Sertraline: Price, Dosage & Where to Buy

Sertraline is a selective serotonin reuptake inhibitor (SSRI) prescribed for major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder. It requires a prescription in the United Kingdom. Generic sertraline has been available since 30 June 2006.

Sertraline belongs to the class of medicines known as selective serotonin reuptake inhibitors. Serotonin is a neurotransmitter that helps regulate mood, sleep, and anxiety. Normally, after serotonin is released in the brain, it is reabsorbed by nerve cells.

Sertraline blocks this reabsorption process, allowing more serotonin to remain active in the spaces between nerve cells. This increase in available serotonin is thought to improve communication between nerve cells and help stabilise mood. The effect builds gradually over several weeks of consistent use.

Sertraline is prescribed for major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder. Major depressive disorder involves persistent low mood and loss of interest in daily activities. Obsessive-compulsive disorder is marked by intrusive thoughts and repetitive behaviours.

Panic disorder causes sudden, intense episodes of fear. Posttraumatic stress disorder follows exposure to traumatic events. Social anxiety disorder involves overwhelming worry in social situations.

Premenstrual dysphoric disorder causes severe mood symptoms in the weeks before menstruation. The medicine addresses these conditions by acting on serotonin, a chemical messenger in the brain.

The label lists tablets in 25 mg, 50 mg, and 100 mg strengths, capsules in 150 mg and 200 mg strengths, and oral solutions at 20 mg/mL. The usual starting dose is 50 mg per day for major depressive disorder and obsessive-compulsive disorder in adults, and 25 mg per day for panic disorder, posttraumatic stress disorder, and social anxiety disorder in adults. The label lists 25 mg per day as the starting dose for children aged 6 to 12 years with obsessive-compulsive disorder, and 50 mg per day for ages 13 and older.

For premenstrual dysphoric disorder, the label lists a starting dose of 50 mg per day, either continuously throughout the menstrual cycle or intermittently during the luteal phase only. The maximum dose is 200 mg per day for most indications. Doses may be increased in 25 to 50 mg increments once weekly if the response is inadequate.

The label lists storage at 20°C to 25°C with excursions permitted to 15°C to 30°C. Tablets and capsules should be kept in their original container to maintain quality, protected from excessive heat and moisture.

The oral solution should also be stored at controlled room temperature. Keep sertraline out of reach of children and do not use it past the expiry date printed on the packaging.

If a dose is missed, it should generally be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular schedule resumed. Doubling up on doses to make up for a missed one is not recommended.

Because sertraline has a 24-hour elimination half-life, occasional missed doses are unlikely to cause immediate problems, but maintaining a consistent schedule helps keep the medicine at steady levels. Patients who have concerns about missed doses should speak with their doctor or pharmacist for guidance specific to their treatment plan.

Published epidemiological studies of pregnant women exposed to sertraline in the first trimester suggest no difference in major birth defect risk compared to the background rate, though some studies have reported increases for specific defects and these results are inconclusive. Exposure to SSRIs, particularly in the month before delivery, has been associated with a less than two-fold increase in the risk of postpartum haemorrhage. Use during late pregnancy may lead to neonatal complications requiring prolonged hospitalisation, respiratory support, and tube feeding, as well as persistent pulmonary hypertension of the newborn.

Women who are pregnant, planning pregnancy, or breastfeeding should discuss the potential risks and benefits with their doctor. A pregnancy exposure registry is available for women who take antidepressants during pregnancy.