Initial: 50 mg q Day PO given continuously throughout menstrual cycle or given during luteal phase only May increase by 50 mg at the onset of each new menstrual cycle; no more than 150 mg q Day when administered continuously or 100 mg q Day when administered during luteal phase only 25 mg PO q Day initially; may increase by 25 mg every 2-3 days; not to exceed 200 mg q Day Alzheimer dementia related depression: Start at 12.5 mg/day and titrate every 1-2 weeks to response; not to exceed 150-200 mg Renal impairment: Dose adjustment not necessary Mild hepatic impairment (Child-Pugh 5-6): Decrease recommended starting dose and therapeutic dose by 50% Moderate-to-severe hepatic impairment (Child-Pugh 7-15): Not recommended; sertraline is extensively metabolized, and the effects in patients with moderate and severe hepatic impairment have not been studied Clinical worsening and suicide ideation may occur despite medication Use caution in patients with seizure disorders May worsen mania symptoms or precipitate mania in patients with bipolar disorder Increases risk of hyponatremia and impairment of cognitive/motor functions in the elderly Increases risk of bleeding in patients taking anticoagulants/antiplatelets concomitantly Risk of mydriasis; may trigger angle closure attack in patients with angle closure glaucoma with anatomically narrow angles without a patent iridectomy Pregnancy: Conflicting evidence regarding use of SSRIs during pregnancy and increased risk of persistent pulmonary hypertension of the newborn (see Pregnancy) In neonates exposed to SNRIs/SSRIs late in third trimester: Risk of complications such as feeding difficulties, irritability, and respiratory problems Avoid abrupt withdrawal Bone fractures reported with antidepressant therapy; consider the possibility if patient presents with bone pain, bruising, or point of tenderness Coadministration with other drugs that enhance the effects of serotonergic neurotransmission (eg, tryptophan, fenfluramine, fentanyl, 5-HT agonists, St. John’s Wort) should be undertaken with caution and avoided whenever possible due to the potential for pharmacodynamic interaction (see Contraindications) May cause false-positive urine immunoassay screening tests for benzodiazepines SSRIs and SNRIs are associated with development of SIADH; hyponatremia reported Several SSRIs (eg, fluoxetine, fluvoxamine, paroxetine, sertraline) are metabolized by CYP2D6 CYP2D6 is involved in the metabolism of approximately 20% of drugs in clinical use and displays large individual-to-individual variability in activity due to genetic polymorphisms More than 80 CYP2D6 variant alleles have been identified; however, 4 of the most prevalent alleles, CYP2D6*3, *4, *5, and *6, account for 93-97% of CYP2D6 poor metabolizers CYP2D6*4, the most common variant (~25% frequency in whites), causes a splicing defect; CYP2D6*3 (2.7% frequency) causes a frameshift mutation; and CYP3D6*5 (2.6%) is an entire deletion of the CYP2D6 gene; individuals homozygous for these alleles have no CYP2D6 activity The impact of CYP2D6 activity is further complicated in some SSRIs (eg, fluoxetine, fluvoxamine, paroxetine, sertraline) because in addition to being substrates for CYP2D6, they are also known to moderately inhibit CYP2D6 activity The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Sertraline is used for a number of conditions, including major depressive disorder (MDD), obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), panic disorder, and social anxiety disorder (SAD). The comparative efficacy of sertraline and TCAs for melancholic depression has not been studied. A 1998 review suggested that, due to its pharmacology, sertraline may be more efficacious than other SSRIs and equal to TCAs for the treatment of melancholic depression. A meta-analysis of 12 new-generation antidepressants showed that sertraline and escitalopram are the best in terms of efficacy and acceptability in the acute-phase treatment of adults with unipolar MDD. Sertraline used for the treatment of depression in elderly (older than 60) patients was superior to placebo and comparable to another SSRI fluoxetine, and TCAs amitriptyline, nortriptyline (Pamelor) and imipramine. Sertraline had much lower rates of adverse effects than these TCAs, with the exception of nausea, which occurred more frequently with sertraline. In addition, sertraline appeared to be more effective than fluoxetine or nortriptyline in the older-than-70 subgroup. placebo in elderly patients showed a statistically significant (that is, unlikely to occur by chance), but clinically very modest improvement in depression and no improvement in quality of life. A meta-analysis on SSRIs and SNRIs that look at partial response (defined as at least a 50% reduction in depression score from baseline) found that sertraline, paroxetine and duloxetine were better than placebo.
This is strikingly similar to reports right after the 2013 school massacre in Newtown, Connecticut, when Mark and Louise Tambascio, family friends of shooter Adam Lanza and his mother, were interviewed on CBS’ “60 Minutes,” during which Louise Tambascio told correspondent Scott Pelley: “I know he was on medication and everything, but she homeschooled him at home cause he couldn’t deal with the school classes sometimes, so she just homeschooled Adam at home. In the case of Nikolas Cruz, the 19-year-old Florida mass-shooter, his mother’s sister, Barbara Kumbatovich, told the Miami Herald that she believed Cruz was on medication to deal with his emotional fragility. ” As information about the perpetrator emerges, a relative confides to a newspaper that the “troubled youth” who committed the mass murder was on psychiatric medications – you know, those powerful, little understood, mind-altering drugs with fearsome side effects including “suicidal ideation” and even “homicidal ideation.” Yet the predictable response from the press is always the same – not only a total lack of curiosity, but disdain for any who ask the question, as though connecting psychiatric meds to mass shootings is pursuing a “conspiracy theory.” Here’s a good way to tell whether or not something is a conspiracy theory: If it’s true, it’s not a conspiracy theory. Pundits urge the public, “If you see something, say something.” And everyone asks, “Why? And that was her life.” And here, Tambascio tells ABC News, “I knew he was on medication, but that’s all I know.” But there was little journalistic curiosity or follow-up, and one wonders whether that will be the case this time around. But, you may well be asking, why is the issue of psychiatric medications even important? Get David Kupelian’s latest blockbuster, “The Snapping of the American Mind: Healing a Nation Broken by a Lawless Government and Godless Culture.” Also available in e-book, audiobook and autographed versions. Fact: A disturbing number of perpetrators of school shootings and similar mass murders in our modern era were either on – or just recently coming off of – psychiatric medications. This Word Press plugin adds the features of a complete support ticket system for Word Press. This allows users to submit tickets to report problems or get support on whatever you want directly through your Word Press website. Users can set the status, priority, product and type of each ticket submitted into this Word Press support plugin. WATS is perfect Word Press plugin for support plus advanced issue management. Word Press Advanced Ticket System : On the official website, you’ll find detailed setup instructions, anwsers to FAQ and premium release order page. THERE IS NO WARRANTY FOR THE PROGRAM, TO THE EXTENT PERMITTED BY APPLICABLE LAW. EXCEPT WHEN OTHERWISE STATED IN WRITING THE COPYRIGHT HOLDERS AND/OR OTHER PARTIES PROVIDE THE PROGRAM “AS IS” WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE.
Dosage in Patients with MDD, OCD, PD, PTSD, and SAD. The recommended initial dosage and maximum ZOLOFT dosage in patients with MDD, OCD, PD, PTSD, and SAD are displayed in Table 1 below. Sertraline hydrochloride C17H18Cl3N CID 63009 - structure, chemical names, physical and chemical properties. Description, chemical compound.