Sertraline is part of a family of drugs called Selective Serotonin Reuptake Inhibitors, or SSRIs. Serotonin is a signaling molecule, called a neurotransmitter, that allows neurons (nerve cells) in the brain to communicate with each other. Certain neurons release serotonin into a small space between it and an adjacent neuron called the synaptic space or synaptic cleft. From there the serotonin can travel to the next neuron to deliver its message. Serotonin gets reabsorbed by the neuron that released it in a process called reuptake. SSRIs prevent this reuptake of serotonin, which increases the amount of serotonin in the synaptic space. Over time, the increased serotonin causes other chemical changes that may be responsible for some of the effects of SSRIs. Serotonin plays a role in mood, social behavior, appetite, digestion, sleep, memory, and sexual desire and function. Serotonin also plays an important role in inhibiting ejaculation, and SSRIs have been studied as a treatment for premature ejaculation. SSRIs are FDA-approved to treat anxiety and depression, but they are also used off-label to treat several other conditions, including premature ejaculation (PE). The American Urological Association (AUA) recommends certain SSRIs, including sertraline, as a primary treatment for PE.
Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressants that are rarely used anymore due to many interactions with other drugs and certain foods. SSRIs are the most commonly used drugs in the modern treatments of depression due to being safer and having better side effect profiles than older drugs, including MAOIs. Sertraline is not an MAOI.
Sertraline is the chemical name of the active ingredient in Zoloft®. Zoloft® was originally patented and sold by Pfizer. It is FDA-approved to treat major depression, social anxiety disorder, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD), panic disorder, and premenstrual dysphoric disorder (PMDD). After the patent expired, the FDA gave permission to other drug companies to manufacture a generic version of Zoloft®. The FDA requires generic drugs to be bioequivalent to the brand name version. This means that they act the same way in the body and are expected to produce the same effects as the original brand name drug. Generic drugs are generally much cheaper than the original brand name drug, and most drugs prescribed in the US are generic.
What is Sertraline Used to Treat (on-label and off-label)?
Sertraline is FDA-approved to treat major depression, social anxiety disorder, obsessive compulsive disorder (OCD), posttraumatic stress disorder (PTSD), panic disorder, and premenstrual dysphoric disorder (PMDD). It is sometimes used off-label to treat premature ejaculation (PE) and several other conditions. The American Urological Association (AUA) recommends certain SSRIs, including sertraline, as a primary treatment for PE. Physicians on the Roman platform have the discretion to prescribe sertraline for PE if they believe that it is an appropriate course of treatment for a particular patient. It is up to the medical judgment of the doctor to decide if off-label treatment is appropriate for a patient based on his unique medical history, symptoms, and preferences. The Roman Pharmacy Network is able to fill prescriptions for sertraline that are issued by a physician on the Roman platform.
Sertraline comes in 25 mg, 50 mg, and 100 mg tablets. It can be used in dosages of anywhere between 25 mg and 200 mg. It is often successfully used at lower doses (25 mg–50 mg) for the treatment of PE. Doses for psychiatric diseases are often higher (50 mg–200 mg).
Sertraline Half-life / How Long Does it Last in Your Body?
The average elimination half-life of sertraline is approximately 26 hours. This means after 52 hours, around 25% of sertraline is still in your body. It takes 104 hours before more than 90% of sertraline is eliminated from the body. N-desmethylsertraline, a less active metabolite of sertraline, has an elimination half-life of 62 to 104 hours.
The most common side effects in adults who take sertraline include:
- Loss of appetite,
- Increased sweating (hyperhidrosis)
- Tremor or shaking
- Change in sleep habits including increased sleepiness or insomnia
- Sexual problems including decreased libido and ejaculation dysfunction
- Feeling tired or fatigued
Do not stop sertraline without first talking to your healthcare provider.
People who abruptly stop taking SSRIs may suffer a constellation of symptoms collectively referred to as Antidepressant Discontinuation Syndrome (ADS). Symptoms include:
- Diaphoresis (excessive sweating)
- Rhinorrhea (runny nose)
Although some SSRIs are known to cause weight gain, sertraline typically does not cause weight gain. Weight loss due to decreased appetite is listed as a potential side effect in the Prescriber’s Digital Reference (PDR).
Sertraline has not been designated as a controlled substance by the Drug Enforcement Administration (DEA). It is not considered to have any serious risk of abuse or addiction.
Sertraline has a “boxed warning,” which states, “There is a causal relationship between the use of antidepressants, such as sertraline, and the risk of suicidal ideation and behavior in children, adolescents, and young adults (ages 18 to 24 years).” The potential for risk of suicidal thoughts and behaviors is also increased in people who abruptly stop the medication. That is why you should discuss any changes in your therapy with all of your healthcare providers. Sertraline is used primarily as an antidepressant and people with depression are at higher risk of suicidal thoughts and behaviors. It’s possible that sertraline taken for other reasons, like PE, might also have this increased risk.