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This may be caused by fluoxetine's relative lack of selectivity over norepinephrine and serotonin-2C receptors (5-HT).3 These side effects are short-lived and may improve with a dose reduction or temporary co-administration of a beta-adrenergic blocker or long-acting benzodiazepine.7 Clinically important drug interactions are listed in Any drug that increases serotonin concentrations, including: MAOIs, tramadol (Ultram), sibutramine (Meridia), meperidine (Demerol), sumatriptan (Imitrex), lithium, St. In two studies, male and female outpatients with PTSD who were randomized to 12 weeks of treatment with sertraline experienced significantly more relief from symptoms of avoidance/numbing and hyperarousal than did patients treated with placebo.1314 [References 13 and 14—Evidence level A, RCTs] Intrusive thoughts/re-experiencing phenomena also improved, although the degree of improvement was not statistically significant for each symptom scale.John's wort, ginkgo biloba, and atypical antipsychotic agents Adapted with permission from Kando JC, Wells BG, Hayes PE. Whether patients with PTSD will benefit from long-term treatment with sertraline or a combination of the drug and behavior therapy is presently unknown. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia.Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action—stimulating the release of norepinephrine and serotonin.

Sertraline has been shown to improve quality-of-life scores and psychologic and behavior symptoms in patients with PMDD.1516 [Reference 15—Evidence level A, RCT] Its effectiveness has been demonstrated with both continuous dosing throughout the month and luteal-phase dosing.The usual dosage of the drug is 20 mg orally once daily throughout the month10 .Administration of fluoxetine during the late luteal phase alone has been investigated in a small study11 of 24 women with PMDD and no psychiatric history.Thus, non-continuous use of fluoxetine for this indication may be an effective option. Stamford, Conn.: Appleton & Lange, 1999;1154–5Any drug that increases serotonin concentrations, including: MAOIs, tramadol (Ultram), sibutramine (Meridia), meperidine (Demerol), sumatriptan (Imitrex), lithium, St. The initial dose in children (six to 12 years of age) with OCD is 25 mg; patients who are at least 13 years of age may take adult doses.The most common early side effects of fluoxetine are agitation, insomnia, and neuromuscular restlessness resembling akathisia. John's wort, ginkgo biloba, and atypical antipsychotic agents Adapted with permission from Kando JC, Wells BG, Hayes PE. Sertraline is also indicated for the treatment of post-traumatic stress disorder (PTSD).

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