For elderly depression, what should we pay attention to when using sertraline?

A friend told Huazi that after his father suffered a stroke, his limbs became inflexible, he sighed every day, and his mental state was very bad. He went to see a doctor, who said he had depression and asked him to take a drug called sertraline. Is there anything he should pay attention to?

Huazi said that many elderly people who suffer from chronic diseases such as coronary heart disease and stroke believe that they are incurable "terminal illnesses", which makes them prone to pessimism, despair, and even depression. Sertraline is a commonly used drug for treating elderly depression.

1. What is the effect of sertraline

Depression is a mental illness, but when it strikes, the body will also experience related physiological changes. The main manifestation is a decrease in the secretion of the neurotransmitter 5-hydroxytryptamine (5-HT) in the central nervous system, which reduces nerve excitability.

Sertraline is a selective serotonin reuptake inhibitor (SSRI) that increases the level of serotonin in the synaptic cleft and increases nerve excitability.

Sertraline can improve the symptoms related to depression, and also has an improving effect on symptoms such as obsessive-compulsive disorder, anxiety disorder, panic attacks, and menstrual irritability in women.

2. How much sertraline should be taken and how long should it be taken

The recommended dose of sertraline starts at 50 mg per day. If the dose needs to be increased, the interval for adjusting the dose should not be shorter than 1 week, and the dose should be increased by 50 mg each time , with a maximum dose of 200 mg per day.

Usually the effect of the medication can be seen after one week of taking it, but it takes 2 to 4 weeks to achieve the best effect . For the treatment of obsessive-compulsive disorder, it may take longer to take the medication.

The treatment of depression usually needs to last for more than 6 months. When taking sertraline for a long time, the dosage should be adjusted according to the efficacy and maintained at the lowest effective therapeutic dose. The maintenance dose is between 25mg and 200mg per day.

3. What should you pay attention to when taking sertraline?

When using sertraline, a few people may experience adverse reactions to the digestive tract, such as dry mouth, nausea, diarrhea, and constipation. These reactions are usually mild and can be tolerated without affecting medication. Adverse reactions to the central nervous system include headache, drowsiness, and insomnia. People who experience drowsiness can take the medicine before bedtime; people who experience insomnia can take the medicine in the early morning to reduce the effects.

Common adverse reactions usually ease and disappear after 1 to 2 weeks of medication .

A very small number of male patients may experience adverse reactions such as ejaculation disorders (delay) after taking the drug , but it has a certain improvement effect on patients with premature ejaculation. There are also some uncommon adverse reactions, such as hyponatremia in the elderly who strictly limit salt in their diet; increased bleeding tendency; and increased intraocular pressure (use with caution in glaucoma).

If an allergic reaction occurs, the drug should be discontinued; if epileptic symptoms occur during treatment, the drug should be stopped immediately; for patients with liver dysfunction, the dosage needs to be reduced.

4. Sertraline is not effective for everyone

The causes of depression are complex, and different people have different sensitivities to drugs. The therapeutic effectiveness of sertraline is about 70%, but some patients may not respond to it . Long-term use of the drug may also lead to drug resistance, leading to treatment failure.

When taking medication, you must follow the doctor's instructions and take the medication in sufficient doses and for a sufficient course of treatment. If the doctor confirms that the depressive symptoms have not improved after taking the medication, you can switch to other types of antidepressants under the doctor's guidance .

After a sufficient course of sertraline treatment, the dosage should be gradually reduced and the drug should be discontinued. If the drug is discontinued suddenly, withdrawal reactions may occur or the disease may relapse. It usually takes several weeks or months to discontinue the drug.

In summary, sertraline, which is used to treat depression, has been used clinically for a long time and has relatively few adverse reactions, so it is often used to treat depression in the elderly. When taking medication, pay attention to the slow increase and decrease of the drug dosage to maintain adequate dosage and sufficient course of treatment. If you find problems when taking medication, you should communicate more with your doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.