Seralyn

Seralin is an antidepressant from the SSRI drug category.

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Indications Seralina

The drug should be used for depression, as well as for anxiety and the presence/absence of mentions of mania in the patient's personal history. The drug can also be prescribed for maintenance treatment after improvements in the patient's condition (to prevent a relapse of the initial depressive episode).

It is also possible to use capsules in therapy for people with OCD. After receiving the initial drug effect, long-term (up to 2 years) maintenance therapy using Seralin can be carried out (most patients tolerate this treatment without complications).

The capsules can also be used in the treatment of people with panic disorders (with or without agoraphobia), as well as with PTSD.

Release form

The substance is released in capsules, in the amount of 7 pieces inside a blister pack. The box contains 2 such packages.

Pharmacodynamics

The drug contains sertraline, an active ingredient that significantly slows down the processes of serotonin reuptake within synapses. In vitro tests showed that this component significantly weakened the reuptake of 5-hydroxytryptamine within neurons.

The drug has some effect on the reuptake of other mediators, including norepinephrine and dopamine. In therapeutic doses, it blocks the processes of serotonin uptake inside platelets.

Seralin does not have a cardiotoxic, sedative or anticholinergic effect, and in addition, it does not stimulate the activity of the central nervous system and does not cause changes in psychomotor activity.

Selective blockade of 5-HT reuptake ensures the absence of potentiation of catecholaminergic effects. The drug has no direct effect on muscarinic, benzodiazepine, GABA, dopamine and histamine endings, as well as adrenergic receptors. Tests have shown that long-term use of Seralin led to some weakening of the activity of noradrenalinergic brain endings, and along with this to a decrease in mental and motor reactions.

The drug differs from tricyclics in that it does not cause weight changes in people with obsessive-compulsive and depressive disorders.

No physical or mental addiction to the drug was observed during treatment.

Pharmacokinetics

The pharmacokinetic parameters of sertraline in the range of 0.05-0.2 g portions are determined by the dosage size. The Cmax values of sertraline after oral administration of a 0.05-0.2 g portion (once per day for 14 days) are noted after 4.5-8.6 hours. The average half-life is 22-36 hours and varies depending on the patient's age. Taking into account the half-life, approximately 2-fold accumulation of the drug can be observed; equilibrium values are observed after 7 days from the beginning of use (once per day).

About 99% of the active ingredient is synthesized with plasma protein.

After the first hepatic passage, active metabolism of the drug is observed. The degree of activity of the main metabolic product (N-desmethylsertraline) is approximately 20% lower compared to sertraline in the unchanged state (in vitro tests). It should be noted that during in vivo tests, N-desmethylsertraline demonstrated almost no activity in models of depressive state.

The half-life of the major metabolic product is in the range of 62–104 hours. Sertraline is subsequently metabolized within the body to N-desmethylsertraline; its derivatives are excreted in equal proportions via the intestine and kidneys. Unchanged sertraline is weakly excreted via the urethra (maximum 0.2% of the dose used).

Dosing and administration

The capsules should be taken orally, without reference to food intake. The daily dosage is often taken in 1 dose (in the morning or in the evening). The portion sizes and duration of treatment should be determined by a physician, taking into account the tolerance of the drug and the nature of the pathology.

People with episodes of depression, as well as OCD, are often prescribed 50 mg of the drug per day. After 7 days from the start of treatment, the dosage can be increased to 0.1 g per day (if good tolerance of the drug and a weak therapeutic effect are noted).

For PTSD and panic disorders, treatment should begin with 25 mg of the drug per day (1 capsule of 50 mg is taken once with 48-hour intervals). If necessary, the dose can be increased after 7 days from the start of therapy.

Some people may need to take up to 0.2 g of sertraline per day. The dose should be increased gradually, with a 7-day interval and a single increase of no more than 50 mg.

The drug effect often develops after 7 days, reaching its maximum level by the 2nd-4th week of treatment. To obtain the final effect, a long treatment cycle is often required. Stopping the use of drugs without a doctor's recommendation is not recommended (due to the risk of relapse).

Serving sizes of medicines for children aged 6-12 years, as well as adolescents over 12 years of age.

In the treatment of OCD and depressive states in adolescents aged 12 years and older, Seralin is often used in doses intended for adults.

For depressive states, children aged 6-12 years should take the drug in a dose of 25 mg per day (1 capsule of 50 mg is taken 1 time every 48 hours).

People with disorders of renal filtration processes.

This group of patients should be prescribed the drug with great caution. It is possible that in such a case it will be necessary to change the mode of use (extend the interval between uses) or reduce single doses.

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Use Seralina during pregnancy

Seralin is prohibited for use in pregnant women.

If the use of the medication is required during lactation, it is necessary to first stop breastfeeding (for the duration of therapy).

If the drug is used in women of reproductive age, it is necessary to select reliable contraceptives. It is not recommended to plan pregnancy while being treated with Seralin.

Contraindications

Main contraindications:

• the presence of hypersensitivity to sertraline, as well as additional components of the drug;
• use with concomitant administration of MAOIs;
• the presence of severe changes in the functioning of the urinary system and liver in the patient;
• convulsive states (epilepsy of an unstable nature).

Side effects Seralina

In placebo-controlled trials, nausea, drowsiness, bowel disorders, dyspepsia, tremor, dizziness, insomnia, sleep disorders, hyperhidrosis, sexual dysfunction (including delayed ejaculation), and dry mouth were commonly reported during sertraline use.

In addition, the use of Seralin may lead to asymptomatic increase in the activity of ALT/AST elements. Changes in liver transaminase activity were often noted in the 1st to 9th week of treatment. The indicators stabilized on their own after correction of single doses or drug withdrawal.

There are isolated reports of hyponatremia developing after the use of the drug (this effect is treatable; after discontinuing the drug, sodium levels return to normal). Most likely, hyponatremia when using Seralin develops due to inadequate secretion of antidiuretic hormone. The risk of hyponatremia is higher in people over 65 years of age, as well as in people using drugs that affect renal function.

People with severe sensitivity may develop manifestations of allergic origin.

Occasionally, use of the drug causes hyperthermia and movement disorders.

There are also reports of worsening of performance in people with hypomania or mania caused by taking the drug.

There are no significant differences in the profile of adverse effects of the drug in individuals with obsessive-compulsive and depressive disorders.

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Overdose

The drug has a fairly wide safety margin. However, there are reports of fatal cases due to sertraline poisoning - during complex treatment or in combination with alcoholic beverages.

The drug has no antidote. In case of overdose, gastric lavage is required, and then sorbents are prescribed. In case of poisoning with the drug, it is also necessary to monitor the functioning of vital body systems.

In addition, it is necessary to ensure free air flow and adequate pulmonary ventilation (if necessary, artificial respiration can be performed). Along with this, supportive procedures and medications are prescribed to reduce the severity of signs of poisoning.

In case of sertraline intoxication, dialysis procedures will be ineffective.

Interactions with other drugs

Substitution of treatment with various SSRIs for therapy with sertraline should be done with great caution. In addition, the transition to Sertraline from antidepressants or anti-obsessional drugs (especially if these drugs have a long half-life, such as fluoxetine) should be done with great caution.

The drug should not be combined with MAOIs (as this may lead to the development of extrapyramidal disorders), and should not be taken for 2 weeks after the last dose of MAOIs was taken.

The drug should be combined with caution with oral hypoglycemic drugs (sulfonylurea derivatives), because sertraline may affect serum glucose levels. It may also be necessary to change the dosage of antidiabetic drugs (especially at the initial stage of sertraline use or when it is discontinued).

When the drug is combined with tricyclics and tranquilizers, the pharmacokinetic parameters of these agents may change.

Combination with substances that block the activity of histamine H1 and H2 endings leads to a decrease in the clearance rates of Seralin.

It is necessary to combine the drug with digoxin very carefully.

The drug should be used with extreme caution in people who are being treated with drugs whose effects may develop indirectly (through serotonergic mechanisms, such as lithium).

You should not drink alcoholic beverages during treatment.

The use of the drug is prohibited for people receiving electroshock therapy.

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Storage conditions

Seralin must be kept in a place out of the reach of small children.

Shelf life

Seralin can be used within 24 months from the date of release of the therapeutic agent.

Application for children

It is prohibited to prescribe the medication in pediatrics - to children under 6 years of age.

Analogues

The analogs of the drug are Zoloft, Fluanksol, Velafaks, Torin, Truxal with Stimuloton, and in addition to this, Simbalta, Serlift, Lerivon, Serenata, Risperidone and Pulsatilla compositum with Cipramil. In addition, the list includes Melipramine, Noben, Ignatia-homaccord, Velaxin, Adepress, Tazepam, Lamotrigine, Plizil and Ludiomil with Velafaks MV.