What is the starting dose of sertraline (Selective Serotonin Reuptake Inhibitor - SSRI)?

From the Guidelines

The starting dose of sertraline for the treatment of premature ejaculation is 50 mg, taken 4 to 8 hours before intercourse, as this dose has been shown to increase ejaculatory latency with minimal side effects 1. When considering the treatment of premature ejaculation with sertraline, it's essential to weigh the benefits and risks, particularly in men not wanting ejaculatory impairment.

• The recommended dose range for sertraline in the treatment of premature ejaculation is 25-200 mg/day, or 50 mg taken 4-8 hours before intercourse 1.
• The choice of dosing regimen, whether continuous daily dosing or situational dosing, often depends on the frequency of sexual activity and patient preference.
• It's crucial to note that higher doses of sertraline may increase efficacy but may also be associated with increased frequency of erectile dysfunction and decreased libido, although studies to date have been too small to substantiate this conclusion about dose-related side effects 1.
• Adverse effects of sertraline, such as nausea, dry mouth, drowsiness, and reduced libido, are generally similar to those reported in patients being treated for depression and are typically acceptable to most patients 1.
• As with any medication, it's essential to monitor patients for potential drug interactions, particularly with concomitant use of monoamine oxidase inhibitors, lithium, sumatriptan, and tryptophan, which can result in a "serotonergic syndrome" 1.

From the FDA Drug Label

Consequently, a dose of 50 mg, administered once daily, is recommended as the initial therapeutic dose. Sertraline treatment should be initiated with a dose of 50 mg/day, either daily throughout the menstrual cycle or limited to the luteal phase of the menstrual cycle, depending on physician assessment Sertraline treatment should be initiated with a dose of 25 mg once daily in children (ages 6 to 12) and at a dose of 50 mg once daily in adolescents (ages 13 to 17)

The starting dose of sertraline is:

• 50 mg/day for adults
• 25 mg/day for children (ages 6 to 12)
• 50 mg/day for adolescents (ages 13 to 17) 2

From the Research

Starting Dose of Sertraline

• The starting dose of sertraline is typically 50 mg/day, as established in the treatment of depression 3.
• This dose is considered the usually effective therapeutic dose and the optimal dose when considering both efficacy and tolerability for most patients 3.
• For patients who do not show an adequate therapeutic response within 24 weeks, the dose of sertraline can be increased in 50 mg/day increments at no less than weekly intervals to a maximum of 200 mg/day 3.

Administration

• Sertraline is generally given as a single daily dose and may be administered at any time of the day 3.
• There is no need for altered dose recommendations in the elderly, unlike other selective serotonin reuptake inhibitors 3.

Other Considerations

• Sertraline has been compared to other SSRIs, such as paroxetine, in the treatment of generalized anxiety disorder, and both medications were found to be similarly effective and well tolerated 4.
• The use of sertraline in the treatment of panic disorder and agoraphobia has also been studied, and it has been found to be effective in reducing symptoms 5.
• Chronic administration of sertraline has been found to alter mood and personality in healthy volunteers, with increases in positive affect and decreases in negative affect 6.
• Sertraline has also been suggested as a potential treatment for borderline personality disorders in older adults, particularly for symptoms of affective instability and impulsive behavior 7.