Sunday, 9th September, 2018

What is sertraline? Facts on uses, benefits and side effects

What you need to know about sertraline

Sertraline (SER-trah-leen) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI class). It’s most commonly used to treat depression, but it’s also prescribed for people with panic attacks, social anxiety disorder, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

Quick facts

  • Sertraline is also known by the brand name Lustral.
  • The medicine was first approved for medical use in the United States in 1991 and was initially made by the pharmaceutical company Pfizer. It entered the UK market around the same time.
  • A whopping 12.8 million items of sertraline hydrochloride were prescribed by GP surgeries in England in 2017. Over 7 million items were prescribed in the first six months of 2018 (source: openprescribing.net).
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Different brands of sertraline

Like many types of medicine, sertraline has a number of names that can be the source of confusion. Sertraline is the generic name and the active ingredient in the medicine, but it is often called by the brand names Lustral and Zoloft.

How does sertraline work?

Sertraline works by increasing the levels of a neurotransmitter called serotonin in the brain (hence its classification as a selective serotonin reuptake inhibitor). This helps to restore balance to the overall levels of chemicals in the brain. Higher levels of serotonin can help lift mood, reduce panic attacks and effectively treat OCD.

It usually takes between four and six weeks for the full effects of sertraline to be felt. For some people, improvements to their condition may be felt earlier.

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Sertraline dosage information

The usual starting dose for adults is 50mg a day. This can be gradually increased in steps of 50mg at intervals of one week or more. For people with depression and OCD, the maximum daily intake is 200mg.

For people with panic disorder, social anxiety disorder and PTSD, dosage initially starts at 25mg per day for the first week. This will then be increased to 50mg. From here, the medicine will only be increased further if it is tolerated and the response is only partial. The maximum dose for these conditions is also 200mg per day.

Children aged 6 to 12 will take 25mg per day, which can then be increased to 50mg per day after the first week of treatment. For children aged 13 to 17, the usual starting dose is 50mg per day. It’s possible for children of any age to have the doses increased to a maximum of 200mg per day (like adults), though this depends on the severity of their condition or symptoms.

If you have any questions about the sertraline dosage of yourself or someone else, speak to your GP or pharmacist. Further dosage information can be found inside the Patient Information Leaflet (PIL) that comes with your medication.

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How and when to take sertraline

Take sertraline once a day. You can take it with or without food, though most people decide to take it with a meal. Swallow the tablet whole with a glass of water, juice or milk. Do not crush, chew or divide the capsules.

If for whatever reason for miss a dose, do not double dose to make up for it. Echo’s reminders can help you to ensure you never miss a dose - meaning you’ll give the medication more chance to work.

Do not stop taking sertraline without the consent of your GP. Doing so can cause serious withdrawal symptoms or a relapse of the condition your are trying to treat.

What are side effects of sertraline?

Like any medication, it’s possible to experience side effects from sertraline. For most people, the side effects will start to wear off after a few weeks. Contact your GP if you are still experiencing unpleasant side effects after a few weeks - they may decide to lower your dose or take you off the medication altogether.

Common side effects of sertraline - which happen in more than 1 in 100 people include:

  • headache
  • stomach pain
  • diarrhoea
  • nausea
  • dizziness
  • vomiting
  • dry mouth
  • problems ejaculating (for men)

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Dizziness is a common side effect of sertraline

Serious side effects happen in less than 1 in 100 people. Tell your GP immediately if you are experiencing:

  • signs of potential low sodium levels, which includes headache, dizziness, difficulty concentrating, brain fog, memory loss or loss of balance
  • thoughts of suicide or self-harm, or about inflicting harm on others
  • chest pain and/or shortness of breath
  • signs of potential liver problem, such as yellow skin or eyes
  • changes in your period, including heavy bleeding or bleeding in between menstrual cycles
  • painful erections that last for hours (even outside of sex)

If you suddenly start experiencing any abnormal bleeding (whether coughing up blood, red stools or bleeding from your gums), this is also a cause for concern. While it may not be related to the use of sertraline, it’s certainly something that your doctor should be looking at.

In even rare cases, it’s possible for some people to have a serious allergic reaction to sertraline. If you start experiencing any of the typical warning signs of a serious allergic reaction - skin rash, trouble breathing or talking, wheezing, tightness in the throat or chest and/or swelling of the face, mouth, lips, tongue or throat - it’s a medical emergency. Contact a doctor straight away if you think either you or someone near you is having an allergic reaction.

sertraline-50mg-film-coated-tablets-packaging

Sertraline interactions

Sertraline can interact with the following medicines when taken together:

  • NSAIDS (e.g. naproxen) and antiplatelets (e.g. clopidogrel) can increase the risk of bleeding.
  • Other antidepressants, including other SSRIs, MAOIs (e.g. moclobemide) can increase the risk of serotonin syndrome, while TCAs such as amitriptyline can increase risk of hyponatremia.
  • Opioids such as tramadol - increased risk of serotonin syndrome

A comprehensive list of interactions with sertraline can be found on the NICE website. For further advice, ask your GP or pharmacist.

Who can and cannot take sertraline?

While sertraline can be taken by adults for a range of mental health conditions, for children aged 6 to 17 it can only be taken for OCD.

Do not take sertraline if you:

  • are allergic to sertraline or any of the ingredients of the medication
  • are taking a MAO inhibitor (such as phenelzine or selegiline) or have taken a MAO inhibitor in the last 14 days
  • are taking pimozide

What’s the easiest way to get sertraline?

Once you’ve been prescribed sertraline, the most hassle-free way to get hold of the medicine is to get it via Echo. Not only do we deliver it straight to you (cutting out the mad pharmacy dash), we also remind you when to take it. Medication management has never been easier.

For more information on sertraline, check out the NHS website


Clinically reviewed by Pooja Raichura MRPharmS: 7/9/18