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Sertraline

Major depressive disorder, Generalized anxiety disorder, PTSD, Panic disorder, OCD, Social anxiety disorder

Indications

  • Major depressive disorder
  • Generalized anxiety disorder
  • PTSD
  • Panic disorder
  • OCD
  • Social anxiety disorder

Adult dosing

  • depression: dose: 50; unit: mg; route: PO daily; interval: Increase by 25-50mg q1-2 weeks; max 200mg/day; fixed: true; anxiety: dose: 25; unit: mg; route: PO daily; interval: Start lower for anxiety disorders; titrate to 50-200mg; fixed: true

Contraindications

  • MAOI use within 14 days
  • Concurrent pimozide
  • Concurrent linezolid or IV methylene blue

Clinical pearls

  • Most evidence-based SSRI for PTSD (FDA-approved)
  • Safe in cardiac patients (SADHART trial)
  • Lower CYP2D6 inhibition than paroxetine or fluoxetine — fewer drug interactions
  • Sexual dysfunction common — consider bupropion augmentation or switch if problematic
  • Taper gradually to avoid discontinuation syndrome

Source and review

  • APA Practice Guidelines; SADHART Trial, JAMA 2002. Last reviewed: 2024-11-01