Sertraline for depression

The active substance sertraline is used to treat  depression  as well as anxiety disorders, obsessive-compulsive disorders and post-traumatic stress disorder. The antidepressant unfolds its effect in the brain by increasing the concentration of the messenger substance  serotonin there  . Like other antidepressants, sertraline also has side effects: During treatment, dizziness, headaches and gastrointestinal problems can occur, among other things. Find out more about possible side effects as well as the effect and dosage of the active ingredient here.

effects of sertraline

Like citalopram  and  fluoxetine , sertraline is   a selective serotonin reuptake inhibitor (SSRI). In the brain, this group inhibits the reabsorption of the messenger substance serotonin into the cells, so that the concentration in the synaptic cleft increases. This counteracts depression – because depression is probably caused by a lack of the neurotransmitters norepinephrine and serotonin in the brain.

If sertraline is used to treat depression, it has a  drive-enhancing effect from the first dose. However, it can take a few days for the mood-enhancing effect of the antidepressant to kick in. However, the active ingredient is not only used to treat depression, but also preventively: the intake is intended to ensure that depressive phases do not occur again.

Side Effects of Sertraline

Sertraline has a number of side effects – the severity of these mainly depends on the dose taken. Some of the side effects will go away over time, or at least get better with continued treatment. In general, the antidepressant has fewer side effects than other SSRIs.

The most common side effects include:

• dizziness
• insomnia and fatigue
• sleepiness
• Tremble
• sexual disorders
• Gastrointestinal problems such as  nausea , vomiting,  diarrhea  or  constipation
• loss of appetite
• skin rash
• headache
• tinnitus
• stomach pain
• palpitations

Occasionally, taking the active ingredient can cause side effects such as weight gain, fever, skin bleeding, liver disorders, hair loss,  high blood pressure  and  cardiac arrhythmia  . Rarely, platelet deficiency,  hypothyroidism , seizures and urinary retention can also occur.

For a full list of sertraline side effects, please see the package insert.

Serotonin syndrome as a dangerous side effect

If you overdose on sertraline or take other medications that affect serotonin levels, the life-threatening serotonin syndrome can occur. The excessively high serotonin level in the brain can lead to symptoms such as nausea, diarrhea, sweating, confusion and seizures and even coma. Serotonin syndrome is  life-threatening  and must therefore be treated in the intensive care unit.

Discontinue sertraline

If you want to stop treatment with sertraline, you must also expect side effects. Whether and to what extent these occur depends not only on the dosage and duration of treatment, but also on the rate at which the dose is reduced. Therefore, you should never discontinue the active ingredient abruptly, but always  end the treatment slowly.  Discuss with your doctor the best way to go about stopping the drug.

Side effects  such as headache, nausea, vomiting,  trouble sleeping , dizziness, and anxiety may occur when you stop taking sertraline  . As a rule, the symptoms subside within two weeks, but it can sometimes take between two and three months for all side effects to disappear.

Sertraline dosage

You should always discuss the optimal dose of sertraline for you with your doctor. Depending on the diagnosis, the dosage of the active ingredient can vary. Unless otherwise prescribed, the usual doses for adults are:

• Depression and OCD: 50 milligrams of sertraline once daily (maximum dose: 200 milligrams)
• Panic Disorder, Anxiety Disorder, and Post-Traumatic Stress Disorder: Initially, 25 milligrams of sertraline once daily, the dose can be increased to 50 milligrams after a week (maximum dose: 200 milligrams)

Sertraline should be taken once daily in the morning or evening. Due to the mood-enhancing effect, it is recommended to take it in the morning. The active ingredient can be taken either with or between meals.

Sertraline contraindications

As with other active ingredients, there are a number of contraindications for sertraline. For example, the active ingredient must not be used if there is hypersensitivity to the antidepressant.

Likewise, sertraline must not be taken if treatment with MAO inhibitors is taking place at the same time. In general, there should be a period of at least 14 days between treatment with MAO inhibitors and therapy with sertraline. Otherwise, the life-threatening serotonin syndrome can occur.

In addition to MAO inhibitors, sertraline must not be taken together with pimozide and disulfiram.

Possible interactions

Interactions with certain other medications can occur while taking sertraline. This applies in particular to the following active ingredients:

• Drugs that contain the  amino acid  tryptophan
• Herbal medicines with St. John’s wort
• Medicines to treat severe pain
• Diuretics
• Medicines used to treat  migraines
• Medicines used to treat ulcers and excess stomach acid

If you are taking any of these medications, it is important that you tell your doctor before starting treatment. This also applies if you are already being treated with another antidepressant.

Increased risk of suicide at the beginning of treatment

Under certain conditions, sertraline may only be taken with particular caution. This is the case, for example, in patients with epilepsy or other seizure disorders. People with a history of  schizophrenia  or manic-depressive illness must also be closely monitored during treatment.

People who have liver disease,  diabetes  or a bleeding disorder should tell their doctor about their condition before starting treatment. The same applies to people who have low sodium levels and are taking blood-thinning or antihypertensive medication.

Taking sertraline may increase the risk of suicide at the beginning of treatment. Young adults under the age of 25 are particularly affected by this side effect. If you have had thoughts of harming or killing yourself in the past, you should talk to your doctor before taking it. If you have thoughts while you are taking it, you should also see your doctor or talk to someone you trust.

sertraline and alcohol

You should refrain from drinking alcohol during treatment with sertraline. Studies have so far not found any negative effects on physical and mental abilities by mixing the two substances. Nevertheless, as with many other medications, it is advisable not to drink alcohol during treatment.

pregnancy and breast feeding period

Sertraline should not be taken during pregnancy or breastfeeding. The active ingredient may only be used if absolutely necessary and after consultation with a doctor. Because taking it can lead to malformations in the unborn child and increased blood pressure in the lungs of the newborn.

In breastfeeding women, small amounts of the antidepressant pass into breast milk. Therefore, the active ingredient should not be taken during breastfeeding. Although no damage to the health of the infant has been observed to date, it cannot be ruled out.

Sertraline in children and adolescents

Children and adolescents should also only be treated with sertraline in exceptional cases and after a careful cost-benefit analysis. Taking them can trigger increased aggressive behavior and an increased risk of suicide. In addition, there is not enough knowledge about possible consequences for the development of the child.