Last Updated on March 16, 2024

Sertraline hydrochloride is a commonly prescribed medication used to treat depression, anxiety, panic attacks, and obsessive-compulsive disorder. It works by increasing the amount of serotonin in the brain, which helps improve mood and reduce anxiety. While it is available on prescription in the UK, many people wonder if it is possible to purchase sertraline hydrochloride over the counter.

Unfortunately, sertraline hydrochloride is not available over the counter in the UK. It is a prescription-only medication, which means that it can only be obtained with a valid prescription from a healthcare professional. This is because sertraline hydrochloride can have serious side effects if not taken correctly or if taken unnecessarily. It is important to consult with a doctor or psychiatrist before starting or stopping any medication.

If you are struggling with depression, anxiety, or other mental health problems, it is strongly recommended that you speak with a healthcare professional. They can provide a thorough evaluation of your symptoms and recommend appropriate treatment options, which may include sertraline hydrochloride or another medication. While it may be tempting to try to purchase medications over the counter, it is important to prioritize your safety and wellbeing by seeking expert medical advice.

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Sertraline hydrochloride belongs to a class of antidepressant agents called selective serotonin-reuptake inhibitors (SSRIs). Despite structural differences between substances in this class, SSRIs have activity that is similar. Prior to there is a effect observed as with antidepressant agents weeks of treatment may be required. SSRIs are potent inhibitors of neuronal serotonin reuptake. They have little to no effect on norepinephrine or dopamine reuptake and don’t antagonize α- or β-adrenergic, dopamine D2 or histamine H1 receptors. During use, SSRIs block boost serotonin stimulation and reuptake of terminal autoreceptors and somatodendritic 5-HT1A. Chronic use results in desensitization of and terminal autoreceptors. Mood and anxiety’s clinical impact is considered to be due to adaptive changes. Side effects include dry mouth, nausea, dizziness, drowsiness, sexual dysfunction and headache (see Toxicity section below for a more comprehensive list of side effects). In comparison to other agents in this class, sertraline can cause sexual dysfunction effects and diarrheal. Side effects are usually frequent and less severe and occur within the first two weeks of treatment than those detected with antidepressants. Sertraline may be used in the treatment of major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic anxiety disorder (PTSD), premenstrual dysphoric disorder (PMDD) and social anxiety disorder (social phobia).

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Whats is sertraline?

Sertraline is one of the main drugs used to treat depressive disorders. Depression is a serious mental illness that should not be confused with the temporary internal upset or grief that is the appropriate response to certain external events (such as loss or the death of a loved one). The active ingredient sertraline helps patients by acting as a mood elevator, activator and anxiolytic. Here you can read all about how sertraline works, how it is used, side effects and warnings.

How does this medicine work? What can it do for me?

Sertraline is in a class of drugs called selective serotonin reuptake inhibitors (SSRIs). It’s used to treat depression, anxiety and obsessive-compulsive disorder (OCD). Sertraline works by affecting the balance of chemicals in the brain. Specifically, it increases levels of a neurotransmitter in the brain called serotonin. Increased levels of serotonin can help reduce anxiety attacks, improve mood and cure OCD.

Although improvements may happen sooner, they may not appear until after 4 months of treatment or more.

This medicine may be available under many other brand names and/or in non-prescription forms. A particular brand name of this medicine may not be available in all forms, or accepted for all conditions discussed here. Some types of this medication may not be used for all conditions.

Your doctor may have recommended this medication for conditions other than those listed in this medication information. If you haven’t discussed this with your doctor or are not sure why you are taking this medicine, talk to your doctor. Don’t stop taking this medicine without telling your doctor.

Don’t give this medicine to anyone else, even if they have the same symptoms as you. It may be harmful for people to take this medicine if it has not been prescribed by their doctor.

Action

In the brain and spinal cord (central nervous system), the interplay of different messengers (neurotransmitters) ensures that you can respond appropriately to certain situations (such as happiness, excitement, etc.). The different messengers (such as serotonin and norepinephrine) are distributed according to the needs of the nerve cells and are later collected and stored.

This neurotransmitter balance is often disturbed in people who suffer from a depressive disorder. Symptoms such as depression, insomnia and anxiety can make it difficult for people to take an active part in normal daily life.

Sertraline belongs to the group of selective serotonin reuptake inhibitors (SSRIs): It inhibits the reuptake of serotonin into its storage cells. This increases the amount of free and active serotonin between brain cells, which has a mood-enhancing, activating and anxiolytic effect.

Absorption, degradation and elimination

The antidepressant is almost completely absorbed from the intestine and then metabolized by the liver. The effect usually occurs after an application period of a week, but it may take up to one month, until the Sertraline effect unfolds completely.

What conditions does sertraline HCL treat?

Sertraline is well suited for long-term therapy. These are some of the areas (indications) where sertraline is used:

• depressive disorders
• Forced Syndrome
• panic attacks
• Anxiety Disorders
• bulimia disease (bulimia)

In what forms is this medicine available?

25 mg capsule

Each hard gelatine capsule, yellow opaque body marked “SL 25” and black opaque cap with logo printed in black, contains 25 mg of sertraline. Non-medical ingredients: anhydrous dibasic calcium phosphate, magnesium stearate, microcrystalline cellulose and sodium starch glycolate; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, and titanium oxide. This product does not contain tartrazine.

50 mg per capsule

Each hard gelatine capsule, white opaque body with “SL 50” printed in yellow and black opaque cap with logo printed in black, contains 50 mg of sertraline. Non medicinal ingredients: anhydrous dibasic calcium phosphate, magnesium stearate, microcrystalline cellulose and sodium starch glycolate; capsule shell: D&C Yellow No. 10, FD&C Yellow No. 6, gelatin, and titanium oxide. This product does not contain tartrazine.

100 mg per capsule

Each hard gelatine capsule, orange opaque body, printed with “SL 100”, dark printed logo in opaque cap, contains 100 mg of sertraline. Non medicinal ingredients: Anhydrous dibasic calcium phosphate, magnesium stearate, microcrystalline cellulose and sodium starch glycolate; capsule shell: D&C Yellow No. 10, FD&C Red No. 40, gelatin, and titanium dioxide. This product does not contain tartrazine.

How should I take sertraline?

Take sertraline. Follow all directions on the prescription label. Your doctor may change your dose. Do not take this medicine in smaller or larger amounts or for longer than recommended.

Sertraline can be taken with or without food. Try to take this medicine by mouth.

The liquid (oral) form of sertraline must be diluted before you take it. To make sure you get the right dose, measure the liquid that comes with the medicine. Mix the dose with 4 ounces (half a cup) of water, ginger ale, lemon/lime soda, lemonade, or orange juice. Do not dilute the medicine with liquids. Stir and drink it all at once. To make sure you get the full dose, add a little more water, swirl, and drink immediately.

This medicine may cause you to need a drug screening test. Tell the laboratory staff that you’re taking sertraline if you give a urine sample for drug screening.

It can take up to 4 weeks before your symptoms get better. If your symptoms don’t improve, stop taking this medicine and tell your doctor or health care professional.

Do not stop using sertraline as it may cause unpleasant or sudden withdrawal symptoms. Ask your doctor how to stop using sertraline.

Store at room temperature away from heat and moisture.

Sertraline is taken as tablets or capsules once a day, in the morning or evening, with a full glass of water. The dose of sertraline is usually 50 milligrams a day. If necessary, the dose can be increased to 200 milligrams a day. If you want to stop taking sertraline, this – like any dose increase – must be done gradually over a period of several weeks.

At the start of treatment, sertraline is mainly effective in increasing drive, while the mood-lifting effect usually comes later. For this reason, people who have suicidal thoughts at the start of treatment may need to be given an additional tranquilliser. This can be stopped as soon as sertraline has had a sufficient mood-lifting effect.

Sertraline dosing information

Usual Adult Dose of Sertraline for Depression:

Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-Obsessive Compulsive Disorder and acute episodes of Major Depressive Disorder require several months or longer of sustained pharmacological therapy.

Usual Adult Dose of Sertraline for Obsessive Compulsive Disorder:

Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-Obsessive Compulsive Disorder and acute episodes of Major Depressive Disorder require several months or longer of sustained pharmacologic therapy.

Usual Adult Dose for Panic Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Usual Adult Dose of Sertraline for Post Traumatic Stress Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Usual Adult Dose for Social Anxiety Disorder:

Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.

Usual Adult Dose of Sertraline for Premenstrual Dysphoric Disorder:

Continuous regimen:
Initial dose: 50 mg orally once a day during the menstrual cycle
Maintenance dose: 50 to 150 mg orally once a day during the menstrual cycle

Cyclic regimen:
Initial dose: 50 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
Maintenance dose: 50 to 100 mg orally once a day

Comments:
-The dose may be increased in increments of 50 mg per menstrual cycle, increased at the onset of each new cycle; dosage adjustments may also include changes between regimens.
-If a 100 mg once daily dose has been established with the cyclic regimen, a titration step of 50 mg per day for three days should be used at the beginning of each dosing period (luteal phase of the menstrual cycle).
-The effectiveness of sertraline for longer than three months has not been systematically evaluated in controlled trials.

Usual Pediatric Dose for Obsessive Compulsive Disorder:

6 to 12 years:
Initial dose: 25 mg orally once a day
Maintenance dose: 25 to 200 mg orally once a day

13 to 17 years:
Initial dose: 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day

Comments:
-The dose may be increased at intervals of at least one week.
-The potential risks versus clinical need should be assessed prior to using this drug in children and adolescents.

Pharmacodynamic

Sertraline, an antidepressant similar to citalopram, fluoxetine and paroxetine, is a selective serotonin reuptake inhibitor (SSRI). As it doesn’t have major anticholinergic, antihistamine or adrenergic effects, sertraline has a metabolite and, unlike the SSRIs, has sedative, anticholinergic and tricyclic antidepressant effects.

What are the side effects of sertraline?

The most common side effects of sertraline are gastrointestinal problems. Sertraline may also cause weight gain or loss and other adverse effects.

Important information

Sertraline should not be used if you are being treated with methylene blue injection or if you are taking pimozide.

Do not use sertraline if you have taken an MAO inhibitor in the previous 14 days. A dangerous interaction may occur. MAO inhibitors include rasagiline, linezolid, phenelzine, isocarboxazid, selegiline and tranylcypromine.

Some people have suicidal thoughts while taking an antidepressant. Watch for any changes in your symptoms or mood. Report any new or worsening symptoms to your doctor or health care professional.

Report any new or worsening symptoms to your doctor or health care professional, such as changes in mood, behaviour, anxiety, panic attacks, trouble sleeping, or if you’re feeling impulsive, irritable, agitated, aggressive, restless, hyperactive (emotionally or physically), more miserable, or have thoughts about suicide or hurting yourself.

Don’t give this medicine to anyone under 18 without doctor’s advice. Sertraline is FDA-approved for use in children with obsessive-compulsive disorder (OCD). It is not approved for use in children with depression.

Contraindications

The active ingredient sertraline must not be taken at the same time as antidepressants from the group of monoamine oxidase inhibitors (MAOIs such as tranylcypromine, moclobemide or selegiline), as this may lead to a harmful increase in serotonin levels in the brain. Signs of such toxicity (serotonin syndrome) include restlessness, tremors, muscle rigidity, temperature rise and loss of consciousness.

Sertraline must not be taken in the presence of severe liver or kidney dysfunction, increased susceptibility to convulsions or acute intoxication with alcohol or drugs (tranquillisers, analgesics, psychotropics).

Interaction

Sertraline increases the concentration of tricyclic antidepressants, haloperidol (for psychosis), phenytoin and carbamazepine (for epilepsy), diazepam (for agitation and anxiety, epilepsy, etc.) and lithium salts (for manic-depressive disorders). If no alternative treatment is available, the dose should be adjusted by the treating physician.

Avoid alcohol during treatment with sertraline.

Pregnancy and lactation

It is one of the antidepressants of choice for pregnant and breastfeeding women. There is considerable experience of its use in these patient groups. Treatment with sertraline should be continued unchanged in patients with depression. Before the birth of a child, sertraline should be discontinued or the dose should be reduced, as this may help to prevent adjustment problems in the newborn. Treatment should be resumed immediately after delivery.

Parental

Children and adolescents suffering from depressive disorders should not be treated with sertraline. Studies show that treatment in this age group can lead to increased aggression, abnormal behaviour and suicidal thoughts.

When was sertraline introduced?

The history of sertraline dates back to the early 1970s, when Pfizer chemist Reinhard Sarges developed a novel collection of carcinogenic chemicals based on the structure of the neuroleptic chlorprothixene.

Further work on these compounds led to lometraline and then to tametraline, a norepinephrine and less potent dopamine reuptake inhibitor. Development of tametraline was soon abandoned because of undesirable stimulant effects observed in animals. A few years later, in 1977, the pharmacologist Kenneth Koe became interested in the tametraline collection after evaluating the structural features of a number of reuptake inhibitors. He asked Willard Welch, another Pfizer chemist, to synthesise some unexplored tametraline derivatives. Welch produced a series of potent norepinephrine and triple reuptake inhibitors, but to the scientists’ surprise, one of the generally inactive cis-analogues was a serotonin reuptake inhibitor. Welch then prepared stereoisomers of the compound, which were analysed in vivo by animal behaviourist Albert Weissman. The most potent and selective (+) isomer was taken for further development and eventually named sertraline. Weissman and Koe recalled that the group hadn’t set out to make an SSRI-type antidepressant – so their question wasn’t “very focused”, and the discovery of the sertraline molecule was also serendipitous. According to Welch, they were working in the mainstream at Pfizer and “did not have an official project team”. When Pfizer considered licensing a candidate, the team had to overcome initial reluctance to pursue development.

Sertraline was approved by the US Food and Drug Administration (FDA) in 1991 on the recommendation of the Psychopharmacological Drugs Advisory Committee; it had been available in the UK the previous year. The FDA committee reached a consensus that sertraline was effective and safe.

Sertraline has been approved for use from the age of 18; earlier this year, it was approved by the FDA for the treatment of OCD in children from the age of 6. In 2003, the UK’s Medicines and Healthcare products Regulatory Agency issued advice that SSRIs, with the exception of fluoxetine (Prozac), weren’t acceptable for treating depression in patients under 18. Sertraline can be used in the UK in children and adolescents to treat obsessive-compulsive disorder (OCD). In 2005, the FDA added a boxed warning about suicidal behaviour in children to all antidepressants, including sertraline. In 2007, the label was changed to include a warning about behaviour in adults aged 18 to 24.