Sertraline

What Does Sertraline Do?

Sertraline, under brand Zoloft, is a prescription drug, used predominantly for treating a variety of mental disorders such as depression, obsessive-compulsive disorder, panic and post-traumatic stress disorder, social anxiety, and premenstrual dysphoric disorder. Off-label uses encompass treatment for body dysmorphic disorder, binge eating disorder, and chronic pain. It is, sadly, a commonly prescribed medication, being the 10th most commonly prescribed drug in the UK in 2024. 

How Does Sertraline Work? (the complicated stuff)

Sertraline enhances the levels of serotonin, a neurotransmitter, in the brain. This is achieved by inhibiting the reuptake of serotonin into the presynaptic cell, leaving more serotonin in the synaptic cleft to bind to the postsynaptic receptor. This amplifies serotonergic neurotransmission, leading to improved mood and reduced anxiety, thereby treating various mental disorders.

Drug Type and Category of Sertraline

Sertraline is a prescription drug classified under selective serotonin reuptake inhibitors (SSRIs). 

What dosage of Sertraline should you be taking? ^1,2

Initial Dose:

• Adults: 50 mg orally once daily
• Children (6-12 years): 25 mg orally once daily, may increase to 50 mg after 1 week 
• Adolescents (13-17 years): 50 mg orally once daily 

Maintenance Dose:

• Adults: 50 to 200 mg orally once daily
• Children (6-17 years): Up to 200 mg orally once daily

The dose may be increased in 25 mg increments at intervals of at least 1 week, if required.

For patients with liver problems, a lower starting and maintenance dose is recommended, such as a 50% reduction.

Sertraline should be taken once daily, either in the morning or evening, and can be taken with or without food. 

What are the side-effects of Sertraline?

Common side effects:

• Nausea 
• Fatigue and tiredness
• Appetite loss 
• Diarrhoea 
• Indigestion 
• Increased sweating 
• Shaking (tremor) 
• Agitation 
• Changes in sleep habits, including sleepiness or trouble sleeping 
• Sexual problems, including decreased sex drive or ejaculation failure 
• Dry mouth
• Anxiety 

Serious side effects:

• Suicidal thoughts or actions, especially in children and young adults 
• Serotonin syndrome (too much serotonin), which can be life-threatening 
• Severe allergic reactions 
• Low sodium levels (hyponatremia) 
• Changes in heart rhythm 
• Sexual problems like decreased libido and delayed orgasm

Drug Interactions

Sertraline interacts with many other medicines, including MAOIs, pimozide, tricyclic antidepressants, SSRIs, SNRIs, triptans, St. John's wort, lithium, buspirone, phenytoin, amphetamines, opioid pain medicines, certain antipsychotics, antibiotics, medicines for abnormal heart rhythm, and medicines that affect bleeding.

Some other medicines may alter the blood levels of sertraline, and vice versa.

Natural Alternatives to Sertraline

St. John's Wort, which has shown efficacy in treating mild to moderate depression. ^3,4 S-adenosylmethionine (SAMe), a naturally occurring compound in the body, has also demonstrated recognised antidepressant effects. Additionally, 5-hydroxytryptophan (5-HTP), a serotonin precursor, possesses some antidepressant properties. ⁴ 

However, the best natural alternatives involve getting outdoors, exposing yourself to sunlight, exercising, walking in nature, resolving family conflicts, relaxation, meditation and having positive thought of mind. 

Interesting facts about Sertraline

In addition to inhibiting the reuptake of serotonin, sertraline also has dopamine reuptake inhibition (DRI) and sigma 1 receptor binding properties, which are less potent than its effects on serotonin. 

The peak effects of sertraline are seen within 4.5 to 8 hours after administration.

Disclaimer

This article is generated for informational purposes only. It was created in December 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References:

1. https://www.nice.org.uk/bnf-uk-only
2. https://www.nhs.uk/medicines/sertraline/how-and-when-to-take-sertraline/
3. https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/alternatives-to-antidepressants/
4. https://www.talkspace.com/blog/zoloft-alternatives/