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Sertraline

It is a potent selective serotonin re uptake inhibitor (SSRI). It is chemically unrelated to tricyclic, tetracyclic anti depressants. It acts at brain synaptosomes as well as at platelet surfaces. The mechanism of action is inhibition of CNS neuronal uptake of serotonin (5-HT).

Indications: Major depressive disorder. Obsessions and compulsion in patients with obsessive compulsive disorder (OCD) panic disorder.

Contradictions: Hypersensitivity, liver disease, concomitant MAOI use.

Safety Profile: Renal & Hepatic impairment. Acute coronary syndromes. Seizure disorders, concomitant use of alcohol, unstable epilepsy, controlled epilepsy.

Pregnancy: use is potential benefits outweighed the risk.

Adverse Effects: Dry mouth, nausea, stomach, upset, diarrhea, tremor, dizziness, sleeplessness, indigestion, insomnia, fatigue.

Drug Interactions: Lithium: Increased incidence of mild to moderate tremors has been observed. Warfarin: May increase prothrombin time. Digitoxin, cimetidine, MAOI’s tricyclic antidepressants, hypoglycaemic drugs, antipyrin, alcohol.

Dosage: Depression: Start with 50mg once a day, oral dose. Increments of 50mg every week upto maximum 200mg per day. Obsessive & compulsive disorder, panic disorders 50-200mg once a day.