Drug breakdown: sertraline

Day 1: The investigation of tametraline psychoactive compounds led to the discovery of #sertraline in the USA in 1983; not licensed until 1991. Indicated for the treatment and prevention of major depressive episodes, panic disorder, social anxiety disorder, OCD and PTSD. Advantages of #sertraline include being well-tolerated compared to some older SSRIs, with fewer pharmacokinetic drug-drug interactions

Day 2: Oral once-daily dose (if this leads to sleepiness take in the evening) 50-200mg/day depression and OCD; 25-50mg/day panic or social anxiety disorders and PTSD. Children OCD 6-12 years, 25-50 mg/day (can be higher); 13-17 50 mg/day titrate as required. Unlicensed for depression age 12-17, as children are more prone to suicidal thoughts

Day 3: Kinetics #sertraline – Extensive first-pass metabolism includes CYP3A4 and 2C19 breakdown. Half-life 22-36 hours; active metabolite prolongs t½ to 4 days. Renal excretion. Not affected by age or renal impairment, but prolonged t½ in hepatic impairment means caution and avoid if severe. Use of #sertraline in pregnancy carries the risk of birth defects and also withdrawal syndrome in the newborn