In elderly patients there is no need for a special selection of doses.
Patients with impaired hepatic function require special attention in the treatment of sertraline. In severe liver function disorder the dose should be reduced dose or increase the interval between receptions. In patients with impaired renal function deca durabolindeca durabolin specially select a dose is not required (see. “Special Instructions”).
Dry mouth, increased sweating, drowsiness, headache, dizziness, tremors, insomnia, anxiety, agitation, hypomania, mania, decreased appetite (rarely – increased) up to anorexia, dyspepsia (bloating, nausea, vomiting, diarrhea), abdominal pain, weight loss, gait disturbance.
It is also possible weakness, redness, blurred vision, ejaculation disorder, decreased libido.
During sertraline treatment were marked extrapyramidal disorder, dyskinesia, tremor, cramps, menstrual disorders, hyperprolactinemia, galactorrhea, skin rash, occasionally erythema multiforme. Movement disorders were more common in patients with indications of their presence in the history or concomitant use of antipsychotics.
When stopping treatment with sertraline described rare cases of withdrawal. May appear paresthesia, gipostezii, depressive symptoms, hallucinations, aggressive reaction, agitation, anxiety or psychotic symptoms that are indistinguishable from symptoms of the underlying disease.
Laboratory tests Data: rarely – in 0.8% of cases, with prolonged use – there is asymptomatic increase transaminase activity in serum. Cancel the drug in this case leads to the normalization of the activity of enzymes.
During treatment with sertraline may occur transient hyponatremia. It occurs more frequently in elderly patients, as well as when taking diuretics or several deca durabolindeca durabolin other drugs. This side effect associated with the syndrome of inappropriate secretion of antidiuretic hormone.
Severe symptoms of an overdose of sertraline is not revealed even in the appointment of the drug in high doses. However, simultaneous administration with other drugs or ethanol may occur severe poisoning.
Overdose can cause serotonin syndrome with nausea, vomiting, somnolence, tachycardia, agitation, dizziness, agitation, diarrhea, sweating, myoclonus and hyperreflexia.
Treatment: No specific antidote. It requires intensive supportive care and constant monitoring of vital body functions. Induce vomiting is not recommended. Introduction of the activated carbon can be more effective than gastric lavage. It is necessary to maintain airway patency. At the large volume of distribution of sertraline, in this regard, increased diuresis, dialysis, hemoperfusion or blood transfusion may be inconclusive.
Interaction with other drugs
Monoamine oxidase inhibitors (MAOIs). There have been severe complications, while the use of sertraline and MAOIs (including selective effect (selegiline) and reversible type of action (moclobemide). The development of serotonin syndrome is possible. Similar complications, sometimes fatal, occur in the appointment of MAOIs on . treatment with antidepressants, depressing neuronal uptake of monoamines or immediately after their withdrawal With simultaneous use of selective inhibitors of reverse neuronal uptake of serotonin and MAOIs arise: hyperthermia, rigidity, myoclonus, lability of the autonomic nervous system (rapid fluctuations in the parameters of the respiratory and cardiovascular system), change mental status, including increased irritability, marked agitation, confusion, which in some cases can go into delirious state or coma. Medications that suppress the central nervous system, and ethanol.
The combined deca durabolindeca durabolin use of sertraline and substances which depress the central nervous system requires close attention, and prohibited the use of alcoholic beverages during treatment with sertraline. The derivatives of coumarin – when coadministered with sertraline showed a significant increase in prothrombin time – in these cases it is recommended to monitor the prothrombin time at the beginning of treatment with sertraline and after its cancellation.