Sertraline

DEA Class;  Rx

Common Brand Names; Zoloft

Hypersensitivity

Do not use disulfiram concomitantly with oral solution due to alcohol in preparation

Concomitant pimozide: Risk of long QT syndrome

• Nausea (15-24%)
• Insomnia (11-24%)
• Dry mouth (9-18%)
• Headache (17%)
• Asthenia (10-15%)
• Constipation (10-15%)
• Diarrhea (9-12%)
• Dizziness (6-14%)
• Ejaculation disorder (10-15%)
• Tremor (4-11%)
• Anxiety (5-10%)
• Blurred vision (5-10%)
• Decreased appetite (5-10%)
• Impotence (2-9%)
• Nervousness (2-5%)
• Paresthesia (2-5%)
• Hypomania (0.3 to 2.2%)
• Hypertension
• Tachycardia
• Emotional lability
• Pruritus
• Weight gain
• Arthralgia
• Tinnitus
• Vertigo
• Angle clossure glaucoma

Clinical worsening and suicide ideation may occur despite medication

Use caution in patients with seizure disorders

May worsen mania symptoms or precipitate mania in patients with bipolar disorder

Increases risk of hyponatremia and impairment of cognitive/motor functions in the elderly

Increases risk of bleeding in patients taking anticoagulants/antiplatelets concomitantly

Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy

Pregnancy: Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn (see Pregnancy)

In neonates exposed to SNRIs/SSRIs late in third trimester: Risk of complications such as feeding difficulties, irritability, and respiratory problems

Avoid abrupt withdrawal

Bone fractures reported with antidepressant therapy; consider the possibility if patient presents with bone pain, bruising, or point of tenderness

Coadministration with other drugs that enhance the effects of serotonergic neurotransmission (eg, tryptophan, fenfluramine, fentanyl, 5-HT agonists, St. John’s Wort) should be undertaken with caution and avoided whenever possible due to the potential for pharmacodynamic interaction (see Contraindications)

Overall, available published epidemiologic studies of pregnant women exposed to sertraline in the first trimester suggest no difference in major birth defect risk compared to the background rate for major birth defects in comparator populations

Available data from published literature demonstrate low levels of sertraline and its metabolites in human milk

There are no data on the effects of sertraline on milk production