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Sertraline should be administered once daily, either in the morning or evening. Sertraline can be administered with or without food.
Initial Treatment: Depression and OCD: 50 mg/day.
Panic Disorder and PTSD: Therapy should be initiated at 25 mg/day. After 1 week, the dose should be increased to 50 mg once daily. This dosage regimen has been shown to reduce the frequency of early treatment emergent side effects characteristic of panic disorder.
Titration: Depression, OCD, Panic Disorder and PTSD: Patients not responding to a 50-mg dose may benefit from dose increases. Dose changes should be made at intervals of at least 1 week, up to a maximum of 200 mg/day. Changes in dose should not be made more frequently than once per week given the 24-hr elimination half-life of sertraline.
The onset of therapeutic effect may be seen within 7 days. However, longer periods are usually necessary to demonstrate therapeutic response, especially in OCD.
Maintenance: Dosage during long-term therapy should be kept at the lowest effective level, with subsequent adjustment depending on therapeutic response.
Elderly: The same dose range as in younger patients may be used in the elderly. Over 700 elderly patients (>65 years) have participated in clinical studies which demonstrated the efficacy of sertraline in this patient population. The pattern and incidence of adverse reactions in the elderly was similar to that in younger patients.
Hepatic Insufficiency: The use of sertraline in patients with hepatic disease should be approached with caution. A lower or less frequent dose should be used (see Precautions).
Renal Insufficiency: Sertraline is extensively metabolized. Excretion of unchanged drug in urine is a minor route of elimination. As expected from the low renal excretion of sertraline, sertraline dosing does not have to be adjusted based on the degree of renal impairment (see Precautions).
