舍曲林
Sertraline
Sertraline hydrochloride
別名: 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
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
舍曲林是一種廣泛使用的人類抗憂鬱藥物，在獸醫學中被標示外使用（off-label use），用於控制犬貓的各種行為相關診斷。
主要臨床應用：
- 犬： 攻擊行為、廣泛性焦慮及強迫症行為（例如：肢端舔舐性皮膚炎、追尾巴）。
- 貓： 尿液記號（噴尿）、情感性或支配性攻擊行為、焦慮引起的室內排泄問題、恐懼症及強迫症。
臨床要點：
與其他 SSRI 類藥物一樣，舍曲林需要較長的治療時間（通常為 4 到 8 週）才能觀察到完整的臨床療效。這種延遲是由於神經受體向下調節所需的時間。由於有學名藥可供選擇，其價格相對低廉，使其成為長期行為管理的理想選擇。
作用機轉
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.
安全性與警告
禁忌症
- 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)
不良反應
- 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
注意事項
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.
藥物交互作用
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.
監測
- 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
藥物動力學
半衰期
吸收
In humans, peak levels occur 30-45 minutes after oral dosing.
分佈
In dogs, the volume of distribution is 25 L/kg. It is highly protein-bound (97% in dogs, 98% in humans).
代謝
Undergoes high first-pass metabolism in the liver. Primarily metabolized to N-desmethylsertraline, which is an active metabolite.
排除
In dogs, clearance is greater than 35 mL/min/kg, and bile is the major route of excretion.
過量
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.
可用產品
劑型
- Tablets
- Oral Solution Concentrate
- 50 mg oral tablet
- 100 mg oral tablet
人用標示
- 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
各地核准狀態
Prescription Only Medicine (POM). Used under the cascade as no veterinary formulation is currently authorized.
Prescription Only Medicine (POM). Used under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
預期效果：
- 耐心是關鍵： 此藥物不會立即見效。通常需要持續每天給藥 4 到 8 週，才能看到寵物行為有明顯改善。
- 承諾： 您必須承諾使用該藥物數個月，以準確評估其療效。
重要指引：
- 請勿突然停藥： 除非獸醫師指示，否則絕對不要突然停止給藥，因為這可能會導致戒斷症狀。如果需要停藥，您的獸醫師會提供逐漸減量的計畫。
- 食慾改變： 在開始服藥時，食慾下降是很常見的（尤其是在狗身上）。這通常是暫時的。您可以嘗試親手餵食或讓食物變得更美味。如果您的寵物完全停止進食，請聯繫您的獸醫師。
- 監測行為： 因為這種藥物會改變大腦化學物質，請注意任何異常行為，例如焦慮增加、焦躁不安或意外的攻擊性。如果發現任何明顯的異常情況，請立即向獸醫師報告。
- 液體藥物： 如果使用口服液，必須在給寵物服用前進行稀釋。只能與水、柳橙汁、薑汁汽水、檸檬水或檸檬/萊姆汽水混合，並在混合後立即餵食。
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