Sertraline

Class SSRI
Chemistry
Synthetic derivative of naphthalenamine
Routes of administration

Oral only

Absorption
Complete but slow absorption (6-8 hrs); almost 100% bioavailability
Solubility
pKa 9.16; poorly water-soluble
Distribution
VOD = 20L/kg; extremely highly protein-bound (99%)
Metabolism
Hepatic metabolism, mainly by N-demethylation to from an extremely long-lived metabolite (with about 10% of the potency of the parent drug, and a half-life of about 100 hours)
Elimination
50% of the metabolites are renally excreted, and 50% of them are eliminated in the faeces, suggesting that there is some biliary excretion.
Time course of action
Half life is about 26 hours
Target receptor

Serotonin reuptake transport protein (SCL6A4, or SERT), for which it has a very high affinity

Mechanism of action

By inhibiting the reuptake of serotonin from the synaptic cleft, SSRIs increase serotonergic neurotransmission, which is thought to be involved in mood regulation.

Clinical effects

Agitation, diarrhoea, loss or gain of weight, vertigo; risk of serotonin syndrome with overdose

Literature reference

Hiemke & Härtter (2000)

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs