Standard Dose of Sertraline for Depression
The standard adult dose of sertraline for major depressive disorder is 50 mg once daily, which serves as both the initial and therapeutic dose for most patients. 1, 2
Initial Dosing
- Start with 50 mg once daily as the recommended initial therapeutic dose for major depressive disorder 2
- This dose can be administered at any time of day (morning or evening) 2
- The 50 mg starting dose is optimal when considering both efficacy and tolerability for most patients 1, 3
Dose Titration
- For patients not responding to 50 mg after 2-4 weeks, the dose may be increased in 50 mg increments 4, 2
- Maximum dose is 200 mg/day 1, 2
- Dose changes should not occur at intervals of less than 1 week due to sertraline's 24-hour elimination half-life 2
- The therapeutic dose range is 50-200 mg/day, though clinical trials demonstrated effectiveness across this entire range 2
Special Population Considerations
- Elderly patients do not require dose adjustment based solely on age 1, 5, 6
- The same 50 mg starting dose applies to geriatric populations 5, 6
- This contrasts with other SSRIs that may require age-based adjustments 1
Adolescent Dosing (Ages 13-17)
- For adolescents with depression, start with 25 mg once daily (lower than adult dose) 7
- Increase in 12.5-25 mg increments as tolerated 7
- Effective dose is typically 50 mg, with a maximum of 200 mg 7
- Avoid starting at higher doses as this increases the risk of deliberate self-harm and suicide-related events 7
Common Pitfalls to Avoid
- Do not start below 50 mg in adults without a specific tolerability concern, as this can delay therapeutic response 4
- Do not increase doses more frequently than weekly intervals to allow adequate time for steady-state levels 2
- Always taper slowly when discontinuing to avoid withdrawal effects including dizziness, fatigue, nausea, headaches, insomnia, and anxiety 4
- Do not prescribe to patients with bipolar depression without mood stabilization due to mania risk 4