セルトラリン

動物種別の用量

投与経路

禁忌

• 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)

有害事象

• 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
• Lethargy
• Decreased appetite
• Vomiting
• Trembling
• Restlessness
• Gastrointestinal disturbance
• Paradoxical increase in anxiety
• Potential increase in aggression

薬物相互作用

• Buspirone · Increased risk for serotonin syndrome
• Cimetidine · May increase sertraline levels
• Cyproheptadine · May decrease or reverse the effects of SSRIs
• Diazepam · Sertraline may decrease diazepam clearance
• Isoniazid · Increased risk for serotonin syndrome
• MAO Inhibitors (e.g., amitraz, selegiline) · 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.
• Pentazocine · Serotonin syndrome-like adverse effects possible
• Tramadol · SSRIs can inhibit the metabolism of tramadol to active metabolites, decreasing efficacy and increasing the risk of toxicity (serotonin syndrome, seizures)
• Tricyclic Antidepressants (e.g., clomipramine, amitriptyline) · Sertraline may increase TCA blood levels and increase the risk for serotonin syndrome
• Warfarin · Sertraline may increase the risk for bleeding
• Selegiline (MAOIs) · 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. · major
• Anticonvulsants · Sertraline antagonizes the effects of anticonvulsants and lowers the seizure threshold. · major

モニタリング

• 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)
• Appetite and body weight
• Signs of serotonin syndrome (tremors, hyperthermia, agitation)
• Seizure activity

過量投与

**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.