Sertraline

Taking Sertraline for Anxiety and Depression

What is Sertraline?

Sertraline is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant. It is commonly prescribed to treat anxiety and depression, but it can also be used to manage other conditions, such as panic attacks, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Sertraline works by increasing the level of serotonin, a chemical in the brain that helps improve mood and reduce anxiety.

How to Take Sertraline

Starting Dose:

• For depression or anxiety, your doctor will typically start you on a low dose of 50 mg once daily (usually in the morning).
• Depending on your response and any side effects, your doctor may gradually increase your dose. The dose can be increased to a maximum of 200 mg per day for most people, though many find relief with lower doses.

How to Take It:

• Sertraline tablets should be swallowed whole with a glass of water.
• You can take sertraline with or without food, but it’s best to take it at the same time each day, ideally in the morning.
• If you forget a dose, take it as soon as you remember, unless it’s almost time for your next dose. Do not take two doses at once to make up for a missed dose.

Starting Treatment:

• Start at a low dose: When starting sertraline, your doctor may begin with a low dose to minimize potential side effects. This dose will typically be increased gradually over a few weeks.
• Follow-up appointments: Your doctor will likely want to monitor your progress after a few weeks of treatment to assess how well the medication is working and if any adjustments are needed.

What to Expect When Taking Sertraline

How Long Will It Take to Work?

• Initial effects: Antidepressants like sertraline usually take 2 to 4 weeks to begin showing noticeable effects, though it may take up to 6-8 weeks for full benefit.
• Patience is important: It is common for people to feel that the medication isn't working right away. However, it’s essential to continue taking the medication as prescribed, even if you don’t notice immediate improvements.
• Continued monitoring: You may need to attend follow-up appointments with your doctor during the first few weeks to assess your progress and any side effects.

Early Side Effects

• Some side effects may occur when you first start taking sertraline or when your dose is increased. These typically improve after the first few weeks as your body adjusts to the medication.

  Common side effects include:

  • Nausea or stomach upset (this often improves over time)
  • Headache
  • Insomnia (difficulty sleeping) or vivid dreams
  • Dizziness or lightheadedness, especially when standing up quickly
  • Dry mouth
  • Increased sweating
  • Fatigue or feeling more tired than usual

Sexual Side Effects:

• Some people may experience reduced sexual desire (libido) or difficulty reaching orgasm. These side effects may improve over time or with dose adjustments, but if they are bothersome, speak to your doctor.

Important Safety Information

Stopping Sertraline

• Do not stop abruptly: It's very important not to stop taking sertraline suddenly without consulting your doctor. Stopping sertraline suddenly can cause withdrawal symptoms such as:

  • Dizziness or lightheadedness
  • Irritability or mood changes
  • Nausea or headache
  • "Electric shock" sensations or "brain zaps"

• Tapering off the medication: If you and your doctor agree that it is time to stop the medication, the dose will be gradually reduced over time to help avoid withdrawal symptoms. This process is called tapering.

• Consult your doctor: Always speak with your GP or pharmacist before making any changes to your medication. Your doctor will provide guidance on how to gradually reduce your dose if necessary.

Increased Risk of Suicidal Thoughts

• Monitor mood changes: Antidepressants, including sertraline, can increase the risk of suicidal thoughts, especially in younger people under the age of 25. This risk is higher in the early stages of treatment or when the dose is adjusted.

• Immediate help: If you feel that your mood has worsened, or if you have thoughts of harming yourself, it’s important to contact your doctor immediately or go to the nearest hospital.

Serotonin Syndrome (A Rare but Serious Condition)

• Serotonin syndrome is a rare but serious condition that can occur when serotonin levels in the brain become too high. Symptoms include:
  • Agitation or restlessness
  • Rapid heart rate
  • High fever
  • Sweating
  • Shivering or tremors
  • Muscle twitching or stiffness

If you notice any of these symptoms, seek medical attention immediately.

When to Contact Your Doctor

You should contact your doctor or pharmacist if you experience:

• Unusual or severe side effects: Particularly if they don’t improve over time or if they are affecting your daily life.
• Mood changes: If you notice new or worsening depressive symptoms, anxiety, or suicidal thoughts.
• Difficulty sleeping or excessive drowsiness.
• Any unusual physical symptoms, such as persistent dizziness, chest pain, or irregular heartbeats.
• Pregnancy: If you are pregnant, planning to become pregnant, or breastfeeding, discuss with your doctor whether sertraline is suitable for you.

Additional Tips for Taking Sertraline

• Consistency: Take your medication every day at the same time to help you remember. It is also helpful to set reminders on your phone or have a family member assist you in staying on track.
• Alcohol: It is best to avoid alcohol while taking sertraline, as alcohol can increase the side effects of dizziness, drowsiness, and impaired coordination.
• Hydration and diet: Drink plenty of water to help reduce side effects like dry mouth and nausea. Eating a balanced diet can also help support your treatment.

More information will be available in the PIL ( patient information leaflet) which accompanies medications. Your local pharmacist will also be able to help with any medication concerns.

Summary

Sertraline is an effective medication for managing anxiety and depression, but it can take several weeks to show full benefits. Common side effects include nausea, insomnia, dizziness, and fatigue, but these often improve after the first few weeks. It is important not to stop taking sertraline suddenly; always discuss any changes with your doctor or pharmacist. If you experience severe side effects or worsening mood, seek medical attention immediately.

Your doctor is the best person to guide you through your treatment, so don’t hesitate to reach out with any questions or concerns about your medication.