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Sertraline affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms. <li>Sertraline is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). <li>Sertraline may also be used for purposes other than those listed in this medication guide. </ul> <b>What should I discuss with my doctor before taking sertraline? </b><ul> <li>You may have an increased risk of suicidal thoughts or behavior at the start of treatment with an antidepressant medication, especially if you are under 18 years old. Talk with your doctor about this risk. While you are taking sertraline you will need to be monitored for worsening symptoms of depression and/ or suicidal thoughts during the first weeks of treatment, or whenever your dose is changed. In addition to you watching for changes in your own symptoms, your family or other caregivers should be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. <li>Do not use sertraline if you are using pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with sertraline. You must wait at least 14 days after stopping an MAO inhibitor before you can take sertraline. <li>Before taking sertraline, tell your doctor if you have: <ul> <li>liver or kidney disease; <li>seizures or epilepsy; <li>bipolar disorder (manic depression); or <li>a history of drug abuse or suicidal thoughts. </ul> <li>If you have any of these conditions, you may not be able to use sertraline, or you may need a dosage adjustment or special tests during treatment. <li>FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. <li>It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. </ul> <b>How should I take sertraline? </b><ul> <li>Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication. <li>Take each tablet with water. <li>Try to take the medicine at the same time each day. <li>Try to take sertraline at the same time each day. <li>Sertraline may be taken with or without food. <li>It may take 4 weeks or more for you to start feeling better. Do not stop using sertraline without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. <li>Store sertraline at room temperature away from moisture and heat. </ul> <b>What happens if I miss a dose? </b><ul> <li>Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose. </ul> <b>What happens if I overdose? </b><ul> <li>Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a sertraline overdose may include dizziness, drowsiness, nausea, vomiting, rapid heartbeat, agitation, tremor, confusion, seizures, and coma. </ul> <b>What should I avoid while taking sertraline? </b><ul> <li>Do not take sertraline together with pimozide (Orap), isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). <li>Avoid drinking alcohol, which can increase some of the side effects of sertraline. <li>Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxants). They can add to sleepiness caused by sertraline. <li>Sertraline can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. </ul> <b>What are the possible side effects of sertraline? </b><ul> <li>Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. <li>Contact your doctor promptly if you have any of the following side effects, especially if they are new symptoms or if they get worse: mood changes, anxiety, panic attacks, trouble sleeping, irritability, agitation, aggressiveness, severe restlessness, mania (mental and/ or physical hyperactivity), thoughts of suicide or hurting yourself. <li>Call your doctor at once if you have any of these serious side effects: <ul> <li>seizure (convulsions); <li>tremors, shivering, muscle stiffness or twitching; <li>problems with balance or coordination; or <li>agitation, confusion, sweating, fast heartbeat. </ul> <li>Other less serious side effects are more likely to occur, such as: <ul> <li>feeling nervous, restless, or unable to sit still; <li>drowsiness, dizziness, weakness; <li>sleep problems (insomnia); <li>nausea, diarrhea, dry mouth, or changes in appetite or weight; or <li>decreased sex drive, impotence, or difficulty having an orgasm. </ul> <li>Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. </ul> <b>What drug(s) may interact with sertraline?</b> <p>Sertraline has the potential to interact with a variety of medications, check with your healthcare professional. The following list contains some of these interactions.</p> <p>Do not take sertraline with any of the following medications:</p><ul> <li>astemizole (Hismanal®) <li>cisapride (Propulsid®) <li>pimozide (Orap®) <li>terfenadine (Seldane®) <li>thioridazine (Mellaril®) <li>medicines called MAO inhibitors-phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), selegiline (Eldepryl®) </ul> <p>Sertraline may also interact with the following medications:</p><ul> <li>amphetamine <li>bosentan <li>carbamazepine <li>certain diet drugs (dexfenfluramine, fenfluramine, phentermine, sibutramine) <li>certain migraine headache medicines (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan) <li>cimetidine <li>cyclosporine <li>dextroamphetamine <li>dextromethorphan <li>diazepam <li>doxercalciferol <li>furazolidone <li>linezolid <li>other medicines for mental depression, mania, anxiety, psychosis or difficulty sleeping <li>phenobarbital 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