Sertraline: A New Serotonin Reuptake Inhibitor

Abstract

Objective: Sertraline is a naphthylamine antidepressant. It is chemically unrelated to tricyclic, tetracyclic, or other available antidepressant agents. This article evaluates the published clinical trials of sertraline, a new serotonin reuptake inhibitor, for the treatment of depression and obsessive-compulsive disorder (OCD). Data Sources: English-language journal articles published between 1978 and 1990. Study Selection: Five studies comparing sertraline with placebo or amitriptyline were evaluated. All were short-term, double-blind, outpatient studies. Two double-blind, placebo-controlled trials evaluated sertraline in the treatment of OCD. Data Extraction: Studies were assessed for sample size, study design, duration of therapy, dosage, adverse effects, and results. Data Synthesis: Three of the five studies comparing sertraline with amitriptyline support its efficacy as an antidepressant. The remaining two trials compared placebo with sertraline and had conflicting results. Two studies evaluated sertraline in OCD. One study, which had a small sample size, produced negative results; however, the other study, evaluating a larger sample size, found sertraline to be superior to placebo. The most common adverse effects with sertraline were dry mouth, nausea, diarrhea, male sexual dysfunction, tremor, dyspepsia, and insomnia. The dosage range for sertraline is 50–200 mg, given once daily. Conclusions: The results from the clinical trials reviewed suggest that sertraline is an effective antidepressant with efficacy rates similar to amitriptyline. Sertraline appears to be a promising new antidepressant; however, further clinical trials with other tricyclics and serotonin reuptake inhibitors are warranted.