From the Guidelines
The maximum recommended dose of sertraline is 200 mg per day. This dose has been established based on the most recent and highest quality study available, which indicates that higher doses may increase efficacy but also may be associated with increased frequency of adverse effects such as erectile dysfunction and decreased libido 1.
Key Considerations
- The dose of sertraline can be administered either continuously or situationally, with situational dosing potentially offering the advantage of less drug usage, although the optimal interval for situational dosing before intercourse has not been established 1.
- The choice between continuous and situational dosing regimens often depends on the frequency of sexual activity by the patient, with some patients benefiting from a loading period of daily dosing before switching to situational dosing 1.
- Therapy for premature ejaculation (PE) with sertraline most likely will be needed on a continuing basis, as PE usually returns upon discontinuing therapy 1.
Dosing and Administration
- Treatment with sertraline typically begins at a lower dose of 25-50 mg daily and is gradually increased as needed based on response and tolerability 1.
- For the treatment of PE, sertraline has been shown to increase ejaculatory latency at doses of 25-200 mg/day, with higher doses potentially offering greater efficacy but also a higher risk of side effects 1.
- Sertraline should be taken once daily, usually in the morning or evening at the same time each day, and exceeding the 200 mg daily maximum is not recommended due to the increased risk of side effects without additional therapeutic benefit 1.
Adverse Effects and Precautions
- The adverse effects of sertraline include nausea, diarrhea, insomnia, sexual dysfunction, and in rare cases, serotonin syndrome 1.
- Patients with liver impairment or elderly patients may require lower maximum doses of sertraline, and dose adjustments should always be made under medical supervision 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.
- The maximum dose of sertraline is 200 mg/day 2.
- This dose can be administered to patients who do not respond to a 50 mg dose, and may benefit from dose increases.
From the Research
Maximum Dose of Sertraline
- The maximum dose of sertraline is 200 mg/day, as stated in the study 3.
- This dose can be achieved by increasing the initial dose of 50 mg/day 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.
- The dose regimen for sertraline has been well established, with the starting dose of 50 mg/day being the usually effective therapeutic dose and the optimal dose when considering both efficacy and tolerability for most patients 3.
Key Points
- 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, in contrast to other selective serotonin reuptake inhibitors 3.
- The efficacy and tolerability of sertraline have been extensively studied, with results showing it to be an effective treatment for depressive and anxiety disorders, with a good tolerability profile and low fatal toxicity 4.
Related Studies
- Other studies have investigated the effects of selective serotonin reuptake inhibitors, including sertraline, on suicidality in adults with depression, with results suggesting that SSRIs may have a beneficial effect on suicidality in people above the age of 24 and a neutral effect in those aged 18-24 5.
- A population-based cohort study found that SSRI treatment may reduce the risk of suicidal behavior, rather than increasing it 6.