Sertraline
- Atc Codes:N06AB06
- CAS Codes:79559-97-0#79617-96-2
- PHARMGKB ID:79559-97-0#79617-96-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Adjuvin, Gladem, SertraPel, Sertralin, Tresleen; Belgium: Serlain, Sertraline; Bulgaria: Asentra, Sertran, Setaloft, Stimuloton, Zoloft; Cyprus: Asentra, Zoloft; Czech Republic: Adjuvin, Apo-Sertral, Serlift, Sertralin, Setaloft, Stimuloton, Zoloft; Denmark: Sertralin, Zoloft; Estonia: Asentra, Serlift, Sertral, Sertralin, Sertraline, Sertranat, Zoloft; Finland: Sertralin, Zoloft; France: Setraline, Zoloft; Germany: Besitran, Gladem, Sertra, Sertralin, Sertralon, Sertraxea, Tifisertral, Tralin, Zoloft; Greece: Certorun, Enipad, Epilyd, Mycinil, Neurosedine, Serolux, Serotyp, Sertral, Sertraline, Zoloft, Zolotrin, Zortal; Hungary: Asentra, Camidlin, Gerotralin, Serlift, Sertadepi, Sertagen, Sertralin, Setaloft, Stimuloton, Zoloft; Ireland: Bellsert, Depreger, Lusert, Lustral, Seretral, Serimel, Serlan, Serlo, Sertraline, Sertraniche; Italy: Sertralina; Latvia: Asentra, Sertralin, Sertraline, Sertranat, Stimuloton, Zoloft; Lithuania: Asentra, Serlift, Sertral, Sertralin, Sertraline, Sertranat, Stimuloton, Zoloft; Luxembourg: Serlain; Malta: Lustral, Sertralin, Sertral; Netherlands: Asentra, Sertraline, Zoloft; Poland: Apresia, Asentra, Asertin, Exazol, Restaline, Sertagen, Sertahexal, Sertiva, Sertrabreck, Sertralin, Sertraline, Setaloft, Setaratio, Stimuloton, Tralix, Zoloft, Zortral, Zotral; Portugal: Aserin, Serlin, Sertralina, Zoloft; Romania: Asentra, Asertin, Belosert, Serlift, Sertralin, Sertralina, Sertraline, Setaloft, Stimuloton, Ximprove, Zoloft; Slovakia: Asentra, Serlift, Sertiva,Sertralin, Sertranat, Stimuloton, Zoloft; Slovenia: Asentra, Mapron, Sertiva, Sertralin, Zoloft; Spain: Altisben, Aremis, Aserin, Besitran, Sertralina; Sweden: Seromeq, Sertralet, Sertralin, Sertranat, Sertratab, Sertraver, Sertraxea, Serunato, Setaloft, Tifisertral, Ziral, Zoloft; UK: Lustral, Sertraline.
North America
Canada: Sertraline, Zoloft; USA: Sertraline, Zoloft.
Latin America
Argentina: Anilar, Atenix, Bicromil, Celonfex, Deprecalm, Insertec, Irradial, Serlina, Sertralina, Servantax, Vunot, Zoloft, Zoxx; Brazil: Assert, Novativ, Serenata, Sertralin, Sertralina, Tolrest, Zoloft; Mexico: Aleval, Altruline, Aluprex, Deptral, Prosertin, Resteral, Serlift, Serolux, Sertex.
Asia
Japan: Jzoloft.
Drug combinations
Chemistry
Sertraline Hydrochloride: C~17~H~17~Cl~2~N HCl. Mw: 342.69. (1) 1-Naphthalenamine, 4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-N-methyl-, hydrochloride, (1S-cis)-; (2)(1S,4S)-4-(3,4-Dichlorophenyl)-1,2,3,4-tetrahydro-N-methyl-1-naphthylamine hydrochloride. CAS-79559-97-0; CAS-79617-96-2 (sertraline)(1983).
Pharmacologic Category
Antidepressants; Selective Serotonin-reuptake Inhibitors. (ATC-Code: N06AB06).
Mechanism of action
Antidepressant with selective inhibitory effects on presynaptic serotonin (5-HT) reuptake and only very weak effects on norepinephrine and dopamine neuronal uptake. In vitro studies demonstrate no significant affinity for adrenergic, cholinergic, GABA, dopaminergic, histaminergic, serotonergic, or benzodiazepine receptors.
Therapeutic use
Major depression. Obsessive-compulsive disorder. Panic disorder. Post-traumatic stress disorder. Premenstrual dysphoric disorder. Social anxiety disorder.
Pregnancy and lactiation implications
Sertraline crosses human placenta. Nonteratogenic effects in newborn following SSRI exposure late in 3^rd^ trimester include respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypo- or hypertonia, hyper-reflexia, jitteriness, irritability, constant crying, and tremor. Increased risk of low birth weight, and blunted behavioral response to pain for prolonged period after delivery also reported. Exposure to SSRIs after 20^th^ week of gestation associated with persistent pulmonary hypertension of newborn. Enters breast milk (use caution).
Unlabeled use
Eating disorders. Generalized anxiety disorder. Impulse control disorders. Mild dementia-associated agitation in nonpsychotic patients.
Contraindications
Hypersensitivity to sertraline or any component of the formulation. Use of MAOIs within 14 days. Concurrent use of pimozide. Concurrent use of sertraline oral concentrate with disulfiram.
Warnings and precautions
Antidepressants increase risk of suicidal thinking and behavior in children, adolescents, and young adults (18-24 years of age) with major depressive disorder and other psychiatric disorders. Not FDA approved for use in children with major depressive disorder. However, approved for treatment of obsessive-compulsive disorder in children ≥6 years of age. May worsen psychosis in some patients or precipitate shift to mania or hypomania in bipolar disorder. Monotherapy in bipolar disorder should be avoided. Not FDA approved for treatment of bipolar depression. Has low potential to impair cognitive or motor performance. Use with caution in previous seizure disorder or condition predisposing to seizures such as brain damage or alcoholism. Potential for severe reaction when used with MAOIs (autonomic instability, coma, death, delirium, diaphoresis, hyperthermia, mental status changes/agitation, muscular rigidity, myoclonus, neuroleptic malignant syndrome features, and seizures may occur). Concomitant use contraindicated. May cause serotonin syndrome (agitation, confusion, hallucinations, hyper-reflexia, myoclonus, shivering, tachycardia; concurrent use of serotonin precursors (e.g. tryptophan) not recommended). May increase risks associated with electroconvulsive therapy. May impair platelet aggregation resulting in increased risk of bleeding events, particularly if used concomitantly with aspirin, NSAIDs, warfarin or other anticoagulants. May cause or exacerbate sexual dysfunction. SSRIs associated with development of SIADH and hyponatremia reported (including severe cases with serum sodium <110 mmol/L), predominately in the elderly. Volume depletion and/or concurrent use of diuretics probably increases risk. May cause weight loss. Use with caution in hepatic/renal impairment (clearance decreased and plasma concentrations increased), and in risk of uric acid nephropathy (sertraline acts as a mild uricosuric). Use oral concentrate formulation with caution in latex sensitivity (dropper dispenser contains dry, natural rubber). May produce withdrawal syndrome (dysphoric mood, irritability, agitation, dizziness, sensory disturbances, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures).