From the Guidelines
The maximum recommended dose of sertraline is 200 mg per day. This dose has been shown to be effective in increasing ejaculatory latency in patients with premature ejaculation, as well as in treating depression and anxiety disorders 1. The recommended dose range for sertraline is 25-200 mg per day, with the option to take it either continuously or situationally, depending on the patient's needs and response to treatment.
Some key points to consider when prescribing sertraline include:
- Starting with a lower dose of 25-50 mg daily and gradually increasing as needed and tolerated
- Increasing doses in 25-50 mg increments at intervals of at least one week to minimize side effects
- Taking sertraline once daily, either in the morning or evening, consistently with or without food
- Being aware of potential side effects, such as nausea, diarrhea, insomnia, sexual dysfunction, and increased sweating, particularly at higher doses
- Avoiding abrupt cessation of sertraline, as this can cause withdrawal symptoms, and instead gradually reducing the dose under medical supervision.
It's also important to note that the optimal interval for situational dosing before intercourse has not been established, and the onset of action of sertraline for this indication is unknown 1. However, the majority of evidence shows effectiveness with daily dosing, thus supporting a general suggestion that this dose of sertraline provides the greatest benefit in remediating premature ejaculation. Additionally, sertraline has been shown to have a favorable side effect profile compared to other SSRIs, with less effect on the metabolism of other medications 1.
From the FDA Drug Label
Patients not responding to a 50 mg dose may benefit from dose increases up to a maximum of 200 mg/day. Patients not responding to an initial dose of 25 or 50 mg/day may benefit from dose increases up to a maximum of 200 mg/day The maximum dose of sertraline is 200 mg/day 2.
- The dose can be increased up to this maximum for patients who do not respond to lower doses.
- This maximum dose applies to both adults and pediatric patients (children and adolescents) with various indications, including major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder.
From the Research
Maximum Dose of Sertraline
- The maximum dose of sertraline is 200 mg/day, which can be achieved by increasing the dose in 50 mg/day increments at no less than weekly intervals for patients who do not show an adequate therapeutic response within 24 weeks 3.
- This dosing regimen is based on the established efficacy and tolerability of sertraline in the treatment of depression and other psychiatric disorders.
- The usual effective therapeutic dose of sertraline is 50 mg/day, which is also the starting dose for most patients 3.
- Sertraline can be administered as a single daily dose, and its elimination half-life of 22-36 hours allows for once-daily administration 4.
Key Considerations
- Sertraline is generally well-tolerated, with a low risk of lethality in overdose and no dependence potential 5, 6.
- The drug has a good tolerability profile, with minimal anticholinergic activity, no significant cardiovascular effects, and a wide therapeutic index 7.
- Sertraline may be associated with gastrointestinal disturbances and male sexual dysfunction, but these effects are usually mild and transient 7.