Sertraline HCL (hydrochloride) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used for depression or anxiety disorders. Though this drug can be useful, there are important warnings about its safety. In addition, certain health conditions or other medications contraindicate sertraline HCL or necessitate dosage changes. The medicine can also have benign to severe adverse effects.
SSRIs treat anxiety and depression by reducing the body’s ability to use serotonin too quickly. Increased amounts of this neurotransmitter can elevate mood or promote calm. In particular, sertraline HCL is beneficial for major depression, dysthymic disorder, and post-traumatic stress disorder (PTSD). Alternately, it could be prescribed for panic disorder, generalized anxiety, social phobia or obsessive-compulsive disorder (OCD). This medication doesn’t always work for these conditions, and another treatment may be more appropriate for some patients.
Though many people use sertraline HCL with few problems, warnings about the drug’s use apply. The most serious side effect is that it can cause a higher risk for suicide, especially in teens and young adults. Individuals taking this medication should be carefully watched by friends or relatives and need to be under the care of a qualified mental health professional. Another warning is that sertraline may foster dependence and some people abruptly discontinuing it experience a form of withdrawal. Patients need to taper off the medicine to avoid this effect.
Additionally, sertraline HCL is usually not appropriate for use by people with bipolar disorder, as it may precipitate manic events. Anyone with a previous history of suicidality may be more susceptible to becoming suicidal again while taking the drug. Moreover, sertraline is never advised for pregnant women due to the likelihood of severe birth defects. Further, any history of epilepsy or kidney or liver disease might be a contraindication or necessitate dosage changes.
Drugs that negatively interact with sertraline HCL include almost all other antidepressants. The medication may also increase the effects of non-steroidal anti-inflammatory drugs (NSAIDs) and cause easier bleeding and bruising. Additional reactions occur with lithium, digoxin, warfarin, and valproic acid. To avoid these and other interactions, patients should tell doctors about all medications, supplements or herbal formulations they use.
A well known adverse reaction of most SSRIs is that they often have negative impacts on sexual desire or performance. Sertraline HCL is especially associated with reduced interest in sex, difficulty achieving orgasm or erectile dysfunction. While this is not medically urgent, patients are encouraged to discuss these symptoms with a physician. Sexual side effects may interfere with relationships or result in poor compliance with drug therapy.
Patients should report other “mild” side effects if they are bothersome. These might include weight changes, insomnia, and stomach difficulties like diarrhea or constipation. Alternately some people develop dizziness, drowsiness or chronic dry mouth with sertraline HCL.
Serious side effects require immediate medical attention. Patients should get help right away for suicidal thinking, changes in behavior like sudden rage, or development of mania. Severe allergy, extreme nausea or diarrhea, or the development of a constellation of symptoms like fast heart rate, high fever, and stiff muscles are also deeply concerning. Any evidence of confusion, hallucinations or memory loss is also considered dangerous and needs emergency treatment.