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SSRI Antidepressant

Sertraline (Elderly)

Brand names: Lustral, Zoloft

Used in: Depression & Anxiety

Sertraline is a selective serotonin reuptake inhibitor (SSRI) used for depression and anxiety disorders; it is a commonly preferred SSRI in older or medically complex patients.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

DOSAGE AND ADMINISTRATION Initial Treatment Dosage for Adults Major Depressive Disorder –Sertraline hydrochloride treatment should be administered at a dose of 50 mg once daily. While a relationship between dose and effect has not been established for major depressive disorder, OCD, panic disorder, PTSD or social anxiety disorder, patients were dosed in a range of 50-200 mg/day in the clinical trials demonstrating the effectiveness of Sertraline hydrochloride for the treatment of this indication. Consequently, a dose of 50 mg, administered once daily, is recommended as the initial therapeutic dose. Patients not responding to a 50 mg dose may benefit from dose increases up to a maximum of …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2019-11-01. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

Sertraline selectively inhibits the reuptake of serotonin (5-HT) at the presynaptic neuron, increasing synaptic serotonin over several weeks.

Prescribing in practice

  • Start low and review early; therapeutic benefit typically takes 2–4 weeks, and initiation can transiently worsen anxiety.
  • In older patients watch for hyponatraemia (SIADH) and an increased bleeding risk, especially with NSAIDs or antithrombotics; consider gastroprotection.
  • Taper when stopping to limit discontinuation symptoms; be alert to serotonin syndrome when combined with other serotonergic drugs.

Monitoring

Review mood, anxiety and suicidal ideation early after starting and at dose changes; check sodium if features of hyponatraemia develop in older patients.

Counselling the patient

  • It can take a few weeks to work, and anxiety may briefly increase at first.
  • Do not stop suddenly — withdrawal effects can occur.
  • Report worsening mood or thoughts of self-harm, and unusual bleeding.

Evidence & guidelines

SSRIs are first-line drug treatment for moderate-to-severe depression and many anxiety disorders (NICE NG222/related guidance), with safety advantages in older patients.

Reference: NICE NG222; PROSPECT trial; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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