Sertraline
Sertraline is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder, panic disorder, OCD, PTSD and social anxiety disorder in adults. Marketed as Zoloft and as authorised generics.
- Chemical formula
- C17H17Cl2N
- CAS number
- 79617-96-2
- ATC code
- N06AB06
- Molecular weight
- 306.2 g/mol
- Drug class
- Selective serotonin reuptake inhibitor (SSRI)
- Also known as
- CP-51974, Sertraline hydrochloride
What is it?
Sertraline is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA in 1991 for the treatment of major depressive disorder. The molecule was developed by Pfizer and is marketed under the brand name Zoloft, with authorised generics widely available since the early 2000s. Sertraline is one of the most-prescribed antidepressants worldwide, with approved indications expanding over time to include panic disorder, OCD, PTSD and social anxiety disorder in adults.
Mechanism of action
Sertraline selectively blocks the reuptake of serotonin (5-HT) by the presynaptic neuron, increasing the concentration of serotonin in the synaptic cleft. This is thought to enhance serotonergic neurotransmission, although the precise link to clinical antidepressant effect remains incompletely understood. The molecule has weak effects on dopamine reuptake at high concentrations and minimal direct effects on norepinephrine, histamine, acetylcholine or other neurotransmitter systems, contributing to a relatively favourable side effect profile compared to older antidepressants.
Pharmacokinetics
After oral administration, sertraline reaches peak plasma concentrations in approximately 4 to 8 hours. Bioavailability is moderate, and absorption is slightly increased by food. The molecule is extensively metabolised in the liver, primarily by CYP2B6, CYP2C19 and CYP3A4, to N-desmethylsertraline, which has minimal pharmacological activity. The terminal half-life is approximately 26 hours, supporting once-daily dosing. Steady-state plasma concentrations are reached in approximately one week.
Indications
Sertraline is approved for several psychiatric indications in adults: major depressive disorder, panic disorder with or without agoraphobia, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder and premenstrual dysphoric disorder. In paediatric patients, sertraline is approved for OCD from age 6 in some jurisdictions. According to clinical guidelines, full antidepressant effect typically develops over 4 to 6 weeks of continuous treatment.
Safety profile
Common adverse effects include nausea, diarrhoea, insomnia, sexual dysfunction, dry mouth and sweating, particularly during the first weeks of treatment. Like all antidepressants, sertraline carries a black-box warning for increased suicidal ideation in young adults. Serious but uncommon events include serotonin syndrome (especially when combined with other serotonergic drugs), QT prolongation at high doses, and discontinuation syndrome on abrupt cessation. According to the prescribing information, careful clinical monitoring during initiation and dose changes is essential.
Products containing this ingredient
Frequently asked questions
How long does sertraline take to work? ▾
Some early effects on sleep and anxiety may appear within the first week or two, but the full antidepressant effect of sertraline typically develops over 4 to 6 weeks of continuous treatment at a therapeutic dose. According to clinical guidelines, treatment response should not be evaluated based only on the first weeks. If insufficient response is observed after 4 to 6 weeks at an adequate dose, the prescribing physician may consider dose adjustment or alternative therapy.
Is sertraline addictive? ▾
Sertraline is not considered addictive in the traditional sense — it does not produce the cravings or compulsive use associated with substances of abuse. However, abrupt discontinuation can cause discontinuation syndrome (dizziness, flu-like symptoms, sleep disturbance, sensory changes), which is sometimes mistaken for withdrawal. According to the prescribing information, sertraline should be tapered gradually rather than stopped abruptly when treatment is to be discontinued.
Can I drink alcohol while taking sertraline? ▾
While sertraline does not appear to have a major direct interaction with alcohol, the combination is not recommended. Alcohol can worsen depression and anxiety symptoms, may increase drowsiness and impair judgement, and can interfere with treatment response. According to clinical guidelines, alcohol consumption should be discussed with the prescribing physician, who may advise abstaining or moderate use depending on the individual situation.
What are the most common side effects? ▾
The most common side effects, particularly during the first weeks of treatment, include nausea, diarrhoea, insomnia, increased sweating and sexual dysfunction (decreased libido, delayed orgasm, erectile difficulties). Most physical side effects diminish over the first 2 to 4 weeks of treatment. Sexual dysfunction may persist throughout treatment in some patients. According to the prescribing information, persistent or severe side effects should be reported to the prescribing physician.
Can sertraline be combined with other medications? ▾
Sertraline interacts with several drug classes. The combination with monoamine oxidase inhibitors (MAOIs) is contraindicated due to the risk of serotonin syndrome. Other clinically important interactions include other serotonergic drugs (including triptans, tramadol, lithium), warfarin (increased bleeding risk), and CYP2D6 substrates. According to the prescribing information, all current medications should be disclosed to the prescriber before starting sertraline.
The information on this website is provided for reference and educational purposes only. It does not replace consultation with a qualified healthcare professional.