Sertraline is an antidepressant from the drug class selective serotonin reuptake inhibitors, or SSRIs. Sertraline relieves the symptoms of depression by increasing the levels of the chemical messenger serotonin in the brain. It additionally is used to treat obsessive compulsive, anxiety disorders and post-traumatic stress. A 2001 review in "CNS Drug Reviews" reports that clinical trials demonstrate that sertraline is efficacious in treating mood and anxiety disorders and that its tolerability and safety profile are favorable.
Sexual Side Effects
Sertraline can cause impotence in men. The drug label on DailyMed reports ejaculation failure occurred in 7 percent of men in a clinical trial study. Daily use of sertraline is also associated with reduced sexual desire in both men and women.
Nausea and Diarrhea
The website Drugs.com reports that in clinical trials sertraline treatment caused diarrhea in 18 percent of patients and nausea in 25 percent of patients treated for manic depressive disorder.
Symptom Worsening
In some cases, sertraline treatment has exacerbated symptoms of depression and mania. These symptoms included insomnia, anxiety, irritability and restlessness. The drug label on DailyMed reports that sertraline treatment caused hypomanic or manic episodes in 0.4 percent of treated patients in clinical studies.
Weight Loss
The drug label on DailyMed reports that on average sertraline treatment decreased weight by 1 to 2 pounds in patients in clinical trials.
Birth Defects
The drug label on DailyMed reports that women who take SSRI antidepressants during pregnancy have babies that have an increased risk for pulmonary hypertension. A safety report published in the June 2009 issue of "CNS Drugs" reports that there is evidence that SSRIs given during pregnancy cause birth defects, most notably cardiac abnormalities in infants. Also, SSRI administration during pregnancy is associated with prematurity and low birth weight in offspring, notes the report. There are no specific studies evaluating the effects of sertraline administration during pregnancy on the risk of birth defects in newborns.
Suicide
The Food and Drug Administration added a warning to all antidepressant medications in 2005 stating that antidepressants in general can increase the risk of suicidal thinking and behavior in children and adolescents. In 2007, the warning was extended to include young adults between the ages of 18 and 24. Sertraline is not approved for use in children except for the treatment of obsessive compulsive disorder, notes DailyMed.
Withdrawal
A review in the May 2000 issue of the "Journal of Psychiatry and Neuroscience" reports that some people on SSRIs experience withdrawal symptoms when treatment is stopped or the administered dose is reduced. The symptoms of SSRI withdrawal include dizziness, shock-like sensations, visual disturbances, tremor, fatigue, nausea, diarrhea, anxiety, headache, insomnia, irritability and tremor.
Drug Interactions
Adverse reactions may occur if this drug is taken in combination with a monoamine oxidase inhibitor, such as isoniazid, phenelzine and tranylcypromine. The symptoms of this drug interaction can include increased body temperature, muscle twitching and rigidity, confusion, extreme agitation, and coma, according to DailyMed. Sertraline may cause gastrointestinal bleeding, and patients should be monitored if they are also taking the blood thinner warfarin or nonsteroidal anti-inflammatory drugs, commonly known as NSAIDs.
Dosage
DailyMed recommends an initial dose of 50mg per day, and the dose may be increased up to a maximum of 200 mg/day.
References
- "CNS Drug Reviews"; The Selective Serotonin Reuptake Inhibitor Sertraline: Its Profile and Use in Psychiatric Disorders; G. MacQueen et al.; Spring 2001
- DailyMed: Sertraline
- "CNS Drugs"; Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy; Sura Alwan and Jan Friedman; June 2009
- Drugs: Sertraline
- "Journal of Psychiatry and Neuroscience"; Selective Serotonin Reuptake Inhibitor Discontinuation Syndrome; K. Black et al.; May 2000
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