Sertraline

For the song by the Lottery Winners, see Anxiety Replacement Therapy.
"Lustral" redirects here. For other uses, see Lustral (disambiguation).

Sertraline
Clinical data
Pronunciation/ˈsɜːrtrəˌliːn/
Trade namesZoloft, Lustral, Setrona, others[1]
AHFS/Drugs.comMonograph
MedlinePlusa697048
License data
Pregnancy
category
Addiction
liability		None[3]
Routes of
administration		By mouth
Drug classSelective serotonin reuptake inhibitor (SSRI)
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • BR: Class C1 (Other controlled substances)[4]
  • CA: ℞-only
  • NZ: Prescription only
  • UK: POM (Prescription only)
  • US: ℞-only
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability44%[citation needed]
Protein binding98.5%[citation needed]
MetabolismLiver (primarily N-demethylation mainly by CYP2B6; also metabolism by CYP2C19, others)[5][9]
Metabolites• Desmethylsertraline
• Others (e.g., hydroxylated metabolites, glucuronide conjugates)[5]
Elimination half-life• Sertraline: 26 hours (32 hours in females, 22 hours in males; range 13–45 hours)[5][6][7][8]
• Desmethylsertraline: 62–104 hours[5]
ExcretionUrine (40–45%)[5]
Feces (40–45%)[5]
Identifiers
  • (1S,4S)-4-(3,4-Dichlorophenyl)-N-methyl-1,2,3,4-tetrahydronaphthalen-1-amine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
Chemical and physical data
FormulaC17H17Cl2N
Molar mass306.23 g·mol−1
3D model (JSmol)
  • ClC1=CC=C([C@H]2C3=C([C@H](CC2)NC)C=CC=C3)C=C1Cl
  • InChI=1S/C17H17NCl2/c1-20-17-9-7-12(13-4-2-3-5-14(13)17)11-6-8-15(18)16(19)10-11/h2-6,8,10,12,17,20H,7,9H2,1H3/t12-,17-/m0/s1 checkY
  • Key:VGKDLMBJGBXTGI-SJCJKPOMSA-N checkY
  (verify)

Sertraline, sold under the brand name Zoloft among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.[10] The effectiveness of sertraline for depression is similar to that of other antidepressants, and the differences are mostly confined to side effects. Sertraline is better tolerated than the older tricyclic antidepressants. Sertraline is effective for panic disorder, social anxiety disorder, generalized anxiety disorder (GAD), and obsessive–compulsive disorder (OCD). Although approved for post-traumatic stress disorder (PTSD), sertraline leads to only modest improvement in this condition.[11][12] Sertraline also alleviates the symptoms of premenstrual dysphoric disorder (PMDD) and can be used in sub-therapeutic doses or intermittently (luteal phase dosing) for its treatment.[13]

Sertraline shares the common side effects and contraindications of other SSRIs, with high rates of diarrhea, nausea, insomnia, and sexual dysfunction, but it appears not to lead to much weight gain, and its effects on cognitive performance are mild. Similar to other antidepressants, the use of sertraline for depression may be associated with a mildly elevated rate of suicidal thoughts in people under the age of 25 years old. It should not be used together with monoamine oxidase inhibitors (MAOIs): this combination may cause serotonin syndrome, which can be life-threatening in some cases. Sertraline taken during pregnancy is associated with an increase in congenital heart defects in newborns.[14][15]

Sertraline was invented and developed by scientists at Pfizer and approved for medical use in the United States in 1991. It is on the World Health Organization's List of Essential Medicines.[16] It is available as a generic medication.[10] In 2016, sertraline was the most commonly prescribed psychotropic medication in the United States.[17] In 2022, it was the eleventh most commonly prescribed medication in the United States, with more than 39 million prescriptions.[18][19] In Australia, it was one of the top 10 most prescribed medications between 2017 and 2023.[20]

  1. ^ Cite error: The named reference Brand2015 was invoked but never defined (see the help page).
  2. ^ "Sertraline (Zoloft) Use During Pregnancy". Drugs.com. 4 May 2020. Retrieved 17 May 2020.
  3. ^ Hubbard JR, Martin PR (2001). Substance Abuse in the Mentally and Physically Disabled. CRC Press. p. 26. ISBN 9780824744977.
  4. ^ Anvisa (31 March 2023). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 4 April 2023). Archived from the original on 3 August 2023. Retrieved 16 August 2023.
  5. ^ a b c d e f Cite error: The named reference FDALabel was invoked but never defined (see the help page).
  6. ^ Brunton L, Chabner B, Knollman B (2010). Goodman and Gilman's The Pharmacological Basis of Therapeutics (Twelfth ed.). McGraw Hill Professional. ISBN 978-0-07-176939-6.
  7. ^ Cite error: The named reference pmid16192315 was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference pmid12452737 was invoked but never defined (see the help page).
  9. ^ Cite error: The named reference pmid15547048 was invoked but never defined (see the help page).
  10. ^ a b "Sertraline Hydrochloride". Drugs.com. The American Society of Health-System Pharmacists. Retrieved 8 January 2018.
  11. ^ Cite error: The named reference pmid25644881 was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference pmid27126398 was invoked but never defined (see the help page).
  13. ^ Yonkers KA, Kornstein SG, Gueorguieva R, Merry B, Van Steenburgh K, Altemus M (October 2015). "Symptom-Onset Dosing of Sertraline for the Treatment of Premenstrual Dysphoric Disorder: A Randomized Clinical Trial". JAMA Psychiatry. 72 (10): 1037–1044. doi:10.1001/jamapsychiatry.2015.1472. PMC 4811029. PMID 26351969.
  14. ^ Cite error: The named reference pmid30415641 was invoked but never defined (see the help page).
  15. ^ Cite error: The named reference pmid33354752 was invoked but never defined (see the help page).
  16. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  17. ^ Grohol JM (12 October 2017). "Top 25 Psychiatric Medications for 2016". Psych Central. Retrieved 22 October 2018.
  18. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  19. ^ "Sertraline Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
  20. ^ "Medicines in the health system". Australian Institute of Health and Welfare. 2 July 2024. Retrieved 30 September 2024.