설트랄린

Sertraline

Sertraline hydrochloride

다른 이름: 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

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

2-4 mg/kg PO once daily or divided twice dailyPO· q24h or q12h

체중— 🐕

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

동물 종별 용량

🌎 NA — North America🌍 EU — Europe

개

적응증	용량	경로	빈도	기간	지역
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.

고양이

적응증	용량	경로	빈도	기간	지역
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.

용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.

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개요

설트랄린은 널리 사용되는 인체용 항우울제로, 수의학에서는 개와 고양이의 다양한 행동 관련 진단을 관리하기 위해 허가 외(off-label)로 사용됩니다.

주요 임상 적용:

개: 공격성, 범불안 장애 및 강박 행동(예: 말단 핥기 피부염, 꼬리 쫓기).
고양이: 소변 표시(스프레이), 정서적 또는 우위성 공격성, 불안으로 인한 실내 배변 문제, 공포증 및 강박 장애.

임상 요점:

다른 SSRI와 마찬가지로 설트랄린은 완전한 임상적 효과가 관찰되기까지 장기간(일반적으로 4~8주)의 치료가 필요합니다. 이러한 지연은 신경 수용체의 하향 조절에 필요한 시간 때문입니다. 제네릭 제형이 있어 비교적 저렴하므로 장기적인 행동 관리에 매력적인 선택지입니다.

작용 기전

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.

안전성·주의사항

금기사항

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)

부작용

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

주의

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.

약물 상호작용

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)Major

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.

AnticonvulsantsMajor

Sertraline antagonizes the effects of anticonvulsants and lowers the seizure threshold.

PhenothiazinesModerate

May lower the seizure threshold when used concurrently.

AspirinModerate

Increased risk of bleeding in the case of tissue trauma.

AnticoagulantsModerate

Increased risk of bleeding.

Other serotonergic agentsMajor

Increased risk of serotonin syndrome.

TrazodoneMajor

Increased risk of serotonin syndrome. Use only in exceptional cases with careful monitoring.

모니터링

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

약동학

반감기

고양이Unknown, likely similar to dogs개Approximately 1-2 days

흡수

In humans, peak levels occur 30-45 minutes after oral dosing.

분포

In dogs, the volume of distribution is 25 L/kg. It is highly protein-bound (97% in dogs, 98% in humans).

대사

Undergoes high first-pass metabolism in the liver. Primarily metabolized to N-desmethylsertraline, which is an active metabolite.

배설

In dogs, clearance is greater than 35 mL/min/kg, and bile is the major route of excretion.

과다투여

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.

제품

제형

Tablets
Oral Solution Concentrate
50 mg oral tablet
100 mg oral tablet

인용의약품

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

규제 현황

European Union✗ 미승인처방전의약품EMA

Prescription Only Medicine (POM). Used under the cascade as no veterinary formulation is currently authorized.

United Kingdom✗ 미승인처방전의약품VMD

Prescription Only Medicine (POM). Used under the cascade.

규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

보관·안정성

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.

보호자 정보

기대 효과:

인내심이 중요합니다: 이 약은 즉시 효과가 나타나지 않습니다. 반려동물의 행동이 눈에 띄게 개선되려면 일반적으로 4~8주 동안 매일 꾸준히 투약해야 합니다.
꾸준한 투약: 약의 효과를 정확히 판단하려면 수개월 동안 약을 사용하겠다는 의지가 필요합니다.

중요 지침:

갑자기 중단하지 마십시오: 수의사의 지시가 없는 한 절대 갑자기 투약을 중단하지 마십시오. 금단 증상이 발생할 수 있습니다. 약을 중단해야 하는 경우 수의사가 점진적인 감량 일정을 안내할 것입니다.
식욕 변화: 약을 처음 시작할 때 식욕 감소가 흔하게 나타납니다(특히 개). 이는 대개 일시적입니다. 손으로 직접 먹여주거나 음식을 더 맛있게 만들어 줄 수 있습니다. 반려동물이 전혀 먹지 않는다면 수의사에게 연락하십시오.
행동 관찰: 이 약은 뇌의 화학 물질을 변화시키므로 불안 증가, 안절부절못함 또는 예상치 못한 공격성과 같은 이상 행동이 나타나는지 관찰하십시오. 심각한 이상 소견이 발견되면 즉시 수의사에게 알리십시오.
액상 약물: 경구용 액제를 사용하는 경우 반려동물에게 먹이기 전에 반드시 희석해야 합니다. 물, 오렌지 주스, 진저에일, 레모네이드 또는 레몬/라임 소다와만 섞어야 하며, 섞은 후 즉시 먹이십시오.

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