舍曲林

用途

• Treatment of compulsive disorders
• Urine marking (spraying), aggression, anxiety-including anxiogenic house soiling, phobias, fears
• Treatment of behavioral diagnoses
• Treatment of fear, affective or dominance aggression
• Generalized anxiety disorder
• Treatment of compulsive disorder, anxiety
• Behavioral diagnoses
• Increase inhibitory control (e.g., play-related aggressive behaviour)
• Treatment of compulsive disorders
• Behavioral diagnoses
• Behavioral diagnoses
• Treatment of behavioral diagnoses
• Compulsive disorder, anxiety
• Behavioral diagnoses
• Generalized anxiety disorder
• Anxiety-related behaviours (including compulsive type behaviour such as acral lick)

給藥方式

可能的副作用

• Anorexia (common in dogs, usually transient)
• Lethargy or sedation
• Gastrointestinal effects (vomiting, diarrhea)
• Anxiety or irritability
• Insomnia or hyperactivity
• Panting (dogs)
• Changes in elimination patterns (cats)
• Paradoxical aggressive behavior in previously non-aggressive animals
• Lethargy
• Decreased appetite
• Vomiting
• Trembling
• Restlessness
• Gastrointestinal disturbance
• Paradoxical increase in anxiety
• Potential increase in aggression

注意事項與禁忌

• Known hypersensitivity to sertraline or other SSRIs
• Concurrent use of Monoamine Oxidase Inhibitors (MAOIs) such as selegiline or amitraz
• Concurrent use of cisapride
• History of seizures or epilepsy
• Concurrent use of MAOIs (e.g., selegiline)
• **Hepatic Impairment:** Use with caution in patients with severe hepatic disease; dosages may need to be decreased or the dosing interval increased due to extensive hepatic metabolism. **Geriatric Patients:** Use with caution; dose adjustments may be necessary. **Pregnancy:** FDA Category C in humans. Animal studies (rats/rabbits) showed delayed ossification and decreased pup survival. Use only if benefits outweigh risks. **Weaning:** Avoid abrupt discontinuation; taper the dose gradually over several weeks to prevent withdrawal signs.

藥物相互作用

• Buspirone: Increased risk for serotonin syndrome
• Cimetidine: May increase sertraline levels
• Cyproheptadine: May decrease or reverse the effects of SSRIs
• Diazepam: Sertraline may decrease diazepam clearance
• Isoniazid: Increased risk for serotonin syndrome
• MAO Inhibitors (e.g., amitraz, selegiline): High risk for serotonin syndrome; use contraindicated. A 5-week washout period is required after discontinuing sertraline before starting an MAOI, and a 2-week washout if discontinuing an MAOI before starting sertraline.
• Pentazocine: Serotonin syndrome-like adverse effects possible
• Tramadol: SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing the risk of toxicity (serotonin syndrome, seizures)
• Tricyclic Antidepressants (e.g., clomipramine, amitriptyline): Sertraline may increase TCA blood levels and increase the risk for serotonin syndrome
• Warfarin: Sertraline may increase the risk for bleeding
• Selegiline (MAOIs): High risk of fatal serotonin syndrome. Do not use sertraline within 2 weeks of an MAOI, and do not use an MAOI within 6 weeks of stopping sertraline.
• Anticonvulsants: Sertraline antagonizes the effects of anticonvulsants and lowers the seizure threshold.
• Phenothiazines: May lower the seizure threshold when used concurrently.
• Aspirin: Increased risk of bleeding in the case of tissue trauma.
• Anticoagulants: Increased risk of bleeding.
• Other serotonergic agents: Increased risk of serotonin syndrome.
• Trazodone: Increased risk of serotonin syndrome. Use only in exceptional cases with careful monitoring.

常見問題