Sertima (sertraline) is an SSRI antidepressant predominantly used in patients age 13 and up to treat depression and/or anxiety, though less commonly it may be used to treat a wide range of other psychiatric conditions. Sertima is also sometimes used as-needed to treat premature ejaculation.

In patients age 12 to 6 Sertima is typically prescribed only to treat obsessive-compulsive disorder. Use in patients below age 6 is not recommended.

Sertima is also known by the brand name Zoloft, a widely-used antidepressant. Patients who take Sertima often experience:

• Improved mood
• More stable mood
• Reduced anxiety
• Better control of thoughts
• Fewer unwanted thoughts
• Improved impulse control
• Reduced compulsion to perform repetitive actions

Patients prone to manic episodes should not take Sertima (or any SSRI) without explicit doctor approval.

Some patients experience a mild euphoria from Sertima, but this effect typically stops occurring within the first month of treatment.

In some countries SSRI medications are associated with an increased risk of aggression and suicidal tendencies. This is a disputed subject, as other countries make no such connection. If an SSRI is going to cause such behaviors, it is typically reported that it's more likely to happen to patients below age 25 and usually (but not always) occurs during the first three months of treatment. Caretakers of younger patients may want to be alert for any behavior changes during the first few months.

In children below age 13, SSRIs, including Sertima, can cause more mood swings than in those age 13 and up. If these become disruptive consulting a doctor is advisable.

Dosage & Administration

Sertima comes in tablets or capsules. Patients who have difficulty swallowing whole pills should speak to a pharmacist about an oral solution, which can usually be prepared for these individuals.

While there may be some variation in dosage due to individual factors, such as weight, age, and other medical considerations, for the most part treatment is surprisingly similar in all conditions:

• Start with 25 to 50 mg taken once per day.
• Dosage may be increased by 50 mg each week, if needed, to a maximum of 200 mg per day.
• Treatment should continue for a minimum of 24 weeks, and may continue indefinitely as long as the medication continues to provide benefits and no serious adverse reactions develop.

The exceptions to the above treatment guidelines are in very young patients, and sometimes when the medication is used to treat premenstrual dysphoric disorder or premature ejaculation:

• Patients aged 6 to 12 being treated for obsessive-compulsive disorder should start on 25 mg per day, which may be increased to a maximum of 50 mg per day.
• For premature ejaculation, Sertima may be taken as-needed at 50 mg 4 to 8 hours prior to sexual activity, or 25 to 200 mg per day long-term.
• For premenstrual dysphoric disorder, either 50 to 150 mg per day continuously, or 50 mg per day during the luteal phase.

Note that while higher doses may be taken long-term, treatment should not start with high doses; if taking Sertima short-term or as-needed, do not exceed 50 mg per day.

Minor effects may be noticeable hours after taking a table, but it usually takes at least a week of treatment for improvements to be clearly noticeable and several weeks for full benefits to be felt.

Potential Complications

SSRIs usually produce at least one side effect in those who take them. Fortunately most side effects are transient and not cause for concern unless severe enough to be disruptive, including:

• Stomach upset
• Appetite loss
• Diarrhea
• Weight loss
• Dry mouth
• Insomnia
• Drowsiness

If insomnia occurs, taking doses in the morning may help. Taking tablets on a full stomach may reduce gastrointestinal side effects.

Certain sexual side effects, though rare, are experienced with all SSRIs, including Sertima:

• Loss of libido
• Impotence
• Difficulty achieving orgasm

Sexual side effects may disappear as the body adjusts to treatment, or may linger throughout treatment. Dosage adjustments may help, or other medications may be administered to counter the effects. If severe, a different antidepressant may be tried. Sexual side effects should reverse entirely a few weeks after treatment ends.