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Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®) is an orally-administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. Sertraline is used medically mainly to treat the symptoms of depression and anxiety.
It has also been prescribed for the treatment of obsessive-compulsive disorder, post-traumatic stress disorder, premenstrual dysphoric mood disorder, panic disorder, and bipolar disorder. It was first approved by the FDA in 1991.
Sertraline is manufactured by Pfizer as small green 25 mg tablets, blue 50 mg tablets, or orange 100 mg tablets. It is an odorless, white, sparingly soluble crystalline solid. The miminum effective dose is 50 mg per day, though some may benefit from less. Patients who do not experience relief of symptoms at 50 mg a day may have their dose increased, up to 200 mg a day.
Sertraline can have a number of adverse effects, including insomnia, asthenia, gastrointestinal complaints, tremors, confusion, and dizziness; it can induce mania or hypomania in around 0.5% of patients. One property of sertraline is that it appears to be also a minor inhibitor of dopamine reuptake. It is contraindicated in individuals taking MAOIs or undergoing electroconvulsive therapy.
In June of 2003, Britain banned the use of Sertraline for children under 18 after studies showed a link to increasing suicidal rates. Similar concern has prevailed in the United States, where only the anti-depressant fluoxetine (an SSRI like sertraline) is officially endorsed by the FDA for the treatment of depression in minors. However, because the antidepressant-suicide link is correlational, scientists do not know whether the increased suicide risk for people taking antidepressants occurs because the drugs make people suicidal, whether suicide occurs because the drugs un-depress the people enough to motivate the energy required to commit suicide (a popular theory), or because of a third, unknown factor.
Because of its metabolism, liver impairment can affect the elimitation of this drug from the body. If someone with liver impairment is treated with sertraline, lower or less frequent dosage should be used. Similarly, patients should limit their alcohol intake while on Sertraline (or any anti-depressant). Because the liver is doubly taxed with processing both substances (in addition to any other drugs the patient may be taking), alcohol remains in the bloodstream longer, so the effects of alcohol may be more strongly and quickly felt by people taking sertraline or other anti-depressants. Also, given the fact that alcohol is a depressant, its abuse in depressed people is generally frowned upon. The recommended limit for alcoholic beverages for people on Sertraline is two per day.
The patent for this brand-name drug will expire in December 2005.
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