Sertralina
Sertraline
Sertraline hydrochloride
También conocido como: Zoloft · Altruline · Anilar · Aremis · Atenix · Besitran · Bicromil · Gladem · Insertec · Irradial · Lustral · Novativ · Sealdin · Serad · Sercerin · Serlain · Serta · Tatig · Tolrest · Tresleen · Sertraline HCl · CP-51974-01 · Sertralinum
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of compulsive disorders | 2-4 mg/kg PO once daily or divided twice daily | PO | q24h or q12h | — | 🌎 NA |
| Behavioral diagnoses | 1-2 mg/kg PO q24h (once daily) | PO | q24h | allow 6-8 weeks for initial trial | 🌎 NA |
| Behavioral diagnoses | 1-3 mg/kg PO once daily | PO | q24h | 3-6 months | 🌎 NA |
| Treatment of behavioral diagnoses | 0.25-0.5 mg/kg PO q24h (once a day) | PO | q24h | Minimum 4-6 months | 🌎 NA |
| Compulsive disorder, anxiety | 1-4 mg/kg PO q24h (once daily) | PO | q24h | — | 🌎 NA |
| Behavioral diagnoses | 0.5-4 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Generalized anxiety disorder | 0.5-4 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Anxiety-related behaviours (including compulsive type behaviour such as acral lick) | 1-3 mg/kg | PO | q24h | Long-term | 🌍 EU |
- Behavioral diagnoses: Plan is to use the drug for a limited time during which behavioral modification is employed. Wean off over 2-4 weeks by halving the dose weekly.
- Treatment of behavioral diagnoses: Treat for 3-5 weeks minimum to assess effects; treat until 'well' (minimum another 1-2 months), then treat another 1-2 months minimum. Wean off over 3-5 weeks or longer.
- Anxiety-related behaviours (including compulsive type behaviour such as acral lick): Higher doses are described in the literature.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Treatment of compulsive disorders | 0.5 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Urine marking (spraying), aggression, anxiety-including anxiogenic house soiling, phobias, fears | 0.5-1 mg/kg PO q24h (once daily) | PO | q24h | — | 🌎 NA |
| Treatment of behavioral diagnoses | 1 mg/kg PO q24h (once a day) | PO | q24h | Minimum 4-6 months | 🌎 NA |
| Treatment of fear, affective or dominance aggression | 0.5-1 mg/kg PO once daily | PO | q24h | — | 🌎 NA |
| Generalized anxiety disorder | 0.5-1.5 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Treatment of compulsive disorder, anxiety | 0.5-1 mg/kg PO q24h (once daily) | PO | q24h | — | 🌎 NA |
| Behavioral diagnoses | 0.25-1.3 mg/kg PO q24h | PO | q24h | — | 🌎 NA |
| Increase inhibitory control (e.g., play-related aggressive behaviour) | 0.5-1.5 mg/kg | PO | q24h | Long-term | 🌍 EU |
- Treatment of behavioral diagnoses: Treat for 3-5 weeks minimum to assess effects; treat until 'well' (minimum another 1-2 months), then treat another 1-2 months minimum. Wean off over 3-5 weeks or longer.
- Increase inhibitory control (e.g., play-related aggressive behaviour): Suggested use, but there are no good empirical studies published to support this.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La sertralina es un antidepresivo humano ampliamente utilizado que se emplea fuera de etiqueta (off-label) en medicina veterinaria para tratar una variedad de diagnósticos relacionados con el comportamiento en perros y gatos.
Aplicaciones clínicas clave:
- Perros: Agresión, ansiedad generalizada y comportamientos obsesivo-compulsivos (p. ej., dermatitis por lamido acral, persecución de la cola).
- Gatos: Marcaje con orina (rociado), agresión afectiva o por dominancia, eliminación inadecuada por ansiedad, fobias y trastornos compulsivos.
Perlas clínicas:
Al igual que otros ISRS, la sertralina requiere una duración prolongada del tratamiento (típicamente de 4 a 8 semanas) antes de observar la eficacia clínica completa. Este retraso se debe al tiempo necesario para la regulación a la baja de los neurorreceptores. Es relativamente económica debido a la disponibilidad de formulaciones genéricas, lo que la convierte en una opción atractiva para el manejo conductual a largo plazo.
Mecanismo de acción
Sertraline is a highly selective inhibitor of the presynaptic reuptake of serotonin (5-hydroxytryptamine or 5-HT) in the central nervous system.
- Mechanism: Blocks the serotonin transporter (SERT) → prevents the reuptake of serotonin into the presynaptic neuron → increases the concentration of serotonin in the synaptic cleft → prolongs stimulation of postsynaptic 5-HT receptors.
- Receptor Specificity: Sertraline has minimal to no effect on the reuptake of dopamine or norepinephrine, and lacks significant affinity for adrenergic, cholinergic, or histaminergic receptors, which minimizes the side effects typically seen with tricyclic antidepressants (TCAs).
- Delayed Onset: The initial increase in synaptic serotonin stimulates presynaptic 5-HT1A autoreceptors, which temporarily decreases serotonin release. Over several weeks, these autoreceptors down-regulate, allowing for enhanced serotonin release and the onset of full therapeutic effects.
Seguridad y advertencias
Contraindicaciones
- 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)
Efectos adversos
- 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
- Decreased appetite
- Trembling
- Restlessness
- Gastrointestinal disturbance
- Paradoxical increase in anxiety
- Potential increase in aggression
Precauciones
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.
Interacciones farmacológicas
Increased risk for serotonin syndrome
May increase sertraline levels
May decrease or reverse the effects of SSRIs
Sertraline may decrease diazepam clearance
Increased risk for serotonin syndrome
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.
Serotonin syndrome-like adverse effects possible
SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing the risk of toxicity (serotonin syndrome, seizures)
Sertraline may increase TCA blood levels and increase the risk for serotonin syndrome
Sertraline may increase the risk for bleeding
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.
Sertraline antagonizes the effects of anticonvulsants and lowers the seizure threshold.
May lower the seizure threshold when used concurrently.
Increased risk of bleeding in the case of tissue trauma.
Increased risk of bleeding.
Increased risk of serotonin syndrome.
Increased risk of serotonin syndrome. Use only in exceptional cases with careful monitoring.
Monitorización
- Efficacy (resolution or improvement of behavioral signs)
- Adverse effects, particularly changes in appetite and body weight
- Baseline liver function tests (consider re-testing as needed)
- Baseline ECG (consider re-testing as needed)
- Behavioral response (efficacy and paradoxical aggression/anxiety)
- Signs of serotonin syndrome (tremors, hyperthermia, agitation)
- Seizure activity
Farmacocinética
Vida media
Absorción
In humans, peak levels occur 30-45 minutes after oral dosing.
Distribución
In dogs, the volume of distribution is 25 L/kg. It is highly protein-bound (97% in dogs, 98% in humans).
Metabolismo
Undergoes high first-pass metabolism in the liver. Primarily metabolized to N-desmethylsertraline, which is an active metabolite.
Eliminación
In dogs, clearance is greater than 35 mL/min/kg, and bile is the major route of excretion.
Sobredosis
Toxicity Profile: Most exposures in dogs below 20 mg/kg are not considered serious. However, massive overdoses can be life-threatening.
Clinical Signs of Overdose:
- Mild to Moderate: Vomiting, diarrhea, hypersalivation (especially in cats), lethargy, tachycardia, somnolence, and vocalization.
- Severe (Serotonin Syndrome): Muscle tremors, rigidity, agitation, hyperthermia, vocalization, hypertension or hypotension, tachycardia, seizures, coma, and potentially death.
Management: Handle aggressively with supportive and symptomatic treatment. Contact an animal poison control center (e.g., ASPCA APCC) for specific guidance.
Productos disponibles
Formulaciones
- Tablets
- Oral Solution Concentrate
- 50 mg oral tablet
- 100 mg oral tablet
Etiquetado para humanos
- Sertraline HCl Tablets: 25 mg, 50 mg & 100 mg (as base); Zoloft® (Pfizer); generic
- Sertraline HCl Oral Solution Concentrate: 20 mg/mL in 60 mL; Zoloft® (Pfizer); generic
- Lustral 50 mg tablets
- Lustral 100 mg tablets
Estado regulador
Prescription Only Medicine (POM). Used under the cascade as no veterinary formulation is currently authorized.
Prescription Only Medicine (POM). Used under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store commercially available tablets and oral solution at controlled room temperature (25°C; 77°F); excursions permitted to 15-30°C (59-86°F). The oral solution must be diluted only in water, orange juice, ginger ale, lemonade, or lemon/lime soda, and used immediately after dilution.
Información para el cliente
Qué esperar:
- La paciencia es clave: Este medicamento no funciona de inmediato. Por lo general, se necesitan de 4 a 8 semanas de administración diaria constante para observar mejoras notables en el comportamiento de su mascota.
- Compromiso: Debe comprometerse a usar el medicamento durante varios meses para determinar con precisión si está ayudando.
Pautas importantes:
- No suspenda el tratamiento abruptamente: Nunca deje de administrar este medicamento repentinamente a menos que su veterinario se lo indique, ya que puede causar síntomas de abstinencia. Si es necesario suspender el medicamento, su veterinario le proporcionará un programa de reducción gradual.
- Cambios en el apetito: Es común una disminución del apetito, especialmente en perros, al comenzar el medicamento. Esto suele ser temporal. Puede intentar alimentar a su mascota con la mano o hacer que la comida sea más apetecible. Si su mascota deja de comer por completo, contacte a su veterinario.
- Monitoreo del comportamiento: Debido a que este fármaco altera la química cerebral, esté atento a cualquier comportamiento inusual, como aumento de la ansiedad, inquietud o agresión inesperada. Informe cualquier hallazgo anormal significativo a su veterinario de inmediato.
- Medicamento líquido: Si utiliza la solución oral, debe diluirse antes de administrarla a su mascota. Mézclela únicamente con agua, jugo de naranja, ginger ale, limonada o refresco de limón/lima, y adminístrela inmediatamente después de mezclarla.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.