The active ingredient sertraline is used to treat depression as well as anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder. The antidepressant exerts its effect in the brain by increasing the concentration of the neurotransmitter serotonin there. Like other antidepressants, sertraline has side effects: During treatment, patients may experience dizziness, headaches, and gastrointestinal problems, among other symptoms. Learn more about possible side effects and the effects and dosage of the active ingredient here.
Effect of sertraline
Just like citalopram and fluoxetine, sertraline belongs to the selective serotonin reuptake inhibitors (SSRIs). This group inhibits the reuptake of the neurotransmitter serotonin into cells in the brain, so that the concentration in the synaptic cleft increases. This counteracts depression – because depression is thought to result from a deficiency of the neurotransmitters norepinephrine and serotonin in the brain. If sertraline is used to treat depression, it has a drive-enhancing effect from the first dose. However, it can take several days before the mood-lifting effect of the antidepressant sets in. However, the active ingredient is not only used to treat depression, but also as a preventive measure: Taking it is intended to ensure that depressive phases do not recur.
Side effects of sertraline
Sertraline has a number of side effects – how severe they are depends mainly on the dose taken. Some of the side effects disappear over time or at least improve over the course of treatment. In general, the antidepressant has fewer side effects than other SSRIs. The most common side effects include:
- Dizziness
- Insomnia and fatigue
- Sleepiness
- Tremor
- Sexual dysfunction
- Gastrointestinal problems such as nausea, vomiting, diarrhea or constipation
- Loss of appetite
- Skin rash
- Headache
- Ringing in the ears
- Abdominal pain
- Palpitations
Occasionally, taking the drug may cause side effects such as weight gain, fever, skin bleeding, liver disorders, hair loss, high blood pressure and cardiac arrhythmias. Rarely, platelet deficiency, hypothyroidism, seizures, and urinary retention may also occur. For a complete list of sertraline side effects, please see the package insert.
Serotonin syndrome as a dangerous side effect.
Overdosing on sertraline or taking other medications that affect serotonin levels at the same time can cause life-threatening serotonin syndrome. The excessively high level of serotonin in the brain can cause symptoms such as nausea, diarrhea, sweating, confusion, and seizures and even coma. Serotonin syndrome is life-threatening and therefore must be treated in the intensive care unit.
Discontinuing sertraline
If you want to stop treatment with sertraline, you must also expect side effects. Whether and how severe these occur depends not only on the dosage and duration of treatment but also on the speed at which the dose is reduced. Therefore, you should never stop the active substance abruptly, but always end the treatment slowly. Discuss with your doctor the best way to proceed when stopping the drug. When stopping sertraline, side effects may include headache, nausea, vomiting, sleep disturbances, dizziness, and anxiety. Usually, the symptoms subside within two weeks, but in some cases it can take between two and three months for all side effects to disappear.
Dosage of sertraline
You should always discuss the optimal dosage of sertraline for you with your treating physician. This is because the dosage of the active ingredient may vary depending on the diagnosis. Unless otherwise prescribed, the following doses are common in adults:
- Depression and obsessive-compulsive disorder: Once daily 50 milligrams of sertraline (maximum dose: 200 milligrams ).
- Panic disorders, anxiety disorders and post-traumatic stress disorder: Initially once daily 25 milligrams of sertraline, the dose can be increased to 50 milligrams after one week (maximum dose: 200 milligrams )
Sertraline should be taken once daily in the morning or evening.Due to the mood-lifting effect, it is recommended to take it in the morning. The active ingredient can be taken either with or between meals.
Contraindications of sertraline
Just as with other active ingredients, there are a number of contraindications to sertraline. For example, the active ingredient must not be used if there is hypersensitivity to the antidepressant. Similarly, sertraline must not be taken if treatment with MAO inhibitors is taking place at the same time. In general, there should be at least a 14-day period between treatment with MAO inhibitors and therapy with sertraline. Otherwise, life-threatening serotonin syndrome may occur. In addition to MAO inhibitors, sertraline should not be taken together with pimozide and disulfiram.
Possible drug interactions
While taking sertraline, it may interact with certain other medications. This is especially true for the following agents:
- Medications containing the amino acid tryptophan.
- Herbal medicines containing St. John’s wort
- Medicines for the treatment of severe pain
- Diuretics
- Medicines for the treatment of migraine
- Medicines for the treatment of ulcers and excess gastric acid.
If you are taking any of these medications, be sure to tell your doctor before starting treatment. This is also true if you are already being treated with another antidepressant.
Increased risk of suicide at the start of treatment.
Under certain conditions, sertraline may be taken only with special caution. This is the case, for example, in patients with epilepsy or other seizure disorders. Also, individuals with a history of schizophrenia or manic-depressive illness must be closely monitored during treatment. Individuals suffering from liver disease, diabetes, or bleeding disorders should inform their physician of their condition prior to starting treatment. The same applies to individuals who have low sodium levels and are taking blood thinning or antihypertensive medications. Taking sertraline may increase the risk of suicide at the beginning of treatment. This side effect particularly affects young adults under 25 years of age. If you have had thoughts of self-harm or suicide in the past, you should talk about this with the doctor treating you before taking the medicine. If the thoughts occur while you are taking the medicine, you should also see your doctor or talk to someone you trust.
Sertraline and alcohol
You should avoid drinking alcohol during treatment with sertraline. Although studies have not yet found any negative effects on physical and mental abilities due to the mixture of the two substances. Nevertheless, as with many other medications, it is recommended that you do not drink alcohol during treatment.
Pregnancy and lactation
During pregnancy and lactation, the use of sertraline is not recommended. The drug should be used only when absolutely necessary and after consulting a doctor. This is because taking it can cause malformations in the unborn child as well as increased blood pressure in the lungs in the newborn. In breastfeeding women, small amounts of the antidepressant pass into breast milk. For this reason, the active ingredient should not be taken during breastfeeding. Although no adverse health effects on the infant have been observed to date, these cannot be ruled out either.
Sertraline in children and adolescents
Children and adolescents should also be treated with sertraline only in exceptional cases and after a careful cost-benefit analysis. In them, increased aggressive behavior and an increased risk of suicide may be triggered by taking the drug. In addition, there is insufficient evidence to date on possible consequences for child development.
