IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

21 October 2021
Medically reviewed by
Sumayya Salam
Pharm D
what-is-sertraline-hydrochloride
Table of Contents

With the introduction of selective serotonin reuptake inhibitors (SSRIs) into clinical practice, they quickly displaced tricyclic antidepressants (TCAs) as first-line choices for treating depression. Sertraline is an SSRI with antidepressant and anxiolytic properties.

It was invented and developed at Pfizer and approved for medical use in 1991 in the United States. It is on the list of essential medications of the World Health Organization. Sertraline works by preventing presynaptic reuptake of serotonin from the synaptic cleft. This action is due to the long-lasting adaptive changes in serotonergic neurotransmission. 

Sertraline has improved tolerability and adverse effect profile and is relatively safe in overdose compared to other SSRIs. Let us see this in detail.

What Is Sertraline Hydrochloride?

Sertraline, sold under the brand name Zoloft, is an antidepressant of the SSRI (selective serotonin reuptake inhibitor) class. Before its approval for treating panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, it was initially recommended for treating Major Depressive Disorder.  

Sertraline is available as a generic medication. In 2016, it was the most commonly prescribed psychiatric medication & in 2019, it was the 12th most frequently prescribed medication, with over 37 million prescriptions in the United States.

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How Does Sertraline Work?

Sertraline belongs to the group of antidepressants known as SSRIs. Sertraline predominantly inhibits presynaptic serotonin reuptake. Serotonin builds up as a result of this obstruction of serotonin reuptake. Blocking serotonin reuptake is advantageous in illnesses like Major Depression because serotonin in the central nervous system regulates mood, personality, and alertness.

Sertraline also has little impact on the absorption of dopamine and norepinephrine. Due to its method of action, sertraline is effective in the treatment of a variety of psychiatric disorders.

The antidepressant sertraline, a selective serotonin uptake inhibitor, has been reported to promote weight loss.
SSRIs, such as Fluoxetine, Citalopram, Paroxetine, Sertraline, Fluvoxamine, and Escitalopram cross the placenta into the fetal bloodstream.
Yes, insomnia is one of the most common side effects of the medication Zoloft.

Uses Of Sertraline Hydrochloride

The drug treats major depressive disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and post-traumatic stress disorder. It also alleviates the symptoms of premenstrual dysphoric disorder and can be used in sub-therapeutic doses or intermittently for its treatment. It is not available over the counter. You can buy Sertraline online from a certified online pharmacy, only if you have a legit prescription from a licensed doctor.

Sertraline may be used as a part of combination therapy. You may administer it with other medications. Sertraline is better tolerated when compared with older tricyclic antidepressants, and it might work better than fluoxetine for some subtypes of depression. It is not approved for use in children except for those with OCD.

Sertraline may be used as a part of combination therapy. You may administer it with other medications. Sertraline is better tolerated when compared with older tricyclic antidepressants, and it might work better than fluoxetine for some subtypes of depression. It is not approved for use in children except those with OCD.

How To Use Sertraline HCL?

Take this medication orally as directed by your healthcare physician, typically once daily, either in the evening or morning. The tablet or liquid form of the medicine can be administered with or without food. Take the capsule form with food. Swallow the whole capsules, and avoid crushing or chewing them.

The liquid form of the medicine must be mixed with another liquid before use. Mix the dose with a half cup of water, ginger ale, lemonade, lemon-lime soda, or orange juice. Avoid using others to mix this drug. Do not prepare it in advance.

Studies Related To Sertraline Use

According to a study by McMahon, CHRIS G. "Treatment of premature ejaculation with sertraline hydrochloride: a single-blind placebo controlled crossover study." The Journal of urology 159.6 (1998), The efficacy of the drug on 37 patients aged 19-70 years old with premature ejaculation were treated with 50mg of sertraline hydrochloride. All the men were either in a stable, healthy relationship or married.

It was observed that after 4 weeks of treatment, 5 patients achieved intravaginal ejaculation with primary premature ejaculation while 2 patients experienced ejaculation. In conclusion, it was found that sertraline appears to be a helpful agent in the treatment of premature ejaculation.

How To Take Sertraline Hydrochloride?

The dosage information is for the oral sertraline tablet. Your dosage, drug form, & how frequent you take them depends on the following-

  • Age
  • Condition being treated
  • Severity of your illness
  • Other medical conditions

Reaction of yours to the initial dosages 

Dosing Information

Adult dose for depression:

  • Initial dose- 50mg once a day
  • Maintenance dose- 50 to 200mg once a day

Adult dose for obsessive compulsive disorder:

  • Initial dose- 50mg once a day
  • Maintenance dose- 50 to 200mg once a day

Adult dose for panic disorder:

  • Initial dose- 25mg once a day, you may increase it after a week to 50 mg once a day
  • Maintenance dose- 50 to 200mg once a day

Adult dose for post-traumatic stress disorder:

  • Initial dose- 25mg once a day, you may increase it after a week to 50 mg once a day
  • Maintenance dose- 50 to 200mg orally once a day

Adult dose for social anxiety disorder:

  • Initial dose- 25mg once a day, you may increase it after a week to 50 mg once a day
  • Maintenance dose- 50 to 200 mg once a day

Pediatric dose for Obsessive Compulsive Disorder:

For 6 to 12 years-

  • Initial dose- 25mg once a day
  • Maintenance dose- 25 to 200mg once a day

For 13 to 17 years-

  • Initial dose- 50mg once a day
  • Maintenance dose- 50 to 200mg once a day 

Side Effects Of Sertraline Hydrochloride

Side effects are undesired drugs that occur on administering the drug. If you are experiencing mild side effects, they may vanish within a couple of days or weeks. But if these effects are severe, you need to consult your healthcare physician or pharmacist. Some of the common and serious side effects of sertraline hydrochloride include-

Common

Serious

Nausea

Suicidal thoughts

Loss of appetite

Severe allergic reactions

Diarrhea

More frequent urination

Indigestion

New or worsening depression

Change in sleep habits including sleepiness and insomnia

Aggressiveness

Increased sweating

Heavy menstrual periods, abnormal bleeding

Sexual problems, including decreased sex drive and ejaculation failure

Slowed growth rate and weight change

Warnings Of Sertraline

Warnings convey crucial instructions for the safe use of the medication, or they indicate rare but potentially harmful side effects. Drugs are labeled with warnings to give patients key information for the proper use of medications.

  • Do not take Sertraline if you are allergic to it.
  • Take Sertraline Hcl as prescribed.
  • Avoid sertraline if you are on pimozide or being treated with methylene blue injection.
  • Avoid sertraline if you have used an MAO inhibitor in the past 14 days (isocarboxazid, methylene blue injection, rasagiline, selegiline, or tranylcypromine).
  • Some young adults have thoughts about suicide before taking an antidepressant. Stay alert to changes in your mood or symptoms and report them to your healthcare physician.
  • Seek immediate medical attention if you have serotonin syndrome like agitation, shivering, twitching, loss of coordination, fast heart rate, fever, sweating, vomiting, nausea, or diarrhea.
  • In the event of a missed dose of Sertraline, do not take an extra pill.
  • Your healthcare physician or pharmacist will provide you with the manufacturer’s guide at the beginning of the treatment. 
  • Read the instructions carefully and follow the guide. Consult your healthcare physician if you have any queries. From the official FDA website, you can obtain the medication guide.

Drug Interactions Of Sertraline

Drug interaction can change the working and mechanism of your medication, or it may also increase the risk of severe side effects. It is always recommended to keep a list of all the products you use and share it with your healthcare physician. Do not start, stop, or alter the medication dose without your healthcare physician's approval.

Interactions of Sertraline

  • Consuming other drugs that increase serotonin increases the risk of serotonin syndrome.
  • NSAIDs such as Ibuprofen, Aspirin can increase the risk of bleeding when used along with sertraline. 
  • Concomitant use of Sertraline with lithium increases your risk for serotonin syndrome.
  • Avoid MAO inhibitor use with Sertraline as it may result in fatal interaction.
  • Taking Warfarin with sertraline increases your risk of bleeding or bruising.
  • Consult your healthcare physician if you're consuming products that cause drowsiness like alcohol, marijuana, antihistamines, drugs for anxiety and insomnia, muscle relaxants, and opioid pain or cough relievers.

Bottom Line From Practical Anxiety Solutions

Sertraline seems to have advantages over the more well-known antidepressant medications, especially in tolerance and acceptance.  It is well suited for treating elderly depressed patients due to its relative lack of anticholinergic and sedative effects. 

Overall, Sertraline has significant advancement in the field of antidepressant medication since it provides far better tolerance and safety than tricyclic antidepressants, which have been the standard of care. Sertraline currently represents a safe substitute for commonly prescribed antidepressant medications in managing depression.

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