Sertraline
Mechanism :
It is an antidepressant agent used in the treatment of depression in children.
Indication :
- Management of major depressive disorder
- Posttraumatic stress disorder
- Obsessive-compulsive disorder
- Panic disorder with or without agoraphobia
- Premenstrual dysphoric disorder
- Social phobia
- Premature ejaculation
- Vascular headaches
Contraindications :
Hypersensitivity.
Do not use disulfiram concomitantly with oral solution due to alcohol in preparation
Concomitant pimozide: Risk of long QT syndrome.
Dosing :
>6 years:
Initially 12.5-25 mg PO 24 hourly increasing slowly as required over several weeks till desired response is seen. Max: 200 mg/day.
Adverse Effect :
Diarrhoea, nausea, headache, insomnia, ejaculation disorder, dizziness, dry mouth, fatigue, somnolence, agitation, anorexia, constipation, dyspepsia and decreased libido.
Interaction :
Linezolid: May increase risk of serotonin syndrome, neuroleptic malignant syndrome.
Pimozide: May increase pimozide levels, risk of QT prolongation, cardiac arrhythmias.
Isocarboxazid: May increase risk of serotonin syndrome, neuroleptic malignant syndrome.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Mild hepatic impairment: Decrease the dose to 50% of the normal daily dose.
Moderate to severe hepatic impairment: Avoid using sertaline.