What are the primary uses of sertraline. How should sertraline be taken for optimal effectiveness. What are the potential side effects and precautions associated with sertraline use. How does sertraline work in the brain to alleviate symptoms of depression and anxiety disorders.

Understanding Sertraline: An Antidepressant Medication

Sertraline is a widely prescribed antidepressant medication belonging to the class of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs). It is used to treat a variety of mental health conditions, primarily depression and anxiety disorders. To fully grasp the importance of this medication, it’s crucial to understand its mechanisms of action, uses, and potential effects on patients.

What is Sertraline?

Sertraline is the generic name for a medication that is sold under various brand names, including Zoloft. It works by altering the balance of serotonin, a neurotransmitter in the brain that plays a crucial role in mood regulation. By inhibiting the reuptake of serotonin, sertraline increases its availability in the brain, which can lead to improved mood and reduced symptoms of depression and anxiety.

The Diverse Applications of Sertraline in Mental Health Treatment

Sertraline has proven to be a versatile medication, effectively treating a range of mental health conditions. Its primary uses include:

• Depression
• Panic attacks
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Social Anxiety Disorder (social phobia)
• Premenstrual Dysphoric Disorder (PMDD)

The medication’s ability to address multiple conditions makes it a valuable tool in the treatment of complex mental health issues. For instance, a patient suffering from both depression and anxiety may find relief from both conditions with a single medication.

How Does Sertraline Improve Mental Health?

Sertraline works by potentially improving various aspects of a patient’s mental state and daily functioning. These improvements may include:

• Enhanced mood
• Better sleep patterns
• Increased appetite
• Improved energy levels
• Restored interest in daily activities
• Reduced fear and anxiety
• Decreased frequency of unwanted thoughts
• Fewer panic attacks
• Diminished urge to perform repetitive tasks (compulsions)

These effects can significantly improve a patient’s quality of life and ability to function in daily activities.

Proper Administration and Dosage of Sertraline

The correct administration of sertraline is crucial for its effectiveness and safety. Here are some key points to consider:

How Should Sertraline Be Taken?

Sertraline is typically taken orally once daily, either in the morning or evening. The medication comes in various forms:

• Tablets
• Liquid
• Capsules (25mg, 50mg, 100mg, 150mg, 200mg)

The tablet and liquid forms can be taken with or without food. For capsules, the lower doses (25mg, 50mg, 100mg) are usually taken with food, while the higher doses (150mg, 200mg) may be taken with or without food.

Special Instructions for Liquid Sertraline

If you’re prescribed the liquid form of sertraline, it’s important to follow these steps:

1. Use the provided medicine dropper to measure the dose accurately.
2. Mix the measured dose with 4 ounces (120 milliliters) of a compatible liquid such as water, ginger ale, lemon-lime soda, lemonade, or orange juice.
3. Drink the entire mixture immediately after preparation.
4. Do not prepare doses in advance.

Dosage Considerations

The appropriate dosage of sertraline varies based on the individual’s medical condition and response to treatment. Typically, doctors will start with a low dose and gradually increase it to minimize side effects. It’s crucial to follow your doctor’s instructions precisely and not adjust your dosage without consulting them first.

Potential Side Effects and Precautions of Sertraline Use

While sertraline can be highly effective in treating various mental health conditions, it’s important to be aware of potential side effects and necessary precautions.

Common Side Effects

Some of the more common side effects of sertraline include:

• Nausea
• Diarrhea
• Dry mouth
• Drowsiness
• Dizziness
• Changes in appetite or weight
• Sleep disturbances
• Sexual dysfunction

These side effects often improve as the body adjusts to the medication. However, if they persist or worsen, it’s important to consult your healthcare provider.

Serious Precautions and Warnings

While antidepressants like sertraline can provide significant benefits, they also come with important warnings, particularly for younger patients:

• Increased risk of suicidal thoughts or behaviors, especially in patients under 25
• Potential worsening of depression or other psychiatric conditions
• Possible emergence of unusual behavior changes
• Risk of developing new or worsening anxiety, panic attacks, insomnia, irritability, hostility, impulsivity, or severe restlessness

It’s crucial to monitor for these symptoms, especially when starting the medication or adjusting the dose. Any concerning changes should be reported to a healthcare provider immediately.

Sertraline’s Mechanism of Action: How It Works in the Brain

Understanding how sertraline works can provide insight into its effectiveness and potential side effects.

The Role of Serotonin

Sertraline primarily targets serotonin, a neurotransmitter that plays a crucial role in mood regulation, sleep, appetite, and other important functions. In individuals with depression or anxiety, there may be an imbalance or deficiency of serotonin in certain areas of the brain.

Selective Serotonin Reuptake Inhibition

As a Selective Serotonin Reuptake Inhibitor (SSRI), sertraline works by blocking the reabsorption (reuptake) of serotonin in the brain. This action increases the availability of serotonin in the synaptic space between neurons, potentially improving communication between brain cells and regulating mood.

Gradual Effects

It’s important to note that the full effects of sertraline may not be immediately apparent. It often takes several weeks of consistent use for the medication to reach its full therapeutic potential. This gradual onset of action is due to the time required for the brain to adapt to the increased serotonin levels and for downstream changes in neurotransmitter systems to occur.

Interactions and Contraindications: What to Watch Out For

When taking sertraline, it’s crucial to be aware of potential interactions with other medications and substances, as well as conditions that may contraindicate its use.

Drug Interactions

Sertraline can interact with various medications, potentially leading to adverse effects or reduced efficacy. Some notable interactions include:

• Monoamine Oxidase Inhibitors (MAOIs): Combining sertraline with MAOIs can lead to potentially life-threatening serotonin syndrome.
• Pimozide: The combination of sertraline and pimozide can increase the risk of serious heart problems.
• Blood thinners: Sertraline may increase the risk of bleeding when taken with anticoagulants.
• Other serotonergic drugs: Combining sertraline with other medications that increase serotonin levels can raise the risk of serotonin syndrome.

Alcohol and Sertraline

Consuming alcohol while taking sertraline is generally not recommended. Alcohol can worsen depression and anxiety symptoms and may increase the sedative effects of sertraline. Additionally, alcohol consumption may exacerbate certain side effects of the medication.

Pregnancy and Breastfeeding

The use of sertraline during pregnancy and breastfeeding requires careful consideration and should be discussed with a healthcare provider. While some studies suggest that sertraline may be one of the safer antidepressant options during pregnancy, there are still potential risks to consider.

Long-Term Use and Discontinuation of Sertraline

Understanding the implications of long-term sertraline use and the process of discontinuation is crucial for patients and healthcare providers alike.

Long-Term Effects

Many patients use sertraline for extended periods, sometimes years, to manage chronic conditions like depression or anxiety disorders. While long-term use is generally considered safe under medical supervision, it’s important to regularly assess the ongoing need for the medication and monitor for any developing side effects.

Discontinuation Syndrome

Abruptly stopping sertraline can lead to discontinuation syndrome, a collection of symptoms that may include:

• Dizziness
• Nausea
• Headaches
• Electric shock sensations
• Anxiety or agitation
• Flu-like symptoms

To avoid these symptoms, it’s crucial to work with a healthcare provider to gradually taper off the medication if discontinuation is desired or necessary.

Tapering Process

The process of tapering off sertraline typically involves gradually reducing the dose over several weeks or months, depending on the individual’s circumstances. This slow reduction allows the brain to adjust to decreasing levels of serotonin and minimizes the risk of discontinuation symptoms.

In conclusion, sertraline is a powerful tool in the treatment of various mental health conditions. Its versatility in addressing multiple disorders, coupled with its generally manageable side effect profile, makes it a valuable option for many patients. However, like all medications, it requires careful consideration, proper administration, and ongoing monitoring to ensure its safe and effective use. As our understanding of mental health and pharmacology continues to evolve, sertraline remains an important component of modern psychiatric treatment.

Sertraline Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Warnings:

Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.

Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

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Uses

Sertraline is used to treat depression, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, social anxiety disorder (social phobia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Sertraline is known as a selective serotonin reuptake inhibitor (SSRI). It works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

How to use Sertraline HCL

Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using sertraline and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually once daily either in the morning or evening. The tablet or liquid form of this medication may be taken with or without food.

The 25 milligrams, 50 milligrams, and 100 milligrams capsule is usually taken with food. The 150 milligrams and 200 milligrams capsule may be taken with or without food. Swallow the capsules whole. Do not crush or chew the capsules. If you have any questions about how to take the capsule form of this medication, ask your doctor or pharmacist.

The liquid form of this medication must be mixed with another liquid before use. Just before taking, carefully measure the dose using the medicine dropper provided. Do not use a household spoon because you may not get the correct dose. Mix the dose with a half cup (4 ounces/120 milliliters) of water, ginger ale, lemon-lime soda, lemonade, or orange juice. Do not use other liquids to mix this drug. The mixture may appear cloudy, which is normal and harmless. Drink all of the mixture right away. Do not prepare a supply in advance.

If you are taking this medication for premenstrual problems, your doctor may direct you to take this drug every day of the month or for only the 2 weeks before your period until the start of your period.

The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor’s instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.

Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Report any new or worsening symptoms right away.

Tell your doctor if your condition lasts or gets worse.

Side Effects

See also Warning section.

Nausea, dizziness, drowsiness, dry mouth, loss of appetite, increased sweating, diarrhea, upset stomach, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor), unusual weight loss.

Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, fainting, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision).

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sertraline, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as latex found in the medicine dropper, tartrazine found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, bleeding problems, liver disease, seizure disorder, thyroid disease, personal or family history of glaucoma (angle-closure type).

Sertraline may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using sertraline, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using sertraline safely.

This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

The liquid form of this medication contains alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Some medications (such as metronidazole, disulfiram) can cause a serious reaction when combined with alcohol. Ask your doctor or pharmacist about using this product safely.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially bleeding, loss of coordination, or QT prolongation (see above). Loss of coordination can increase the risk of falling. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking “water pills” (diuretics).

Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.

During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.

Since untreated mental/mood problems (such as depression, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, discuss with your doctor right away the benefits and risks of using this medication during pregnancy.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

See also Precautions section.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug are: pimozide, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, “blood thinners” such as dabigatran/warfarin).

Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain or cough relievers (such as codeine, hydrocodone).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.

This medication may interfere with certain medical/lab tests (including brain scan for Parkinson’s disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

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Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Do not share this medication with others.

Keep all regular medical and psychiatric appointments.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

sertraline 100 mg tablet

Color: light yellowShape: ovalImprint: I G 214

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: light blueShape: ovalImprint: I G 213

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: yellowShape: roundImprint: S3

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: light blueShape: roundImprint: S2

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: blueShape: oblongImprint: A 1 7

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: greenShape: oblongImprint: A 1 6

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: light greenShape: ovalImprint: I G 212

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: blueShape: oblongImprint: T 50

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: greenShape: oblongImprint: T 25

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: yellowShape: oblongImprint: A 1 8

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 20 mg/mL oral concentrate

Color: colorlessShape: Imprint:

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: light yellowShape: oblongImprint: G 4910 100 mg

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: yellowShape: oblongImprint: L U D03

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: blueShape: oblongImprint: L U D02

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: light yellowShape: oblongImprint: T 100

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: light blueShape: oblongImprint: ZOLOFT 50 MG

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: greenShape: oblongImprint: L U D01

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: light greenShape: oblongImprint: ZOLOFT 25 MG

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 100 mg tablet

Color: light yellowShape: oblongImprint: ZOLOFT 100 MG

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 50 mg tablet

Color: light blueShape: oblongImprint: G 4900 50 MG

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 20 mg/mL oral concentrate

Color: colorlessShape: Imprint:

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: light greenShape: roundImprint: S1

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 25 mg tablet

Color: whiteShape: roundImprint: S 21

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

sertraline 20 mg/mL oral concentrate

Color: colorlessShape: Imprint:

This medicine is a light yellow, oval, scored, film-coated, tablet imprinted with “I G” and “214”.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Uses, how to take, side effects, and interactions

Sertraline (Zoloft) belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Doctors use it to treat depression, obsessive compulsive disorder (OCD), panic disorder, and other conditions.

Sertraline is sold under the brand name Zoloft, and there are also generic versions. It is available at most pharmacies.

Healthcare professionals can prescribe over 30 medications intended to help with depression and improve a person’s quality of life.

Sertraline is sold under the brand name Zoloft, and there are also generic versions. It is available at most pharmacies.

Share on PinterestSertraline increases the amount of serotonin that is available in the brain.
Image credit: https://commons.wikimedia.org/wiki/File:Zoloft_50_mg_(CN).JPG, 2012

Sertraline has the same mechanism of action as other SSRIs. It works by increasing the amount of serotonin that is available in the brain.

Serotonin is a neurotransmitter, or chemical messenger, that is involved in regulating many elements of a person’s daily life, including mood, sleep, rewards, learning, and memory.

Research has linked depression with low levels of serotonin.

Sertraline increases the amount of serotonin present in the brain, helping to reduce chemical imbalances and improve a person’s overall mood.

Other SSRIs include:

• escitalopram (Lexapro)
• citalopram (Celexa)
• fluvoxamine (Luvox, Luvox CR)
• fluoxetine (Prozac, Sarafem, Symbyax)
• paroxetine (Paxil, Paxil CR, Pexeva)
• vilazodone (Viibryd)

The Food and Drug Administration (FDA) note that people use sertraline to treat depression, anxiety, and other mood disorders.

The main use of sertraline is to treat depression, though healthcare providers also prescribe this drug to help treat other conditions, including:

• obsessive compulsive disorder, or OCD
• panic disorder
• social anxiety disorder
• post-traumatic stress disorder, or PTSD
• premenstrual dysphoric disorder — to reduce bloating, mood swings, irritability, and breast tenderness

A doctor may prescribe sertraline to treat other issues, such as sexual dysfunction or headaches. Anyone interested in the range of uses should consult a doctor.

Sertraline is available as either an oral tablet or a liquid.

Typically, a person takes a dose in the morning or evening, once a day. People using it to treat premenstrual dysphoric disorder may take it every day or only on select days of the month.

According to the National Alliance on Mental Illness, sertraline comes in the following doses:

• 25 milligram (mg) tablets
• 50 mg tablets
• 100 mg tablets
• 20 milligrams per liter of liquid

A person taking sertraline should follow these general guidelines:

• Take it at about the same time every day.
• Take with or without food.
• Follow all instructions on the prescription packaging and from the doctor.
• If you miss a dose, take it as soon as you remember to, but do not double the dose the next day.
• Take only the amount that the healthcare provider has prescribed.

When using the liquid, dilute it in a drink. According to the National Library of Medicine, a person should mix 4 ounces (half a cup) of medication with one of the following beverages, then drink it immediately:

• water
• lemon soda
• orange juice
• lemonade
• ginger ale

However, the right dosage will vary, based on a person’s age and weight.

Typically, a healthcare provider will prescribe a low dose and increase the amount over time, but no more than once per week. It can take several weeks before a person feels any effects of sertraline.

People should not stop taking the drug without speaking to a doctor, even if they are feeling better. This may mean that the drug is working, and missing a dose can result in a return of symptoms.

Side effects can vary from person to person. Talk to a healthcare provider if severe side effects occur or if any side effects do not go away.

Common side effects of sertraline include:

• nausea
• diarrhea
• headache
• dry mouth
• sweating
• nervousness
• feeling restless
• fatigue
• trouble sleeping
• sexual dysfunction

These side effects usually go away after the first week or two. However, sexual dysfunction often does not reduce over time.

The package insert for Zoloft states that it and other antidepressants can increase the risk of suicidal thoughts or actions in people aged 24 years or younger.

Pay close attention to any new or sudden changes in mood, behavior, thoughts, or feelings, and speak to a healthcare provider about these changes.

Other severe side effects of sertraline may include:

• serotonin syndrome
• low sodium levels
• eye problems such as angle-closure glaucoma
• increased risk of bleeding, especially when a person is also taking blood thinners or nonsteroidal anti-inflammatory drugs

In children, sertraline can cause a loss of weight and appetite. The pediatrician will likely monitor their weight.

Share on PinterestIf a person stops taking sertraline abruptly they may experience sleep problems, tinnitus, or irritability.

Whenever possible, a person should come off sertraline gradually. Stopping the dosage suddenly can cause the following side effects:

• tinnitus
• irritability
• agitation
• anxiety
• nausea
• dizziness
• tremors
• confusion
• sleep problems
• seizures

Sertraline contains a warning for children, teens, and adults under 24 years of age. It states that sertraline may increase a person’s suicidal thoughts or actions.

Parents and caregivers should make doctors aware of any family history of suicide. It is also important to recognize possible signs of suicidal thoughts or actions.

Adults can also experience suicidal thoughts in the first month or two of taking sertraline, as well as when the doctor increases the dosage.

Look carefully for signs such as:

• agitation
• irritability
• acting without thinking
• difficulty falling asleep or staying asleep
• new or worsening anxiety
• new or worsening depression
• aggressive behavior
• severe restlessness
• frenzied or unusual excitement
• extreme worry
• panic attacks
• thoughts of self-harm
• planning or trying to commit suicide

In addition, it is important to pay close attention to side effects. If any are severe or do not go away, talk to a doctor.

People using sertraline may test positive on certain drug tests. Before taking a drug test, ask a healthcare professional for advice.

When first taking sertraline, avoid using heavy machinery or driving immediately after a dose, until it becomes clear how the body will react. Some people continue to experience dizziness, tiredness, or other effects that can impair judgment after doses.

Avoid drinking alcohol while taking sertraline.

Certain medications can interact with sertraline. An interaction can cause unwanted side effects or cause medications to be more or less potent than intended.

People should not take any monoamine oxidase inhibitors — another type of antidepressant, commonly called MAOIs — while taking sertraline or up to 2 weeks after stopping.

Taking sertraline along with other drugs that affect serotonin can increase the risk of serotonin syndrome. This syndrome involves a range of symptoms, including agitation and loss of muscle coordination.

Some drugs that affect serotonin include:

• migraine medications called triptans
• certain other antidepressants
• some pain medications, such as tramadol
• an antibiotic called linezolid

People should not take pimozide while taking sertraline. Pimozide is an antipsychotic that helps treat Tourette’s syndrome.

Also, use caution when taking medications such as ibuprofen, warfarin, and aspirin. Sertraline can increase the risk of bleeding associated with these medications.

Sertraline is available in brand and generic forms. Most insurance plans and Medicare cover the cost of the generic version of sertraline. In this case, a person will pay only the associated medication cost of their insurance plan.

People who do not have insurance may be able to use coupons to reduce the cost of sertraline.

Share on PinterestA person should discuss their medication history with their doctor before starting sertraline.

Doctors generally consider sertraline to be the preferred medication for the treatment of depression.

There is some evidence that sertraline is preferable to other antidepressants. For example, a medical review determined, based on almost 60 studies, that sertraline was more effective than other antidepressants. However, the researchers acknowledged that the majority of the studies were of low quality.

Each individual is different, and what works well for one person may not for another. Before taking sertraline, a person should discuss their medication history and family history with the doctor, who should describe the potential side effects of the drug. For some people, another option is more appropriate.

Sertraline is an antidepressant that can help treat depression and other mood disorders.

Some people find that taking sertraline helps them manage their symptoms. Others can experience side effects that are not manageable. If this happens, see a healthcare provider who can recommend alternatives, before stopping the medication.

Like other drugs, sertraline can cause mild to severe side effects. As with any treatment, discuss the benefits and potential side effects with a doctor before taking the medication.

Active substance SERTRALINUM | Compendium – drug reference book

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• Pharmacological properties
• Indications SERTRALINE
• Application of SERTRALINE
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal preparations containing the active substance SERTRALINE

Zalox

capsules 50 mg blister, no. 30

Pharmascience

Prices in pharmacies

Zalox

capsules 50 mg bottle, no. 250

Pharmascience

Pharmacy prices

Zoloft ^®

tablets, film-coated 50 mg blister no. 28

Upjohn US 1 LLS

Pharmacy prices

Serlift

film-coated tablets 50 mg blister no. 28

SUN

Prices in pharmacies

Serlift

tablets, coated 100 mg blister, № 28

SUN

Prices in pharmacies

Sertraloft 25

tablets, coated e-coated 25 mg blister, № 30

Zdorovye

Prices in

Sertraloft 50

coated tablets 50 mg blister № 30

Health

Pharmacy prices

Sertraloft 100

coated tablets 100 mg blister, № 30 9Prices in pharmacies ax

Stimuloton ^®

film-coated tablets 100 mg blister , № 28

Egis

Prices in pharmacies

Emoton

capsules 50 mg container, № 30

Ersel Pharma

Prices in pharmacies

9002 8 Emoton

film-coated tablets 50 mg blister, № 30

Ersel Pharma

Pharmacy prices

specific serotonin (5-HT) reuptake inhibitor in neurons in vitro . It has little effect on the reuptake of norepinephrine and dopamine. At clinical doses, sertraline blocks the uptake of serotonin in human platelets. It does not have a stimulating, sedative or anticholinergic effect and does not have cardiotoxicity. Due to selective inhibition of 5-HT uptake, sertraline does not enhance catecholaminergic activity. Sertraline has no affinity for muscarinic (cholinergic), serotonin, dopamine, adrenergic, histamine, GABA or benzodiazepine receptors. Long-term use of sertraline in animals led to a decrease in the activity of norepinephrine receptors in the brain; other clinically effective antidepressant and anti-obsessional drugs have a similar effect.

Unlike tricyclic antidepressants, sertraline does not cause weight gain in the treatment of depression or obsessive-compulsive disorder (OCD); in some patients, it even decreases. The development of drug dependence has not been established.

Sertraline is actively biotransformed during the first pass through the liver. The main metabolite, N-desmethylsertraline, is almost 20 times less active than sertraline in vitro and is actually inactive in models of depression in vivo . T _½ N-desmethylsertraline varies within 62–104 hours. Sertraline and N-desmethylsertraline are actively biotransformed in the body; the resulting metabolites are excreted in the feces and urine in equal amounts. Unchanged sertraline is excreted in the urine in small amounts (<0.2%). Eating does not significantly affect the bioavailability of sertraline.

depression (symptomatic treatment), including accompanied by anxiety, with or without a history of mania. After achieving a clinical effect, maintenance therapy with sertraline can prevent relapses of depression.

Sertraline is also indicated for the treatment of OCD, including in children. Long-term (up to 2 years) treatment of OCD with sertraline is quite effective, safe and well tolerated after the initial effect is achieved.

Sertraline is also used to treat panic disorders with or without agoraphobia.

sertraline is prescribed once a day in the morning or evening, regardless of the meal. The usual therapeutic dose is 50 mg/day.

Treatment of panic disorders should be started at 25 mg/day, after 1 week of use the dose of sertraline is increased to 50 mg/day. Such a scheme helps to reduce the frequency of occurrence of negative reactions characteristic of panic disorder at an early stage of treatment.

The daily dose of the drug for all indications can be increased from 50 mg/day (with insufficient therapeutic effect) to 200 mg/day over several weeks.

Initial therapeutic effect may develop within 7 days; however, it usually takes 2-4 weeks or more to achieve the full effect (in the treatment of OCD). Maintenance dose for long-term treatment should be minimally effective; in the future, it is corrected depending on the therapeutic effect. Like many drugs, sertraline should be used with caution in patients with renal or hepatic impairment.

The safety and efficacy of sertraline in children aged 6–17 years has been established. The initial dose for the treatment of OCD in children aged 13-17 years is 50 mg / day, for children aged 6-12 years, a dose of 25 mg / day is prescribed initially, after 1 week it is increased to 50 mg / day. If necessary, in the future, the dose can be increased from 50 mg / day (with insufficient therapeutic efficacy) to 200 mg / day. When increasing the dose to prevent overdose, the lower body weight in children compared with adults should be taken into account. Considering 24 hour T _½ sertraline, the dose should be changed no more than once a week.

simultaneous treatment with MAO inhibitors, hypersensitivity to sertraline.

possible nausea and other dyspeptic symptoms, unstable stool or diarrhea, tremor, dizziness, insomnia, drowsiness, increased sweating, dry mouth and sexual dysfunction in men (mainly delayed ejaculation), withdrawal syndrome (rare cases), asymptomatic increased activity of ALT and AST (usually during the first 9weeks of treatment and quickly disappear after the abolition of sertraline), hyponatremia, platelet dysfunction, sometimes reactions that cannot be distinguished from the manifestations of the course of the underlying disease: paresthesia, hypoesthesia, symptoms of depression, hallucinations, aggressive behavior, agitation, anxiety and psychosis.

during treatment with antidepressants or anti-obsessional agents, there may be cases of exacerbation of mania or hypomania, convulsions. If seizures occur, in all cases, sertraline should be discontinued.

Patients with depression are prone to suicidal attempts, therefore, at the beginning of treatment, such patients should be under strict medical supervision.

The safety and efficacy of sertraline in children under 6 years of age have not been established. Sertraline should only be used during pregnancy if the expected benefit to the mother outweighs the potential risk to the fetus. Women of reproductive age during treatment with sertraline should use adequate methods of contraception. There is no information on the penetration of sertraline into breast milk, so it is not recommended to prescribe it during breastfeeding.

severe reactions (symptoms resembling serotonin syndrome) are possible in patients receiving sertraline in combination with MAO inhibitors. Symptoms of the interaction of selective serotonin reuptake inhibitors and MAO inhibitors include: hyperthermia, rigidity, muscle cramps, autonomic instability, changes in mental state (confusion, irritability and excessive arousal with the development of delirium and coma). In this regard, sertraline should not be used in combination with MAO inhibitors and should not be administered within 14 days after stopping treatment with them. You can prescribe an MAO inhibitor no earlier than 14 days after the abolition of sertraline.

When prescribing sertraline with other serotonergic drugs (tryptophan, fenfluramine), care must be taken and, if possible, such a combination should be avoided due to the existing possibility of pharmacodynamic interaction.

Substitution of other antidepressants or anti-obsessional drugs with sertraline should be done with extreme caution, especially when replacing long-acting drugs (eg fluoxetine).

Co-administration of sertraline 200 mg/day does not potentiate the effects of alcohol, carbamazepine, haloperidol, or phenytoin on cognitive and psychomotor function in healthy individuals; however, concomitant use of sertraline and alcohol should be avoided.

Co-administration of sertraline with diazepam or tolbutamide results in a small but statistically significant change in some pharmacokinetic parameters. Cimetidine causes a significant decrease in the clearance of sertraline in their combined use. The clinical significance of this effect is unknown. Sertraline had no effect on the β-adrenergic blocking activity of atenolol. Signs of interaction of sertraline at a dose of 200 mg/day with glibenclamide and digoxin were not identified.

Co-administration of sertraline 200 mg/day with warfarin resulted in a slight but statistically significant increase in prothrombin time; the clinical significance of this effect is unknown. In this regard, the prothrombin time should be carefully monitored at the beginning of sertraline therapy and after its withdrawal.

Caution should be exercised when sertraline is co-administered with drugs such as lithium, the effect of which may be mediated by serotonergic mechanisms.

possible death if the dose of sertraline is exceeded in combination with other drugs and / or alcohol. There is no specific antidote for sertraline. It is advisable to wash the stomach, prescribe enterosorbents, control vital functions, ensure airway patency and adequate ventilation of the lungs, and carry out symptomatic and supportive therapy. Given the large volume of distribution of sertraline, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are ineffective.

Seralin (sertraline) in the treatment of depression | #10/05

The prevalence of depressive disorders, the variability of their structure, combination with other neurotic or psychotic disorders, connection with personal attitudes, somatic and social factors give rise to a large number of clinical forms of depression and, therefore, require the use of a variety of therapeutic agents.

Affective disorders occur during the life of every fifth person. The risk of developing depression reaches a level of 20%, 1% of cases are diagnosed initially each year, depression recurs in 55% of individuals, and becomes chronic in 12–15%. More than 60% of patients with depression do not fall into the field of view of psychiatrists, since atypical clinical forms predominate in the structure of morbidity.

Only 10-15% of patients with depression receive treatment, and only 0.1% of patients are admitted to psychiatric hospitals. According to WHO estimates, major depression is now the 4th leading cause of reduced life expectancy, taking into account reduced work capacity.

30-40% of patients with depression remain resistant to adequate thymoanaleptic therapy. In this case, resistance to the first drug reaches 40-60%.

Modern requirements for an antidepressant, along with a sufficiently effective thymoanaleptic effect, include good tolerability and a favorable side effect profile, as well as the absence of “behavioral toxicity”.

In this regard, there is a constant search for drugs that would optimally combine both high thymoanaleptic efficacy and a sufficient degree of safety.

Antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs) are the most widely used in the world psychiatric and general medical practice. Their therapeutic effect is associated with inhibition of serotonin reuptake both in the central nervous system and in the peripheral nervous system. At the next stage, the blocking function of serotonin IA receptors located in the somatodendritic part of neurons in the raphe region of the midbrain is disrupted. At the same time, the side effects of the drug that occur at the 1st stage are mitigated, and signs of a therapeutic antidepressant effect appear. Serotonin neurons are disinhibited (disinhibited), and serotonin begins to rapidly release from the axons leading to different brain structures. SSRI preparations do not have pronounced “behavioral toxicity”, anticholinergic side effects, adverse hepato-, cardiotropic effects and teratogenicity. They are convenient to use, as they have a prolonged action up to a day, can be used without dose titration, do not cause dependence and withdrawal syndrome.

This group of drugs includes sertraline (zoloft, seraline). However, it has its own specific features that predetermine its relevance in clinical practice.

Firstly, it is a balanced type of drug that does not cause an exacerbation of anxiety and emotional tension, which makes it possible to expand the scope of its application.

Secondly, it can be attributed to the SSRIs of the second generation, since the geometry of the antidepressant at the molecular level has been changed in its structure, as a result of which it was possible to achieve a more “precise” interaction with the receptor. So, when comparing the S- and R-enantiomers, it turned out that the S-enantiomer of the active substance is 30 times more potent serotonin reuptake inhibitor than its optical antipode.

Thirdly, sertraline is one of the few antidepressants approved for use in pediatric practice, which, apparently, may indicate the level of its safety.

Fourthly, this drug has proven itself in the treatment of depression with comorbid mental disorders, which expands the range of its use both in psychiatry and in general medical practice: chronic pain syndrome, bulimia, obesity, alcoholism, obsessive-compulsive disorders, attention deficit disorder with hyperactivity, panic disorders, etc.

Side effects of the drug are associated with hyperstimulation of the serotonin system: gastrointestinal disorders, loss of appetite, dizziness, nausea, diarrhea, hyperreflexia.

Sertraline hydrochloride is a bicyclic drug, a derivative of naphthylamine. It is a potent selective inhibitor of serotonin reuptake, does not cause blockade of muscarinic, serotonin, adrenergic and GABAergic receptors. The drug has practically no anticholinergic, cardiotoxic and sedative properties. The basis of its action profile is a distinct thymoleptic effect with a weak stimulating component. Relieving depressive symptoms, the drug also successfully affects the parameters of the immune, neurotransmitter and hormonal systems.

A number of works by modern authors are devoted to the clinical evaluation of the use of sertraline for the relief of depression in patients [1, 2, 3, 4, 5, 6, 7, 8, 9].

Our study pursued the following objectives: to confirm the antidepressant activity of the drug seralin ^* ; determine the effectiveness of the drug depending on the complexity, depth of the structure of depressive disorders; clarify the spectrum of psychotropic activity of the drug, identify the side effects.

The study involved 40 patients (14 men, 26 women), whose clinical picture revealed depressive conditions within a single or recurrent depressive episode (F-33.1; F-33.2), bipolar affective disorder (F-31, 3; F-31.4), cyclothymia with comorbid anxiety-phobic personality disorders (F-60.1; F-60.3).

The selection criteria were: the leading mental disorder — depressive syndrome; relative monomorphism of the disorder.

Exclusion criteria: children’s and senile age; severe somatoneurological pathology; the severity of the schizophrenic defect; substance abuse.

The patients’ age ranged from 20 to 61 years. The duration of the disease ranged from 1 week to 18 years. The mental state of patients at the start of therapy was determined by depressive symptoms of varying depth and structure.

The patients were diagnosed with the following syndromes: typical classical depression; anxious depression; apathetic depression; obsessive-phobic syndrome; depressive delusional syndrome.

Comorbid anxiety-phobic disorders were represented by panic attacks in 21 patients, manifestations of the type of generalized anxiety – in 14, obsessive-compulsive disorders – in 5 patients. The duration of treatment was 6 weeks. The initial daily dose was determined individually (50 or 100 mg/day). The maximum dose is up to 150 mg / day. The drug was administered orally in the morning, along with food; combinations with other antidepressants were avoided whenever possible. However, the peculiarities of the mental state of patients dictated the need to prescribe sedative or hypnotic drugs. Therefore, we used clonazepam, phenazepam and small doses of neuroleptics: sonapax, chlorproxen. During the follow-up period, 5 patients dropped out of the study for various reasons: 2 of them were discharged from the hospital due to family reasons against the background of some improvement in their condition; in 2 clinical cases, there was a transition to another phase (affect inversion).

Feeling of nausea, mild diarrhea, increased heartburn, loss of appetite was noted by 1 patient.

The therapeutic effect of seralin was determined by the degree of reduction in the total score of the Hamilton scale (HDRS) to assess depressive symptoms at different periods of treatment. The total score was recorded during five visits: H0 — at inclusion in the study; H1 – 1 week after the start of the drug; H2 – after 2 weeks; H3 – after 4 weeks; H6 – after 6 weeks after the start of taking seralin.

The criterion for the effectiveness of therapy was a 50% reduction in symptoms according to HDRS. An additional assessment of the effectiveness of therapeutic measures was performed on the basis of the CGI scale of general clinical impression. All patients were examined daily by a doctor. The dynamics of the state was reflected in extended diaries according to rating scales and the results of paraclinical studies.

When analyzing the results of the study, attention is drawn to the dynamism and relative harmony of the reduction of depressive symptoms, the absence of a period of hyperstimulation, increased anxiety, agitation, and activation of suicidal tendencies. This is especially important for depressed patients with obsessive-phobic disorders in the form of panic attacks, since the initial level of anxiety in them at the beginning of therapy significantly exceeded the level of anxiety in other patients. At the 1st stage of treatment, the actualization of anxious fears decreases, a more relaxed attitude towards phobias is formed, hypochondriacal manifestations fade, by the end of the 2nd week, the manifestation of anxiety and somatization decreases in patients, the level of anxiety harmoniously decreases and mood improves.

Obsessive-phobic symptoms cease to dominate in consciousness, manifestations of avoidant behavior soften, obsessions and phobias cease to be painfully painful, their significance decreases. On the 4th week of therapy, patients have plans for the future, interest in cognitive and work activities awakens, they move more easily, communicate and gradually return to their usual way of life. Patients develop a positive attitude towards the drug and an understanding of the need for long-term maintenance therapy.

Dynamics in the form of a dissociated variant of the reduction of symptoms was observed in those clinical cases when melancholy or apathy was the predominant affect in the structure of the depressive syndrome, and comorbid symptoms were represented by a generalized anxiety state or “depressive alienation” of mental functions (apathy, anhedonia, abscess in the form of influxes of painful reasoning, without a pronounced somatovegetative component, adynamia, etc.). At the 1st stage of the study, anxiety and the relevance of painful experiences decreased, and at the 2nd stage, mood improved and vital activity appeared.

At the end of the study, the results of therapy showed that 22 patients had a “marked improvement” (according to the CGI scale), 11 patients had a “moderate improvement”, 4 patients had a “slight improvement”, 2 patients had an “undetermined antidepressant effect” ( short-term improvement, without stabilization of the condition) and 1 – no change.

The pronounced thymoleptic activity of the drug was confirmed by the dynamics of the HDRS depression scale indicators: a pronounced therapeutic effect (a decrease in indicators by more than 50%) was registered at the transition from the 3rd to the 4th week of the study. By the end of therapy, a decrease in the average score on the HDRS scale by 34% from the baseline was noted.

In all patients, the stimulating effect appeared on the 4th week of therapy.

In the course of the study, side effects were identified in 5 patients. On the 3rd day, 1 patient developed anxiety, an excited state, which, apparently, is associated with the still insufficiently formed anxiolytic effect of the drug. In three clinical cases, transient symptoms of nausea were observed. In 1 patient, there was a short-term urinary retention, which resolved without discontinuation of the drug and dose reduction. Side effects described in the literature (L. Ziplinski et al., 1989; H. Gommans, 1990) were not registered in our study.

Analyzing clinical observations, we can draw the following conclusions.

• Seralin (sertraline) has a pronounced thymoleptic effect.
• The profile of the therapeutic activity of the antidepressant seralin consists of a harmonious, sequentially formed anxiolytic, thymoleptic and stimulating effects.
• Seralin can serve as the drug of choice in the treatment of depression with a predominance of anxiety, especially with comorbid obsessive-phobic disorders.
• The peculiarity of the therapeutic profile of the drug makes it possible to avoid an increase in suicidal risk in the early stages of depression treatment.
• The drug seralin is well tolerated, side effects are minor, quickly stopped and do not interfere with therapy.
• The antidepressant seraline (sertraline) is characterized by a balanced therapeutic effect with sequentially occurring anxiolytic, thymoleptic and weak stimulating effects.

For literature, please contact the editor.

B. A. Tashmatov , Doctor of Medical Sciences, Professor
N. Bulychev, Associate Professor
1st Tashkent State Medical Institute , Tashkent

^* The drug is registered in Ukraine, Kazakhstan, Uzbekistan and a number of other CIS countries; in Russia passes the stage of registration.