SERTRALINE WITHDRAWAL SYMPTOMS HELP / HOW TO WEAN OFF SERTRALINE SUCCESSFULLY

SERTRALINE SIDE EFFECTS MAY INCLUDE: 

The side effects of antidepressants can cause problems at first, but they generally improve with time. 

It's important to continue treatment, even if you're affected by side effects, as it will take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh any problems from side effects. 

During the first few months of treatment, you'll usually see your doctor or a specialist nurse at least once every 2 to 4 weeks to see how well the medicine is working. 

For more information about your specific medicine, see the patient information leaflet that comes with it.

SSRIs and SNRIs 

Common side effects of selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) can include: 

feeling agitated, shaky or anxious, feeling and being sick, indigestion and stomach aches, diarrhoea or constipation, loss of appetite, dizziness, not sleeping well (insomnia), or feeling very sleepy, headaches, loss of libido (reduced sex drive), difficulties achieving orgasm during sex or masturbation, difficulties obtaining or maintaining an erection (erectile dysfunction)

These side effects should improve within a few weeks, although some can occasionally persist.

Tricyclic antidepressants (TCAs) 

Common side effects of TCAs can include: 

dry mouth, slight blurring of vision, constipation, problems passing urine, drowsiness, dizziness, weight gain, excessive sweating (especially at night), heart rhythm problems (arrhythmia), such as noticeable palpitations or a fast heartbeat (tachycardia).  

The side effects should ease after a couple of weeks as your body begins to get used to the medicine.

SERTRALINE ADVERSE REACTIONS MAY INCLUDE: per PDR   

Severe: visual impairment, coma, seizures, anaphylactoid reactions, bronchospasm, ocular hypertension, suicidal ideation, SIADH, torsade de pointes, AV block, ventricular tachycardia, vasculitis, bradycardia, lupus-like symptoms, agranulocytosis, serum sickness, GI bleeding, pancytopenia, aplastic anemia, Stevens-Johnson syndrome, toxic epidermal necrolysis, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), angioedema, rhabdomyolysis, optic neuritis, pancreatitis, hepatic failure, pulmonary hypertension, renal failure (unspecified), serotonin syndrome, bone fractures, neonatal abstinence syndrome, persistent pulmonary hypertension of the newborn  

Moderate: ejaculation dysfunction, constipation, palpitations, impotence (erectile dysfunction), melena, ataxia, euphoria, teeth grinding (bruxism), hallucinations, confusion, hypertension, sinus tachycardia, peripheral vasodilation, hypercholesterolemia, bullous rash, blurred vision, elevated hepatic enzymes, edema, hematuria, vaginal bleeding, priapism, hypothyroidism, hyperglycemia, galactorrhea, hypoglycemia, diabetes, dystonic reaction, akathisia, depression, impulse control symptoms, hostility, psychosis, mania, hyponatremia, QT prolongation, bleeding, thrombocytopenia, platelet dysfunction, leukopenia, hematoma, trismus, cataracts, hepatitis, jaundice, urinary incontinence, hyperprolactinemia, osteopenia, withdrawal withdrawal, growth inhibition

Mild: nausea, diarrhea, insomnia, xerostomia, dizziness, fatigue, drowsiness, tremor, dyspepsia, agitation, hyperhidrosis, libido decrease, vomiting, appetite stimulation, lethargy, hypoesthesia, hyperactivity, syncope, irritability, purpura, epistaxis, maculopapular rash, alopecia, pruritus, urticaria, muscle cramps, arthralgia, tinnitus, mydriasis, yawning, fever, orgasm dysfunction, hyperkinesis, headache, nightmares, anxiet, petechiae, ecchymosis, photosensitivity, malaise, nocturia, gynecomastia, menstrual irregularity, weight loss

SERTRALINE BOXED WARNINGS: per PDR    

Children, growth inhibition, suicidal ideation

The safety and efficacy of sertraline have been established in the treatment of obsessive compulsive disorder in children and adolescents 6 to 17 years of age. Two placebo-controlled trials were conducted in pediatric patients with major depression, but the data were not sufficient to support an indication for use. 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). Pooled analysis of 24 placebo-controlled trials (n = 4,400) lasting up to 16 weeks in pediatric patients with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders showed a greater risk of suicidality during the first few months of treatment in those receiving antidepressants (SSRIs and others). The average risk of such events on drug was 4% and 2% for placebo; however, no suicides occurred in these trials. Risk for suicidality does not appear to differ among individual antidepressant agents. However, data from a cohort of 36,842 children (age range: 6 to 18 years) suggested those who use multiple antidepressants may have a higher risk of suicide behavior, most likely a result of increased severity of depression rather than drug effect. Suicidal ideation appears to be more prevalent in children with or at high risk for bipolar affective disorder on antidepressants. In a study of 52 patients (mean age: 15 years; range: 7 to 22 years) with bipolar affective disorder or subthreshold manic symptoms, 25.5% had new onset suicidal ideation within the first 3 months of antidepressant use. The clinical need for an antidepressant in children or young adults for any use must be weighed against the risk of increased suicidality; patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior, particularly within the first few months of starting therapy or after dose changes. It is unknown if the suicidality risk extends to longer-term therapy (i.e., beyond several months). The possibility of a suicide attempt is inherent in patients with primary depressive symptoms or symptoms secondary to another primary disorder such as OCD. All patients with a history of suicidal ideation or behaviors prior to treatment are considered at an increased risk for suicidal ideation or attempts, and should be closely monitored during treatment with sertraline. In patients who exhibit a worsening of depression or emerging suicidality, a decision should be made to change or discontinue treatment. If discontinuing, the medication should be tapered as rapidly as possible, but with recognition that abrupt discontinuation can also cause adverse symptoms. All antidepressants should be prescribed in the smallest quantity consistent with good patient management in order to reduce the risk of overdose. Data are inadequate to determine whether the chronic use of SSRIs causes long-term growth inhibition; however, decreased appetite and weight loss have been observed with the use of SSRIs. Monitor for potential growth inhibition (e.g., weight and height) in pediatric patients treated with an SSRI.   

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