Sertraline 25mg

Selective Serotonin Reuptake Inhibitor; Antidepressant

“ALERT: US Boxed Warning

Suicidality and antidepressant drugs:

Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Zoloft/Sertraline enhances serotonergic neurotransmission by selectively inhibiting the reuptake of serotonin.  The antidepressant response is likely not due entirely to this effect; subsequent down-regulation of post-synaptic serotonin-2 (5HT2) receptors and restoration of normal neurotransmitter function may play an important role.  Zoloft/Sertraline exhibits only weak affinity for alpha, beta, histaminic, muscarinic and serotonin receptors as well as has weak anticholinergic effects.

Sertraline/Zoloft is officially indicated for use in major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social anxiety disorder.  It is also prescribed off-label for binge eating disorder, body dysmorphic disorder, bulimia nervosa, generalized anxiety disorder, and to treat premature ejaculation.

Premature ejaculation (PE) is also known as rapid or early ejaculation and is characterized by the following features:

• Ejaculation that always or nearly always occurs prior to or within approximately one minute of vaginal penetration.
• The inability to delay ejaculation on all or nearly all vaginal penetrations.
• Personal feelings of distress, frustration, anxiety, and/or the avoidance of sexual intimacy.

Do not use in patients receiving monoamine oxidase inhibitors currently or within 2 weeks because of the risk of serotonin syndrome.

Use with caution in patients with liver disease.

Use with caution in patients with a history of seizures.

Has been rarely associated with platelet dysfunction, use cautiously in patients with underlying coagulation (platelet) defects.

Premature ejaculation (off-label use)

Initial dose is 50mg daily, can increase the dose based on response and tolerability at intervals of 3 to 4 weeks in 50mg increments up to a maximum daily dose of 200mg once daily. 

How to Take Sertraline, Zoloft: Swallow the capsules whole, do not chew it.  Should be taken with food as this medication can cause stomach upset.  If you feel drowsy after taking the medication in the morning, reschedule your medication time and take it in the evening.

How to Manage Common Side Effects of Sertraline, Zoloft: Majority of side effects are mild and transient and disappear over time.  Nausea, headache, dry mouth, diarrhea, sleep disturbance and loss of appetite can occur.  However, if you develop a rash, hives or experience undesirable weight loss contact your doctor.  

You Need to Avoid Sertraline, Zoloft: If you have hypersensitivity to Zoloft/Sertraline or any of its components in the formulation; use of MAO inhibitors, linezolid, or intravenous methylene blue, pimozide or thioridazine. 

Contact Your Doctor if You Ever Experience: Stop taking this medication and contact your doctor if you experience a rash (particularly in combination with facial swelling, breathing difficulties or flu-like symptoms); severe agitation, anxiety or excitation, major sleep disturbance or unusual change mood, muscle twitching or convulsions.

Well tolerated, most side effects are transient and mild to moderate in nature.  The most common side effects include:

>10%

Central nervous system: Insomnia (20%), dizziness (12%), fatigue (12%), drowsiness (11%)

Gastrointestinal: Nausea (26%), diarrhea (20%), xerostomia (14%)

1. Do you take Sertraline/Zoloft with food or on an empty stomach?
   Take Zoloft/Sertraline with food to reduce the likelihood of an upset stomach.
2. Can you drink alcohol when you are on Sertraline/Zoloft?
   You should limit or completely avoid alcohol consumption when taking Zoloft/Sertraline because it may increase psychomotor impairment.
3. What if you miss a dose?
   If you miss taking a dose, take it as soon as you remember.  However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule.  Do not take two doses to make for a missed dose.
4. How quickly will you experience an improvement?
   If you are taking this medication it may take up to 2 to 4 weeks before you notice any improvement.