What is the recommended dose of Lustral (sertraline)?

From the Guidelines

The recommended dose of Lustral (sertraline) is 25-200 mg/day, with situational dosing of 50 mg 4-8 hours prior to intercourse, as this has been shown to increase ejaculatory latency and improve patient satisfaction 1. When considering the treatment of premature ejaculation with sertraline, it's essential to weigh the benefits and risks, particularly in terms of adverse effects such as nausea, dry mouth, drowsiness, and reduced libido.

• Key factors influencing the choice of dose include the frequency of sexual activity, the patient's response to the medication, and potential side effects.
• The optimal interval for situational dosing before intercourse has not been established, but a dose of 50 mg 4-8 hours prior to intercourse is commonly used.
• Continuous daily dosing may also be effective, with doses ranging from 25 to 200 mg/day, and the choice of regimen often depends on the patient's individual needs and preferences.
• It's crucial to monitor patients for adverse effects and adjust the dose accordingly, as higher doses may increase the risk of side effects such as erectile dysfunction and decreased libido.
• The benefits of sertraline in treating premature ejaculation are well-established, but the long-term effects and potential for discontinuation of therapy are not yet fully understood 1.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Initial Treatment Dosage for Adults Major Depressive Disorder and Obsessive-Compulsive Disorder Sertraline treatment should be administered at a dose of 50 mg once daily. Patients not responding to a 50 mg dose may benefit from dose increases up to a maximum of 200 mg/day.

The recommended dose of Lustral (sertraline) is 50 mg once daily. Patients who do not respond to this dose may benefit from increases up to a maximum of 200 mg/day 2.

From the Research

Lustral (Sertraline) Dose

• The recommended dose of Lustral (sertraline) is 50 mg daily, which is 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.
• Sertraline is generally given as a single daily dose and may be administered at any time of the day 3.
• The elimination half-life of sertraline ranges from 22-36 hours, and once-daily administration is therapeutically effective 4.
• Steady-state plasma concentrations vary widely, up to 15-fold, in patients receiving usual antidepressant dosages between 50 and 150 mg/day 4.

Factors Affecting Dose

• The kinetics of sertraline in the elderly and in patients with renal impairment are similar to those in young healthy female volunteers 5.
• No reduction in dosage is recommended for elderly patients or patients with renal impairment 5.
• Patients who achieve a stable daily dose of sertraline in an efficient and timely manner are more likely to remain persistent throughout 1-year follow-up 6.

Dosing Recommendations

• Simplifying the treatment regimen and decreasing pill burden can improve adherence and/or persistence with sertraline therapy (100 or 150 mg/d) 6.
• The importance of achieving a stable daily dose of sertraline (time taken, number of dose adjustments needed) can impact adherence/persistence and healthcare resource utilisation 6.
• SSRIs, including sertraline, are safer and more tolerable than previous antidepressants, with dosing recommendations varying depending on the specific medication and patient population 7.