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(ser' tra leen)A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants ('mood elevators') such as sertraline during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. You should know that your mental health may change in unexpected ways when you take sertraline or other antidepressants even if you are an adult over 24 years of age. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; new or worsening anxiety; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own. Your healthcare provider will want to see you often while you are taking sertraline, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor. No matter what your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. This risk is higher if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.
Before taking sertraline,
- tell your doctor and pharmacist if you are allergic to sertraline, any other medications, or any of the ingredients in sertraline preparations. Before taking sertraline liquid concentrate, tell your doctor if you are allergic to latex. Ask your pharmacist for a list of the ingredients.
- tell your doctor if you are taking monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks, or if you are taking pimozide (Orap). Your doctor will probably tell you not to take sertraline. If you stop taking sertraline, you should wait at least 2 weeks before you start to take an MAO inhibitor.
- do not take disulfiram (Antabuse) while taking sertraline oral concentrate.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphetamines; anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven) and heparin; aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); atomoxetine (Straterra); buspirone, clopidogrel (Plavix), dextromethorphan (found in many cough medications; in Nuedexta); diazepam (Valium), fentanyl (Actiq, Duragesic, Fentora), fosphenytoin (Cerebyx), lithium ( Lithobid); medications for anxiety, mental illness, Parkinson's disease, and seizures; medications for irregular heartbeat such as flecainide (Tambocor) and propafenone (Rythmol); metoprolol (Lopressor, Toprol XL); medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig); nebivolol (Bystolic, in Byvalson); perphenazine; phenytoin (Dilantin, Phenytek); sedatives; sibutramine (Meridia); sleeping pills; other selective serotonin-reuptake inhibitors such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra), or fluvoxamine (Luvox); serotonin–norepinephrine reuptake inhibitors (SNRI) medications desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine; thoridazine, tolterodine (Detrol), tramadol (Conzip, Ultram), tranquilizers, or tricyclic antidepressants ('mood elevators') such as desipramine (Norpramin) or protriptyline (Vivactil). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor what herbal products and nutritional supplements you are taking, especially St. John's wort and tryptophan.
- tell your doctor if you have recently had a heart attack or if you have a low level of sodium in your blood and if you have or have ever had seizures or liver or heart disease.
- tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, or if you plan to become pregnant or are breastfeeding. If you become pregnant while taking sertraline, call your doctor. Sertraline may cause problems in newborns following delivery if it is taken during the last months of pregnancy.
- you should know that sertraline may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- ask your doctor about the safe use of alcoholic beverages while you are taking sertraline.
- you should know that sertraline may cause angle-closure glaucoma (a condition where the fluid is suddenly blocked and unable to flow out of the eye causing a quick, severe increase in eye pressure which may lead to a loss of vision). Talk to your doctor about having an eye examination before you start taking this medication. If you have nausea, eye pain, changes in vision, such as seeing colored rings around lights, and swelling or redness in or around the eye, call your doctor or get emergency medical treatment right away.
- difficulty falling asleep or staying asleep
- dry mouth
- loss of appetite
- weight changes
- excessive tiredness
- uncontrollable shaking of a part of the body
- changes in sex drive or ability
- excessive sweating
- abnormal bleeding or bruising
- agitation, hallucinations, fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- difficulty breathing
The content on this page is for informational and educational purposes only and does not constitute professional medical advice. Patients should not use the information presented on this page for diagnosing a health-related issue or disease. Before taking any medication or supplements, patients should always consult a physician or qualified healthcare professional for medical advice or information about whether a drug is safe, appropriate or effective.