Classification: Selective serotonin reuptake inhibitor (SSRI) antidepressant.

Common usage: Sertraline is indicated for the treatment of depression, panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), social anxiety disorder, and obsessive-compulsive disorder (OCD) in adults. It is also indicated for the treatment of OCD in children and adolescents ages 6 to 17. Sertraline is not approved for treating depression in children.

Important side effects: Most side effects experienced by patients taking sertraline are mild in severity and do not usually result in the need to stop this medication. The most common side effects experienced by patients taking sertraline include sedation, trouble sleeping, decreased appetite, dry mouth, diarrhea/loose stools, stomach upset, increased sweating, tremor, and agitation. Children taking sertraline may also experience other side effects, such as excessive movement or twitching, not “feeling well,” weight loss, manic or excited behavior, or rapid mood swings.

Clinical worsening and suicide risk:

Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. There has been a longstanding concern that antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients. Antidepressants increased the risk of suicidality in short-term studies in children and adolescents with MDD and other psychiatric disorders.

As with other SSRIs, sertraline has been associated with cases of clinically significant hyponatremia (a low sodium level in the blood) in elderly patients.

This is not a complete list of all known or potential adverse effects. Notify your prescriber of any symptoms that have started since you began taking this medication, changing its dose, or adding or changing other medication or diet. Take care when performing any task (such as driving a car or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform the task safely.

Interactions with other medications:Sertraline should not be used with monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate). If any of these medications were used and discontinued, a waiting period of 14 days should elapse before beginning treatment with sertraline. When on an SSRI, consideration should be given prior to the addition of another medication (prescription or over-the-counter) that increases serotonin, because of concerns about serotonin syndrome.

This is not a complete list of all known or potential drug interactions. To help prevent problems, always make sure that your pharmacist and all prescribers know about all medications you are taking, including over-the-counter drugs, dietary herbal supplements, folk or home remedies, or unusual foods, drinks, or dietary habits.

Common dosages: For depression, PMDD, and OCD in adults, sertraline should be administered at a dose of 50 mg/day. For panic disorder, PTSD, and social anxiety disorder in adults, sertraline should be started at 25 mg/day, and increased to 50 mg/day after one week. For treatment of OCD in children ages 6 to 12, the initial dose is usually 25 mg/day; for children ages 13 to 17, the recommended dose is 50 mg/day. Dosages can be increased gradually, if necessary, up to 200 mg/day.

Identification: Sertraline is available in 25-mg, 50-mg, and 100-mg capsular-shaped scored tablets. The 25-mg tablet is light green, engraved on one side with “ZOLOFT” and on the other side scored and engraved with “25 mg”. The 50-mg tablet is light blue, engraved on one side with “ZOLOFT” and on the other side scored and engraved with “50 mg”. The 100-mg tablet is light yellow, engraved on one side with “ZOLOFT” and on the other side scored and engraved with “100 mg”.

Sertraline is also available in a clear, colorless oral concentrate (20 mg/mL). The oral concentrate must be diluted before use. Just before taking, use the dropper provided to remove the required amount of oral concentrate and mix with 4 ounces (half a cup) of water, ginger ale, lemon/lime soda, lemonade or orange juice only. Do not mix the oral concentrate with anything other than the liquids listed. The dose should be taken immediately after mixing. At times, a slight haze may appear after mixing; this is normal. To make sure you take the entire dose, add a little more water to the same glass, swirl gently, and drink right away. Do not take the liquid form of sertraline if you are taking disulfiram (Antabuse), as the concentrate may contain alcohol.

Storage: Sertraline should be stored at controlled room temperature (59° F to 86° F), in a tightly closed, child-, light-, and moisture-resistant container. If you have difficulty opening child-resistant containers, your pharmacist can provide you with a container that is easier to open. Keep the medication out of direct sunlight and avoid storing it in a warm and humid area, such as the bathroom or kitchen, to avoid deterioration. To prevent accidental poisoning, keep all medications out of the reach of children or adults with dementia. Do not take expired medication. Do not transfer medication from one container to another. Carefully discard discontinued medication where children or adults with dementia cannot find it.