Sertraline

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Sertraline (brand name Zoloft) — Antidepressant, antianxiety; Selective serotonin reuptake inhibitor (SSRI).

Identification

• Therapeutic class: Antidepressant, antianxiety.
• Pharmacologic class: Selective serotonin reuptake inhibitor (SSRI).

Pharmacology

• Mechanism of action: Blocks serotonin reuptake to increase synaptic serotonin.
• Onset / peak / duration: Mood effect over 2 to 4 weeks (up to 6 to 8 for full effect).
• Half-life / therapeutic level: Half-life about 26 hours; level not routine.

Clinical use

• Indications: Depression, anxiety disorders, OCD, PTSD, panic, premenstrual dysphoric disorder.
• Usual dose, route, frequency: 25 to 200 mg PO once daily; oral concentrate available.
• Maximum dose / adjustments: Max 200 mg/day; reduce in hepatic impairment; taper to stop.

Safety

• Contraindications: MAO inhibitor within 14 days, pimozide.
• Black box warning: Increased risk of suicidal thoughts and behavior in children, adolescents, and young adults under 25.
• Interactions: MAO inhibitors and serotonergic drugs (serotonin syndrome), NSAIDs and anticoagulants (bleeding), triptans, St. John's wort (herbal).
• Pregnancy / lactation: Often continued when benefits outweigh risks; SSRIs relatively favored.
• High-alert: No.

Adverse effects

• Common side effects: Nausea, headache, insomnia or somnolence, sexual dysfunction, diarrhea.
• Serious effects to report: Suicidal thoughts, serotonin syndrome, hyponatremia (SIADH), increased bleeding.
• Antidote / reversal: Supportive care; cyproheptadine sometimes used for serotonin syndrome.

Nursing process

• Assessment before administration: Mood and suicide risk, current serotonergic drugs, sodium baseline.
• Interventions during therapy: Monitor mood closely early in therapy and after dose changes; taper to stop.
• Monitor: Mood, suicidality, sodium, bleeding signs.
• Evaluation / expected outcome: Improved mood and anxiety.

Patient teaching

• Patient teaching: Full effect takes weeks; do not stop abruptly; report worsening mood.
• Notify provider if: Suicidal thoughts, agitation with fever and rapid heartbeat, unusual bleeding.
• Administration tips: Same time daily; with food if GI upset.