Sertraline

What is Sertraline?

Sertraline is a prescription-only medication widely used to treat major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD). It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs).

Unlike older tricyclic antidepressants, Sertraline specifically targets and increases serotonin levels in the brain without significantly affecting other neurotransmitters like norepinephrine or dopamine. This targeted action provides a more favourable side-effect profile for long-term mood regulation.

Generic Names:

• Sertraline hydrochloride: The standard generic chemical name used by medical professionals globally.

Global Brand Names:

Sertraline is manufactured by multiple pharmaceutical companies and is available under various brand names.

• Zoloft (左洛復): The original brand by Pfizer, widely available in Hong Kong hospitals and registered pharmacies.
• Apo-Sertraline: A common generic alternative available in Hong Kong.
• Sertraline-Teva: Another widely accessible generic version registered with the Hong Kong Drug Office.

These names all refer to the same medication. It's important to note that while the active ingredient is the same, different countries may have different regulations and available medication formulations.

What is Sertraline used for?

Sertraline is used to relieve:

• Symptoms of major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Panic attacks and panic disorder
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder
• Premenstrual dysphoric disorder (PMDD)

How do you use Sertraline?

Availability:

• Oral tablets
• Oral liquid concentrate

Dosage Information:

• Adults: Start with 25 mg to 50 mg once daily depending on the condition, increasing up to a maximum of 200 mg daily if required.
• Children and Adolescents (OCD only): Ages 6 to 12 start at 25 mg daily; ages 13 to 17 start at 50 mg daily.

Suitability:

• Adults: Yes, for indicated mental health conditions.
• Children: Yes, but strictly limited to OCD treatment for those aged 6 and older.
• Elderly: Yes, but with caution regarding sodium levels.

Who cannot take Sertraline?

Allergies and unsuitability:

• Rare, but possible severe allergic reactions to sertraline hydrochloride.

Conditions where the drug should not be used:

• Active use of Monoamine Oxidase Inhibitors (MAOIs)
• Active use of Pimozide
• Concurrent use of Disulfiram (for the liquid concentrate form only)

Common side effects of Sertraline include nausea, diarrhoea, trouble sleeping, dry mouth, dizziness, and increased sweating. Many patients also experience temporary changes in sexual function, such as a decreased libido or delayed ejaculation. These effects often diminish as the body adjusts to the medication.

Severe adverse reactions are rare but require immediate attention. These include Serotonin Syndrome, which causes agitation, hallucinations, and muscle rigidity, as well as dangerously low blood sodium levels in the elderly. Abruptly stopping Sertraline can trigger discontinuation syndrome, marked by irritability, nausea, and sensory disturbances like "brain zaps," making gradual dose tapering essential.

• Do not take with Monoamine Oxidase Inhibitors (MAOIs); allow a 14-day washout period to prevent life-threatening Serotonin Syndrome.
• Check with a doctor before using Aspirin, NSAIDs, or blood thinners due to an increased risk of abnormal bleeding.
• Monitor closely for emerging suicidal thoughts or sudden behavioural changes, especially in children, adolescents, and young adults.
• Avoid alcohol to reduce the risk of central nervous system depression and worsening side effects.
• Do not mix the oral liquid concentrate with Disulfiram, as the liquid formulation contains alcohol.

Storage information:

• Keep in a dry environment at controlled room temperature between 20°C and 25°C.
• Protect the medication from direct sunlight and excessive moisture.
• Store strictly out of sight and reach of children.

Handling instructions:

• Swallow the tablets whole with a glass of water.
• Use the specific measuring dropper provided with the medication if taking the oral liquid concentrate.
• Dilute the liquid concentrate immediately before use with a suitable liquid, as directed by a pharmacist.

Where is Sertraline available in Hong Kong?

In Hong Kong, Sertraline is strictly classified as a Prescription Only Medicine. This means you must present a valid doctor's prescription to purchase it legally.

You can obtain this medication at registered pharmacies displaying the "Rx" logo, as well as hospital pharmacies and specialised medical clinics across the territory.