Sertraline should be administered once daily, either in the morning or evening. Sertraline tablet can be administered with or without food.
Initial treatment: Depression and OCD: Sertraline treatment should be administered at a dose of 50 mg/day.
Panic Disorder, PTSD, and Social Phobia: Therapy should be initiated at 25 mg/day. After one week, the dose should be increased to 50 mg once daily. This dosage regimen has been shown to reduce the frequency of early treatment emergent side effects characteristic of panic disorder.
Titration: Depression, OCD, Panic Disorder, Social Anxiety Disorder and PTSD: Patients not responding to a 50 mg dose may benefit from dose increases. Dose changes should be made at interval of at least one week, up to a maximum of 200 mg/day. Changes in dose should not be made more frequently than once per week given the 24 hour elimination half life of Sertraline.
The onset of therapeutic effect may be seen within 7 days. However, longer periods are usually necessary to demonstrate therapeutic response, especially in OCD.
Maintenance: Dosage during long-term therapy should be kept at the lowest effective level, with subsequent adjustment depending on therapeutic response.
Use in children: The safety and effectiveness of Sertraline in children have not been fully established. In patients aged 6-17 with depression or OCD, Sertraline appeared to have a similar pharmacokinetic profile to that found in adults.
Use in elderly: The same dose range as in younger patients may be used in the elderly. The pattern and incidence of adverse reactions in the elderly (> 65 years) has been reported to be similar to that in younger patients.
Use in hepatic insufficiency: The use of Sertraline in patients with hepatic disease should be approached with caution. A lower or less frequent dose should be used in patients with hepatic impairment.
Use in renal insufficiency: Sertraline is extensively metabolized. Excretion of unchanged drug, in urine is a minor route of elimination. As expected from the low renal excretion of Sertraline, Sertraline dosing does not have to be adjusted based on the degree of renal impairment.