From the Guidelines
Sertraline is primarily indicated for the treatment of major depressive disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD) as suggested by the most recent guideline evidence 1.
Indications for Sertraline
The indications for sertraline are varied and include:
- Major depressive disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD) It's also used off-label for generalized anxiety disorder, eating disorders, premature ejaculation, and certain pain conditions.
Dosage and Administration
The typical starting dose of sertraline is 50mg once daily, which can be gradually increased to a maximum of 200mg daily based on response and tolerability, as noted in the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1. For OCD, doses may need to be higher (up to 200mg), while for PMDD, doses typically range from 50-150mg daily during the luteal phase or continuously.
Mechanism of Action
Sertraline works by inhibiting serotonin reuptake in the brain, increasing serotonin availability at synapses, which helps regulate mood, anxiety, and other neurological functions.
Important Considerations
Patients should be aware that therapeutic effects may take 2-4 weeks to become noticeable, and treatment should continue for at least 6-12 months after symptom resolution for depression to prevent relapse, as suggested by the guideline for managing depressive disorders 1. Common side effects include nausea, diarrhea, insomnia, sexual dysfunction, and increased sweating, which often improve with time. It's also important to note that sertraline may have a higher rate of diarrhea compared to other SSRIs, and may interact with certain medications, such as those metabolized by CYP2D6 1.
Special Considerations
When prescribing sertraline, it's essential to consider the potential for drug-drug interactions, particularly with monoamine oxidase inhibitors (MAOIs), and to monitor patients for symptoms of serotonin syndrome, as warned by the guideline for managing anxiety disorders 1. Additionally, sertraline may be associated with a higher risk of suicidal thinking or behavior, especially in children and adolescents, as noted in the guideline for treating depressive disorders 1.
From the FDA Drug Label
Sertraline Hydrochloride Oral Concentrate is indicated for the treatment of major depressive disorder in adults Sertraline Hydrochloride Oral Concentrate is indicated for the treatment of obsessions and compulsions in patients with obsessive-compulsive disorder (OCD) Sertraline Hydrochloride Oral Concentrate is indicated for the treatment of panic disorder in adults, with or without agoraphobia, as defined in DSM-IV Sertraline Hydrochloride Oral Concentrate is indicated for the treatment of posttraumatic stress disorder (PTSD) in adults, and for the treatment of social anxiety disorder in adults, and for the treatment of premature ejaculation, are not mentioned in this label but other sources may have this information.
The indications for Sertraline are:
- Major Depressive Disorder in adults
- Obsessive-Compulsive Disorder (OCD) in patients
- Panic Disorder in adults, with or without agoraphobia 2
From the Research
Indications for Sertraline
The indications for sertraline, a selective serotonin reuptake inhibitor (SSRI), include:
- Major depressive disorder 3, 4, 5
- Panic disorder 3, 6, 4
- Obsessive-compulsive disorder (OCD) 3, 7, 4, 5
- Post-traumatic stress disorder (PTSD) 3, 4
- Social anxiety disorder 4
- Generalized anxiety disorder 4
Therapeutic Uses
Sertraline has been shown to be effective in the treatment of various mood and anxiety disorders, including:
- Acute treatment of major depressive disorders 4
- Prevention of relapse or recurrence of major depressive disorders 4, 5
- Acute treatment and longer-term management of social anxiety disorder, posttraumatic stress disorder, panic disorder, and generalized anxiety disorder 4
- Short-term and long-term treatment of obsessive compulsive disorder in adults and pediatric patients 4
Pharmacological Properties
Sertraline has a pharmacological profile that includes: