Sertraline is sold under the brand name "Zoloft".
Sertraline was the third serotonin reuptake inhibitor available in the US and the most recent one to go off patent (earlier this year). It is FDA approved for Major Depression, OCD, Panic Disorder, Social Phobia, PTSD, and Premenstrual Dysphoric Disorder.
Sertraline, like its cousins, fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil) and fluvoxamine (Luvox), reversibly blocks the recycling of serotonin from outside the nerve to inside the nerve. This increase in serotonin in the gap between nerves in the central nervous system (the synapse) leads to alterations in serotonin function that have been associated with improvements in depression and anxiety. Each of these serotonin reuptake inhibitors (SSRIs for short) has its own personality, if you will. Sertraline is not activating like fluoxetine and generally does not cause patients to feel lethargic and “numb” like paroxetine and fluoxetine. It's a good “middle of the road” kind of SSRI.
Sertraline is processed for elimination from the body (“metabolized”) in the liver to an inactive compound that is in turn eliminated by the kidneys. The half life of sertraline is about one day and consequently if stopped abruptly (not recommended) it is out of the body in about 5 days.
Sertraline in combination with a monoamine oxidase inhibitor can cause serotonin syndrome that in turn can be fatal.
Possible adverse effects can include sexual dysfunction, nausea, insomnia, agitation, diarrhea, difficulty thinking and others. Sometimes, in common with other SSRIs, it may leave a person feeling a bit numb emotionally rather than really well and “perky”.
Sertraline has very limited effects on liver enzyme symptoms and consequently does not significantly effect the elimination of other medications.
Sertraline has been associated, along with the other SSRIs, with neonatal pulmonary hypertension in neonates exposed to sertraline in the final trimester of pregnancy. It has has the distinction, however, of being the SSRI that has the least amount of medication passed through the placenta and the least amount secreted into breast milk, making it the SSRI of choice for use during pregnancy and after delivery.
All antidepressants have a warning from the FDA against new onset suicidal “thoughts and behaviors”. There is no evidence children taking antidepressants are suiciding; quite otherwise, there is very good evidence that children treated for depression suicide less often than children who are depressed who are not treated with antidepressants.
If you miss a dose of sertraline do not add it to your next dose. It is important to take sertraline regularly as prescribed.
