La sertraline est un inhibiteur sélectif de la recapture de la sérotonine.
Indications : Épisodes dépressifs majeurs, trouble obsessionnel compulsif, trouble panique, la phobie sociale, trouble de stress post-traumatique
Posologie : 50 à 200 mg/jour
Effets indésirables :
- Somnolence
- Insomnie
- Nervosité
- Maux de tête
- Cauchemars
- Diminution de l’appétit
- Nausées, vomissement
- Sécheresse buccale
- Transpiration excessive
- Syndrome de sevrage à l’arrêt
- Troubles sexuels, diminution de la libido et troubles de l’orgasme, trouble de l’érection et de l’éjaculation
- Lente absorption (Tmax de 4 – 8 h)
- Demi-vie d’élimination 22 – 36 h
- Soumis à un métabolisme de premier passage important
- Déméthylation par CYP2D6, 2C9, 2B6, 2C19 et 3A4
- Inhibe le CYP2D6
A lire :
Mandrioli R, Mercolini L, Raggi MA. Evaluation of the pharmacokinetics, safety and clinical efficacy of sertraline used to treat social anxiety. Expert Opin Drug Metab Toxicol. 2013;9(11):1495-505
En addictologie Jan 2022 :
Addiction à l’alcool
- Résultats mixtes (Niveau d’évidences Ib) 1–6 7–11
Addiction au jeu d’hasard
- Sértraline non efficace (Niveau d’évidences IIb) 12
Addiction à la cocaine
- Résultats mixtes (Niveau d’évidences IIb) 13, 14
Addiction aux amphétamines
- Pas d’efficacité (Niveau d’évidences Ib) 15, 16
Comorbidité dépression et addiction à l’alcool
- Réduction des symptômes dépressifs (Niveau d’évidences Ib) 17–19 et résultat mixtes concernant la consommation d’alcool (Niveau d’évidences Ib) 17, 19–21
Comorbidité dépression et addiction aux opiacés
- Combinaison sertraline / naltrexone diminue les symptomes dépressifs et le craving (Niveau d’évidences IIb) 22
- Pas d’effet chez de patients sous méthadone (Niveau d’évidences IIb) 23
Comorbidité dépression et addiction au tabac
- Pas de réduction de la fumée (Niveau d’évidences IIb) 24
Comorbidité dépression et addiction à la cocaïne
- Réduction de la consommation de cocaïne et des symptômes dépressifs (Niveau d’évidences IIb) 25, 26
Comorbidité PTSD et addiction à l’alcool
- Combinaison avec TCC : amélioration des symptômes du PTSD (Niveau d’évidences Ib) 27–29, résultats mixtes concernant la consommation d’alcool (Niveau d’évidences Ib) 27, 28
Comorbidité trouble Borderline et addiction aux opiacés
- Réduction des symptômes chez des patients sous traitement assisté par méthadone (Niveau d’évidences IIIb) 30
Désaccoutumance du tabac
- Combinaison bupropion / sertraline efficace (Niveau d’évidences IIb) 31
Taux plasmatiques de méthadone
- La sertraline augmente les taux plasmatiques de la méthadone par environ 25% (Niveau d’évidences IIb) 32
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