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

From the Guidelines

The starting dose of Sertraline for adults is typically 50 mg once daily, while for children and adolescents, it is recommended to start with a lower dose, such as 25 mg daily, due to potential adverse effects and the need for slow up-titration 1. When initiating sertraline treatment, it is essential to consider the patient's age, medical history, and potential interactions with other medications.

• For adults, the typical starting dose is 50 mg once daily, usually taken in the morning or evening.
• For elderly patients or those with liver disease, a lower starting dose of 25 mg daily is recommended.
• For children and adolescents, the recommended starting dose is also 25 mg daily, with the possibility of twice-daily dosing due to the shorter elimination half-life of sertraline at low doses 1. The dose may be gradually increased at weekly intervals to a maximum of 200 mg daily if needed, depending on the patient's response and tolerance to the medication.
• It is crucial to monitor patients closely for potential adverse effects, such as suicidal thinking and behavior, behavioral activation/agitation, and serotonin syndrome, especially during the initial treatment period and after dosage adjustments 1.
• Common side effects of sertraline include nausea, diarrhea, insomnia, and sexual dysfunction, which often improve over time 1. Patients should take sertraline consistently at the same time each day and should not stop taking it abruptly without medical supervision, as this can cause withdrawal symptoms.
• The medication works by increasing serotonin levels in the brain, which helps regulate mood, but it typically takes 2-4 weeks to experience the full therapeutic effects 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 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.
• The dose can be increased in 50 mg/day increments at no less than weekly intervals to a maximum of 200 mg/day for patients who do not show an adequate therapeutic response within 24 weeks 3, 4.
• Sertraline is generally given as a single daily dose and may be administered at any time of the day 3.
• The initial dose of 50mg once daily is also used in the treatment of Major Depressive Disorder (MDD) in patients with Chronic Kidney Disease (CKD) 4.
• In pediatric patients, sertraline can be safely administered using the currently recommended adult titration schedule, with a starting dose of 25 mg/day or 50 mg/day titrated to 200 mg/day in 25-mg or 50-mg increments 5.