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Sertraline
(1S)-cis-4-(3,4-dichlorophenyl)-
1,2,3,4-tetrahydro-N-methyl-
1-naphthalenamine hydrochloride
CAS number
79617-96-2		 ATC code
N06AB06
Chemical formula C17H17NCl2·HCl
Molecular weight 342.7
Bioavailability 95%
Metabolism N-demethylation (liver)
Elimination half-life ~26 hours
Excretion Urine
Pregnancy category C
Legal status Rx-only, not a controlled substance
Routes of administration Oral tablets 25, 50 and 100 mg

Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®, Xydep®, Serlain®) is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type.

Contents

  • 1 Uses
  • 2 Side effects
  • 3 Forms and dosages
  • 4 Precautions
  • 5 Controversy
  • 6 External links

Uses

Sertraline is used medically mainly to treat the symptoms of depression and anxiety. It has also been prescribed for the treatment of obsessive-compulsive disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, panic disorder, and bipolar disorder. It was first approved by the FDA in 1991. The patent for this brand-name drug expired in December 2005. It is anticipated that the generic drug will be available June of 2006, manufactured by Andrx, Aurobindo, Genpharm, Ivax, Mylan, and Roxane.

Side effects

Sertraline can have a number of adverse effects, including insomnia, asthenia, gastrointestinal complaints, tremors, confusion, dizziness, anorgasmia, and decreased libido; it can induce mania or hypomania in around 0.5% of patients. It has also been known to cause minor weight loss. Sertraline also has dopamine reuptake inhibition properties at high doses. It is contraindicated in individuals taking MAOIs or undergoing electroconvulsive therapy.

Forms and dosages

Sertraline is manufactured by Pfizer and sold as Zoloft in the United States as small green 25 mg tablets, blue 50 mg tablets, and orange 100 mg tablets (Generic 100mg sertraline tablets are yellow), each of which is scored to allow easy halving. In Australia, only the 50 mg and 100 mg strengths are available, both as white tablets. Sertraline is an odorless, white, sparingly soluble crystalline solid. The minimum effective dose is 50 mg per day, but lower doses may be used in the initial weeks of treatment to acclimate the patient's body, especially the liver, to the drug and to minimize the severity of any side effects. Patients who do not experience relief of symptoms at 50 mg a day may have their dose increased, up to 200 mg a day.

Precautions

Because of its metabolism, liver impairment can affect the elimination of this drug from the body. If someone with liver impairment is treated with sertraline, lower or less frequent dosage should be used. Similarly, patients should limit their alcohol intake while on sertraline (or any antidepressant). Because the liver is doubly taxed with processing both substances (in addition to any other drugs the patient may be taking), alcohol remains in the bloodstream longer, so the effects of alcohol may be more strongly and quickly felt by people taking sertraline or other antidepressants.

Controversy

In June 2003, Britain banned the use of sertraline for children under 18 after studies showed a link to increasing suicidal rates. Similar concern has prevailed in the United States, where only the anti-depressant fluoxetine (another SSRI) is officially endorsed by the FDA for the treatment of depression in minors. However, because the antidepressant-suicide link is correlational, scientists do not know whether the increased suicide risk for people taking antidepressants occurs because the drugs make people suicidal, whether suicide occurs because the drugs un-depress the people enough to motivate the energy required to commit suicide (a popular theory), or because of a third, unknown factor.

External links

  • Zoloft.com official website
  • Zoloft research abstracts Medical literature research abstracts
  • Information from Webmd on Zoloft Dosage and other drug interaction information
  • Pictures of Zoloft Tablets Pictures of Zoloft Tablets


Antidepressants (ATC N06A) edit
Monoamine oxidase inhibitors: {Harmaline} {Nialamide} {Selegiline} {Isocarboxazid} {Iproniazid} {Iproclozide} {Moclobemide} {Phenelzine} {Toloxatone} {Tranylcypromine}

Dopamine reuptake inhibitors: {Bupropion} {Amineptine}

Norepinephrine reuptake inhibitors: {Atomoxetine} {Reboxetine} {Viloxazine}

Serotonin-norepinephrine reuptake inhibitors: {Desipramine} {Duloxetine} {Milnacipran} {Nefazodone} {Venlafaxine}

Selective serotonin reuptake inhibitors: {Alaproclate} {Etoperidone} {Citalopram} {Escitalopram} {Fluoxetine} {Fluvoxamine} {Paroxetine} {Sertraline} {Zimelidine}

Selective serotonin reuptake enhancers: {Tianeptine}

Tricyclic antidepressants: {Amitriptyline} {Clomipramine} {Desipramine} {Dothiepin} {Doxepin} {Imipramine} {Lofepramine} {Nortriptyline} {Protriptyline} {Trimipramine} {Iprindole} {Opipramol}

Tetracyclic antidepressants: {Maprotiline} {Mianserin} {Mirtazapine} {Amoxapine}

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