Sertraline

Sertraline

Sertraline hydrochloride (trade names Zoloft and Lustral, among others; also known as sertralinium chloride) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It was discovered by Pfizer. Sertraline is primarily used to treat major depressive disorder in adult outpatients as well as obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder and social anxiety disorder in both adults and children. In 2007, it was the most prescribed antidepressant on the U.S. retail market, with 29,652,000 prescriptions.

The efficacy of sertraline for depression is similar to that of older tricyclic antidepressants, but its side effects are much less pronounced. Differences with newer antidepressants are subtler and also mostly confined to side effects. Evidence suggests that sertraline may work better than fluoxetine (Prozac) for some subtypes of depression. Cognitive behavioral therapy in combination with sertraline is a better treatment for obsessive-compulsive disorder than sertraline alone. Although approved for social phobia and posttraumatic stress disorder, sertraline leads to only modest improvement in these conditions. Sertraline also alleviates the symptoms of premenstrual dysphoric disorder and can be used in sub-therapeutic doses or intermittently for its treatment.

Sertraline shares the common side effects and contraindications of other SSRIs, with high rates of nausea, diarrhea, insomnia, and sexual side effects; however, it has relatively mild effects on both cognition and vigilance. The unique effect of sertraline on dopaminergic neurotransmission may be related to these milder effects on cognition and vigilance. In pregnant women taking sertraline, the drug was present in significant concentrations in fetal blood, and was also associated with a higher rate of various birth defects. Similarly to other antidepressants, the use of sertraline for depression may be associated with a higher rate of suicidal behavior.