Sertraline: Usage, Dose, Side Effects, and Interactions

Sertraline is used to help balance the levels of serotonin in the brain. There is a high risk of side effects associated with this medication. Learn the usage tips.

Sertraline is a serotonin reuptake inhibitor that increases the amount of serotonin in the brain for those that are currently suffering from an imbalance. This can help treat a number of different mental ailments, most notably depression. In some cases, this drug can assist with physical ailments that may accompany premenstrual dysphoric disorder. There is a high risk of side effects here compared to other medications, so it is important to monitor your condition closely to help your doctor make crucial decisions regarding dose size to avoid these side effects.

Indications and Usage

Sertraline is typically sold under the brand name Zoloft. This medication is primarily used to treat depression, though it can also be used to assist with the treatment of panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, or social anxiety disorder. In some cases, this medication may also be prescribed to treat premenstrual dysphoric disorder and the bloating, breast tenderness, irritability and mood swings that may accompany this condition. In more rare cases, the drug may be used to treat sexual problems or headaches. It is prescribed as a liquid that will be taken daily in the morning or evening. If you are treating premenstrual dysphoric disorder, you will only take this medication certain days each month.

Patients will be given a dropper that will be used to measure their prescription. You will dilute your dose in at least 4 ounces of liquid. You may only use water, lemon or lime soda, ginger ale, orange juice or lemonade for these purposes to ensure the proper pH balance. These ingredients must be mixed immediately before you consume your dose. Try to take does around the same time every day to ensure a proper balance. If you forget, take your dose as soon as you remember, but you should not double up doses in order to make up for those you have missed.

Sertraline Dosage

Doses for adults average at 50 mg once a day for those dealing with depression or obsessive tendencies. Doses typically begin at the minimum effective dose of 25 mg per day and are increased gradually to this point. Those treating post-traumatic stress disorder may receive doses between 50-200 mg per day. When treating premenstrual dysphoric disorder, doses will range from 50-150 mg per day during the luteal phase of the menstrual cycle. Doses for any treatment should not exceed 200 mg per day.

Children between the ages of 6-12 will usually receive a dose of 25 mg per day. Those between the ages of 13-17 can increase their dose to 50 mg per day if their body is no longer responding to the smaller dose. Those under the age of 6 should not use the drug.

Patients suffering from liver disease will need to take caution when starting a prescription. Large doses of this drug may not clear from the body as effectively, and could result in hepatic impairment. Taking doses less frequently may be necessary to avoid this side effect.

Sertraline Side Effects

Up to 30 percent of users report instances of side effects. These may include dry mouth, loss of appetite, weight changes, vomiting, constipations, weakness, drowsiness, mood or behavior changes, trouble concentrating or remembering, anxiety, panic attacks, depressiveness, trouble sleeping, tremor, ringing in the ears, impotence, or overactive reflexes. In most cases, these side effects are not serious and decrease within a week of starting the medication once your body has become used to the increased serotonin level. Inform your doctor if your side effects are severe or if they are interrupting your ability to function normally.

Those suffering from an adverse reaction may experience vertigo, confusion, twitching, ataxia, eye pain, conjunctivitis, cough, dyspensia, hot flashes, teeth-grinding, or back pain. If you notice any symptoms that are out of the ordinary, contact your doctor to discuss your symptoms and what can be done to help eliminate them. In most cases, adjusting your prescription will help to eliminate these side effects.

Women who are using the drug to treat premenstrual dysphoric disorder should not use this drug beyond three menstrual cycles. This may result in their symptoms becoming worse or bringing on menopause earlier than normal. Talk with your doctor about how to break up your treatment and to have your symptoms reassessed to determine if further treatment is necessary and if it is safe to keep using this drug.

Pregnant women taking sertraline during their third trimester have reported cases where their infant required prolonged hospitalization after birth because they required respiratory support or tube feeding. Discuss these potential risks with your doctor before continuing your prescription during pregnancy to help prevent these side effects.

In the event of an overdose, the patient may suffer changes in sex drive, diarrhea, difficulty falling asleep, pounding or irregular heartbeat, shaking, seizures, hallucinating, unconsciousness, fainting, nausea, hair loss or excessive tiredness. If you notice someone suffering from these symptoms, contact your local poison control center to get advice on how to proceed. Have any information regarding the patient's regular dosage or how much they might have consumed recently that you may be aware of ready when you make this call. If the patient collapses or is not breathing, contact emergency medical services immediately.

In the case of an allergic reaction, patients can expect to see rash, urticarial, difficulty swallowing or breathing, itching, tightness in the chest or swelling. If you notice any of these symptoms come on suddenly after taking your medication, contact emergency medical services right away. If possible, have information on your dosage ready when you make this call.

Patients who are ready to cease their use should not stop taking their medication suddenly. This can lead to withdrawal effects which could be dangerous. Work with your doctor to develop a step-down dosing schedule to help avoid these issues. If you begin to suffer agitation, dizziness, dyspohoric mood, sensory disturbances such as an electric shock sensations, anxiety, headache, lethargy, confusion, emotional lability, hypomania or insomnia contact your doctor as soon as possible. They will give you a recommendation on how to adjust your medication to help eliminate these symptoms.

Interactions

Any medications that tightly bind to proteins should be limited or eliminated while you are taking the drug. Because the drug binds itself to proteins, doubling up on these drugs can cause a shift in plasma which could cause side effects. Specific medications to avoid include warfarin, digitoxin, and cimetidine. If you are currently taking CNS active drugs, these can cause an overdose as this drug group often contains similar ingredients to those found in sertraline. Talk with your doctor about any prescriptions you are currently taking to help avoid a negative reaction. These include monoamine oxidase inhibitors, serotonergic drugs, triptans, sumatriptan and tricyclic antidepressants.

You should not combine the drug with alcohol. This can enhance the effects of the drug to an unsafe level. You should also inform your doctor regarding any usage you may be undergoing before you start electroconvulsive therapy to help avoid a negative reaction to the therapy.

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