[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Selective serotonin reuptake inhibitors (SSRIs)](https://durgical.com/en/pharmacology/classes/selective-serotonin-reuptake-inhibitors/) › Sertraline [Pharmacology](https://durgical.com/en/pharmacology/) · [Selective serotonin reuptake inhibitors (SSRIs)](https://durgical.com/en/pharmacology/classes/selective-serotonin-reuptake-inhibitors/) # Sertraline A widely used SSRI for depression and anxiety disorders, including PTSD and OCD. It blocks serotonin reuptake and is often a first choice. Updated 2026-11-01 - Class: [Selective serotonin reuptake inhibitors (SSRIs)](https://durgical.com/en/pharmacology/classes/selective-serotonin-reuptake-inhibitors/) - Transporter: Serotonin transporter (SERT) - ATC code: N06AB06 ⇄**Serotonin transporter (SERT)**Sertraline ⓘ The figure shows sertraline bound at the central site of a thermostabilised human SERT (ts3). **Target in 3D:** Serotonin transporter (SERT). PDB structure 6AWO (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6AWO) · Drag to rotate · pinch to zoom ## Mechanism of action Sertraline binds the central substrate site of the serotonin transporter and blocks serotonin reuptake, strengthening serotonergic signalling in the brain. Clinical improvement follows over weeks as the system adapts. - Sertraline binds the central site of the serotonin transporter - Serotonin reuptake is blocked - Serotonin signalling in limbic and cortical circuits increases - Depression and anxiety improve over weeks ## Pharmacokinetics **Absorption** By mouth, with or without food **Metabolism** Extensive in the liver to N-desmethylsertraline, which is much less active **Half-life** About 26 hours for sertraline; 62 to 104 hours for N-desmethylsertraline **Onset and duration** Benefit builds over several weeks ## Indications - Major depressive disorder - Obsessive-compulsive disorder - Panic disorder - Post-traumatic stress disorder - Social anxiety disorder and premenstrual dysphoric disorder ## Adverse effects ### Common - Nausea and diarrhoea - Insomnia or somnolence - Sexual dysfunction (ejaculatory delay, low libido) - Sweating, tremor, dizziness ### Serious (rare, important) - Suicidal thoughts and behaviour in young people (boxed warning) - Serotonin syndrome - Bleeding, including postpartum haemorrhage - Hyponatraemia (SIADH) - Activation of mania - Seizures - Angle-closure glaucoma - QTc prolongation ## Contraindications - MAO inhibitors, including linezolid and intravenous methylene blue, or within 14 days of stopping an MAOI - Pimozide - Known hypersensitivity to sertraline ## Key interactions **MAO inhibitors, triptans, tramadol, fentanyl, lithium, St John's wort** Serotonin syndrome **NSAIDs, aspirin, warfarin** Higher bleeding risk **Pimozide** Higher pimozide levels and QT prolongation **Urine screening tests for benzodiazepines** False-positive results ## What is monitored - Mood and suicidal thoughts, especially early and after dose changes - Signs of mania - Sodium in older adults - Bleeding when combined with antithrombotic drugs ## Administration and safety - Given by mouth, with or without food - Stopped gradually rather than abruptly to avoid a discontinuation syndrome - A false-positive benzodiazepine urine screen is possible; confirmatory testing clarifies it ## Nursing care - Assess suicide risk at baseline and during the first weeks; teach families the warning signs - Explain that improvement takes weeks and that early nausea or sleep changes often settle - Teach that abrupt stopping can cause dizziness, «electric-shock» sensations, irritability and insomnia - Watch for bleeding with NSAIDs or anticoagulants, and for confusion from low sodium in older adults ## Pregnancy and breastfeeding Studies of first-trimester use do not show a clear rise in major malformations; exposure late in pregnancy is linked to neonatal adaptation problems, persistent pulmonary hypertension and postpartum haemorrhage. ## Memory aid Sertraline is the «broad-label» SSRI: depression, OCD, panic, PTSD, social anxiety and PMDD. ## Test yourself Think of the answer, then tap the question to see it. ## Which SSRI has approved indications that include PTSD, OCD, panic disorder and premenstrual dysphoric disorder? Sertraline. ## A patient on sertraline has a positive urine screen for benzodiazepines without taking any. What explains it? Sertraline can cause false-positive benzodiazepine screening results; a confirmatory test (such as chromatography with mass spectrometry) distinguishes them. ## What symptoms suggest a discontinuation syndrome after stopping sertraline abruptly? Dizziness, nausea, sweating, irritability, anxiety, insomnia and sensory disturbances such as electric-shock sensations. Gradual tapering reduces the risk. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/sertraline/) ## Related drugs - [Fluoxetine](https://durgical.com/en/pharmacology/fluoxetine/) - [Escitalopram](https://durgical.com/en/pharmacology/escitalopram/) [← Back to the class: Selective serotonin reuptake inhibitors (SSRIs)](https://durgical.com/en/pharmacology/classes/selective-serotonin-reuptake-inhibitors/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [DailyMed - SERTRALINE HYDROCHLORIDE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cf71d1b9-5ebb-429f-a07f-a87cd168250f) (DailyMed (U.S. National Library of Medicine), 2026); [Sertraline: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a697048.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [6AWO: X-ray structure of the ts3 human serotonin transporter complexed with sertraline at the central site](https://www.rcsb.org/structure/6AWO) (RCSB Protein Data Bank, 2017). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/sertraline/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sertraline/