      3. Elderly: 25 mg PO qAM
    2. Titrate
      1. Adults: Increase by 50 mg every 2 weeks
    3. Maximum: 200 mg per day
  6. Drug Interactions
    1. Significantly raises Pimozide levels
      1. Concurrent use with Pimozide is contraindicated
    2. Inhibits Cytochrome P450-2C and P450-3A4
      1. Clinically Significant interactions are uncommon
    3. Highly protein bound
      1. Interacts with other protein bound medications
    4. Absorption affected by food intake
    5. Raises Tricyclic Antidepressant levels
    6. Allow two week wash-out prior to starting MAO inhibitor
  7. Pharmacokinetics
    1. Half Life: 1 to 4 days
    2. Therapeutic Blood level 9.5 to 56 ng/ml
  8. Adverse Effects
    1. Neutral on the Sedation to excitation continuum
      1. Less sedating than Paxil or Luvox
    2. Anxiety, Insomnia or other sleep disturbance
      1. Less stimulating than Prozac
      2. Consider Trazodone (Desyrel) at bedtime
    3. Diarrhea or gastrointestinal upset
      1. Diarrhea more common than with Fluoxetine
      2. Usually resolves within 2 weeks
    4. Sexual Dysfunction may be more common
      1. Includes decreased libido
      2. See Antidepressant Induced Sexual Dysfunction
    5. Antidepressant Withdrawal symptoms on stopping
      1. Taper 50 mg per every 5-7 days
      2. Taper to 25-50 mg daily before stopping

Sertraline (C0074393)

Definition (CSP)selective serotonin uptake inhibitor; used as an antidepressant.
Definition (MSH)A selective serotonin uptake inhibitor that is used in the treatment of depression.
Definition (PDQ)The salt form of a synthetic derivative of naphthalenamine with anti-serotoninergic and anti-depressant properties. Sertraline appears to selectively inhibit the neuronal uptake of serotonin, raising serotonin levels in the CNS. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=322832&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=322832&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C29451" NCI Thesaurus)
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD020280
EnglishSertraline, SERTRALINE PREPARATION
Spanishsertralina
Parent Concepts1-naphthtlamine (C0815033), Antidepressive Agents (C0003289), Serotonin Uptake Inhibitors (C0162758), 1-Naphthylamine (C0000102), [CN609] ANTIDEPRESSANTS, OTHER (C0973506), Selective serotonin re-uptake inhibitor (C0360105), Drug allergen (C1320237)
SourcesAOD, CSP, LNC, MSH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Zoloft (C0284660)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD020280
EnglishAltruline, Lustral, Parke Davis Brand of Sertraline Hydrochloride, Pfizer Brand of Sertraline Hydrochloride, Roerig Brand of Sertraline Hydrochloride, Zoloft
SourcesCSP, MSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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