Sertraline

Sertraline is a selective serotonin reuptake inhibitor (ssri) antidepressant medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Sertraline is prescribed by doctors, ideally psychiatrists, for:

• Major depression — persistent low mood, loss of interest, changes in sleep and appetite
• Generalised anxiety and excessive worry
• Panic disorder — sudden attacks of intense fear with palpitations and breathlessness
• Obsessive-compulsive disorder (OCD) — unwanted repeated thoughts and compulsive rituals
• Social anxiety disorder
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder in some women

Only a qualified doctor can confirm whether Sertraline is the right medicine for your condition.

Sertraline is a strictly prescription-only medicine — the information below is general guidance only, and your doctor will decide the exact dose for you.

• Depression and anxiety (adults): usually started at 25–50 mg once daily, increased gradually if needed, up to a maximum of 200 mg daily.
• OCD, panic and PTSD: often started at a low dose (25 mg) and increased slowly.
• Take it at the same time every day, with or without food.

Benefit appears after 2–4 weeks, so do not stop early thinking it is not working. Never stop Sertraline suddenly — the dose must be reduced step by step under your doctor's guidance to avoid withdrawal symptoms such as dizziness, electric-shock sensations, irritability and sleep problems.

Most side effects of Sertraline are mild and settle within the first 1–2 weeks:

• Nausea, loose stools or stomach upset
• Headache, dizziness
• Sleep disturbance or drowsiness
• Increased sweating, dry mouth
• Reduced sexual desire or delayed orgasm
• Temporary restlessness or increased anxiety at the start of treatment

Contact your doctor urgently if you notice unusual agitation, worsening mood or thoughts of self-harm (especially in people under 25), unusual bleeding or bruising, a severe rash, or fever with muscle stiffness, sweating and confusion (possible serotonin syndrome).

Take these precautions while using Sertraline:

• Use it only under medical supervision, preferably by a psychiatrist, and attend follow-up visits regularly.
• Never stop suddenly — the dose must be tapered slowly to avoid withdrawal symptoms.
• Avoid alcohol completely; it worsens depression and increases side effects.
• Be careful when driving or operating machinery until you know how the medicine affects you.
• Tell your doctor if you have epilepsy, liver disease, a bleeding disorder, glaucoma, diabetes or bipolar disorder.
• Young people under 25 should be watched closely during the first few weeks for mood changes or suicidal thoughts.

Tell your doctor about every medicine you take, including herbal products. Important interactions with Sertraline include:

• MAO inhibitor antidepressants — must never be combined; a gap of at least 14 days is required.
• Other serotonergic drugs — tramadol, triptans (migraine medicines), lithium and other antidepressants increase the risk of serotonin syndrome.
• Blood thinners and painkillers — warfarin, aspirin and NSAIDs such as ibuprofen increase bleeding risk.
• Pimozide — this combination is contraindicated.
• Alcohol and sedatives — increased drowsiness and impaired judgement.

Sertraline should not be used in the following situations:

• Known allergy to Sertraline or any ingredient of the preparation
• Treatment with an MAO inhibitor now or within the last 14 days
• Use together with pimozide

Sertraline should be used with extra caution and specialist advice in people with epilepsy, significant liver disease, bipolar disorder (risk of switching to mania) or bleeding tendencies.

Pregnancy: Sertraline should be used in pregnancy only when the doctor judges that the benefit outweighs the risk. Remember that untreated depression itself can harm both mother and baby, so never stop the medicine on your own — if you are pregnant or planning pregnancy, discuss it with your psychiatrist immediately.

Breastfeeding: only small amounts of Sertraline pass into breast milk, and sertraline is generally considered one of the preferred antidepressants during breastfeeding. Even so, use it only under medical supervision and watch the baby for unusual sleepiness or poor feeding.

Store Sertraline below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep the medicine in its original pack and strictly out of the reach of children. Do not use it after the expiry date printed on the pack, and return unused tablets to a pharmacy instead of throwing them into household waste.