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Sertraline

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Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, panic attacks, obsessive-compulsive disorder, and social anxiety. It helps restore the balance of serotonin in the brain, which improves mood, sleep, and energy levels in adult patients.


Ingredient
Availability
In Stock
Delivery Time
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Active Ingredient(s)
Sertraline
Reference Brand
Lustral
Product Form
Tablet, Oral concentrate
Regulatory Classification
Rx
Primary Category
Mental Health
Product Category
Nervous system, Psychoanaleptics, Antidepressants, Selective serotonin reuptake inhibitors
Pharmacological Class
Selective Serotonin Reuptake Inhibitor (SSRI)
Manufacturer Description
A common antidepressant used to treat mood and anxiety disorders by balancing brain chemicals.
Mechanism of Action
Sertraline works by increasing the levels of serotonin, a mood-regulating chemical, in the brain. It does this by preventing the brain cells from reabsorbing the serotonin once it has been released, which helps to improve mood and reduce anxiety.
Route of Administration
Oral
Onset Time
2-4 weeks
Duration
24 hours
Contraindications
Concurrent use with MAOIs, Uncontrolled epilepsy, Severe liver disease
Severe Adverse Events
Serotonin syndrome, Suicidal thoughts, Seizures, Manic episodes
Common Side Effects
Nausea, Insomnia, Drowsiness
Uncommon Side Effects
Dry mouth, Diarrhoea, Increased sweating, Sexual dysfunction
Drug Interactions
MAOIs, Lithium, NSAIDs, Warfarin
Pregnancy Safety Warnings
Consult doctor; potential risk of persistent pulmonary hypertension in newborns.
Age Restrictions
OCD treatment only for children and adolescents 6-17 years; not typically for depression in children.
Storage Guidelines
Store at room temperature.
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Sertraline FAQ

Can sertraline cause a positive drug test for illegal substances?

Sertraline is not a controlled substance and does not trigger positive results for illicit drugs on standard employment or sports drug screens. However, some immunoassays may produce false-positive results for certain classes; confirmatory testing (e.g., GC-MS) is recommended if a positive screen occurs.

What does a sertraline tablet look like?

In the UK, generic sertraline tablets are typically round, white to off-white, and may bear a debossed imprint indicating the manufacturer and dosage (e.g., “25 mg SRT”). Exact appearance can vary between producers.

Is it safe to travel abroad with sertraline?

Yes, but you should carry the medication in its original packaging with a copy of the prescription or a doctor’s letter. Some countries require proof of prescription for psychotropic medicines; checking the destination’s import regulations before travel is advisable.

How long does it take for sertraline to start working?

Patients often notice subtle mood improvements within the first two weeks, but the full therapeutic effect may require 4-6 weeks of consistent dosing.

Can I drink alcohol while taking sertraline?

Alcohol does not directly interfere with sertraline metabolism, but it can worsen depression, increase sedation, and reduce judgement. Moderation is advised, and heavy drinking should be avoided.

What should I do if I miss a dose?

Take the missed tablet as soon as you remember, unless it is nearly time for the next scheduled dose. In that case, skip the missed tablet and continue with your regular dosing schedule-do not double the dose.

Are there any special considerations for pregnant women?

Sertraline is one of the SSRIs most frequently prescribed during pregnancy because it has a relatively favorable safety record. Nonetheless, it should be used only when the expected benefits outweigh potential risks, particularly in the first trimester.

Why might sertraline cause sexual side effects?

By increasing serotonin levels, sertraline can dampen dopaminergic pathways involved in sexual arousal and orgasm, leading to reduced libido or delayed climax. These effects are common but may improve with dose adjustment or adjunctive therapy.

How does sertraline compare with other SSRIs like fluoxetine?

Both medications inhibit serotonin reuptake, but sertraline has a slightly higher affinity for the SERT and a shorter half-life, which may result in quicker onset of side effects. Fluoxetine’s longer half-life can lead to a smoother discontinuation profile but may cause prolonged drug interactions. Choice of agent is individualized based on patient response and tolerability.

Sertraline: Generic Medication Overview

Sertraline is an antidepressant belonging to the selective serotonin reuptake inhibitor (SSRI) class. It is available in pill form in strengths of 25 mg, 50 mg, and 100 mg and is prescribed in the United Kingdom under the oversight of the Medicines and Healthcare products Regulatory Agency (MHRA). While the medication itself is generic, it is also marketed under several brand names, most notably Zoloft.

Sertraline is a prescription-only medicine (POM) and is typically dispensed by community pharmacies after a clinician’s assessment.

How Sertraline Works in the Body

Sertraline blocks the re-uptake of the neurotransmitter serotonin into presynaptic nerve terminals. By inhibiting the serotonin transporter (SERT), more serotonin remains available in the synaptic cleft, enhancing serotonergic neurotransmission across brain circuits that regulate mood, anxiety, and fear responses.

Key pharmacological points:

  • Onset of action: Clinical effects generally begin within 2-4 weeks, although some patients notice mood improvement earlier.
  • Peak plasma concentration: Reached about 4-6 hours after oral ingestion.
  • Metabolism: Primarily processed by the liver enzyme CYP2C19 and, to a lesser extent, CYP2D6 and CYP3A4.
  • Elimination: Metabolites are excreted in urine; the drug’s half-life is approximately 26 hours, allowing once-daily dosing.

Conditions Treated by Sertraline

Sertraline is approved by the MHRA for several psychiatric indications:

  • Major depressive disorder (MDD)
  • Panic disorder
  • Social anxiety disorder (social phobia)
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)
  • Generalised anxiety disorder (GAD) (approved in some European jurisdictions)

These indications reflect the drug’s ability to modulate serotonin pathways implicated in mood regulation and anxiety processing.

Evidence-Based Off-Label Uses

Some clinicians prescribe sertraline for conditions that lack formal regulatory approval but have supporting evidence:

  • Bulimia nervosa - limited open-label trials suggest modest benefit in reducing binge-eating episodes.
  • Chronic pain syndromes - small studies indicate possible improvement in neuropathic pain, likely via central serotonergic mechanisms.

Disclaimer: Off-label use requires careful medical supervision and individualized risk assessment. It is not endorsed by the MHRA for these purposes.

Who Should (Not) Use Sertraline?

Absolute Contraindications

  • Known hypersensitivity to sertraline or any of its excipients.
  • Concurrent use of monoamine oxidase inhibitors (MAOIs) - a 14-day washout is required when switching.
  • Concomitant therapy with pimozide or thioridazine (both have a risk of QT prolongation).

Relative Contraindications & Precautions

  • Pregnancy & lactation: Use only if the expected benefit outweighs potential risks; sertraline is generally considered the SSRI of choice in pregnancy due to a favorable safety profile, but it is avoided in the first trimester unless essential.
  • Breastfeeding: Low levels are excreted in milk; discuss risks with a healthcare professional.
  • Severe hepatic impairment: Dose reduction may be necessary because metabolism is liver-dependent.
  • Renal impairment: No dose adjustment is typically required, but monitor for accumulation of metabolites.
  • Bipolar disorder: May precipitate mania; a mood stabiliser is often co-prescribed.

Safety Profile and Interactions

Common Side Effects

  • Nausea or upset stomach
  • Diarrhoea or constipation
  • Insomnia or somnolence (variable)
  • Dry mouth
  • Dizziness
  • Sexual dysfunction (reduced libido, delayed orgasm, anorgasmia)

These effects are usually mild and tend to improve within the first few weeks of therapy.

Serious Adverse Events

  • Serotonin syndrome - characterised by agitation, hyperthermia, tremor, sweating, and hyperreflexia; requires urgent medical attention.
  • Increased suicidal thoughts - particularly in patients under 25 years; regular monitoring is essential during the initial treatment phase.
  • QTc prolongation - rare but possible, especially when combined with other QT-prolonging agents.
  • Hyponatraemia - may occur in elderly patients; monitor serum sodium if clinically indicated.

Drug Interactions

  • MAOIs (e.g., phenelzine, tranylcypromine) - risk of serotonin syndrome; avoid concomitant use.
  • Other serotonergic agents - tramadol, linezolid, St John’s wort, triptans; may increase serotonin toxicity.
  • CYP2C19 inhibitors (e.g., fluconazole, omeprazole) - can raise sertraline plasma levels, potentially heightening side-effect risk.
  • CYP2D6 substrates (e.g., tamoxifen) - sertraline may reduce the efficacy of tamoxifen by inhibiting its activation.
  • Anticoagulants (e.g., warfarin) - sertraline can modestly increase bleeding risk; periodic INR monitoring may be warranted.

Food and Lifestyle Interactions

  • Alcohol: No direct pharmacokinetic interaction, but combined use can amplify sedation and impair judgement.
  • Caffeine: May exacerbate anxiety or insomnia in sensitive individuals.
  • Driving: Most patients can drive safely once the drug’s sedative effects have stabilised; caution is advised during the first week of treatment.

How to Take Sertraline

  • Starting dose: 25 mg once daily, usually taken in the morning.
  • Titration: After one week, the dose may be increased to 50 mg daily; further increments of 50 mg are possible every week up to a maximum of 200 mg (the highest available strength in the UK is 100 mg, so two tablets may be used).
  • Administration: Swallow the pill whole with water; it can be taken with or without food.
  • Missed dose: Take the missed tablet as soon as remembered unless it is near the time of the next scheduled dose; do not double-dose.
  • Overdose: Symptoms may include nausea, vomiting, tremor, and cardiac arrhythmia. Seek emergency medical help; activated charcoal may be considered if presentation is early.
  • Discontinuation: Do not stop abruptly. Gradual taper (e.g., reducing by 25 mg every 1-2 weeks) helps minimise discontinuation syndrome, which can manifest as dizziness, irritability, or flu-like symptoms.

Monitoring and Follow-Up

  • Baseline assessment: Depression severity scales (e.g., PHQ-9), anxiety inventories, and a thorough medication review.
  • Early follow-up: Within 2-4 weeks to evaluate response, side effects, and suicidality, especially in patients under 25 years.
  • Long-term monitoring: Periodic evaluation of mood, sleep, and any emergent adverse events. Routine laboratory testing is not required unless clinically indicated (e.g., hyponatraemia suspicion).

Storage and Handling

  • Store at room temperature (15-25 °C), away from excess moisture and direct sunlight.
  • Keep the bottle tightly closed and out of reach of children.
  • Do not use the medication past the expiry date printed on the package.
  • Dispose of unused tablets via a pharmacy take-back scheme or according to local hazardous waste guidelines.

Medication-Specific Glossary

Serotonin reuptake inhibition
The process by which sertraline blocks the transporter that normally removes serotonin from the synaptic cleft, thereby increasing its availability.
Serotonin syndrome
A potentially life-threatening condition caused by excessive serotonergic activity, presenting with mental status changes, autonomic instability, and neuromuscular abnormalities.
QTc prolongation
Extension of the heart’s electrical repolarisation interval on an ECG; may predispose to arrhythmias when combined with other QT-prolonging drugs.
Discontinuation syndrome
A set of transient symptoms (e.g., dizziness, irritability, flu-like sensations) that can occur after abrupt cessation or rapid dose reduction of SSRIs.

Medical Disclaimer

This article provides educational information about sertraline and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Information for Sertraline is sourced from established medical standards and updated frequently. It is provided for general guidance and should be confirmed with a healthcare professional before use.
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