A prescription for sertraline 50 mg doesn’t mean much to the average person. What makes 50 mg better for treatment of depression than 100 mg — or 10 mg? Why 50 mg?
Sertraline, like many other antidepressants, can be prescribed in a variety of dosages to fit the unique needs of different people. But because antidepressant drugs are essentially apples and oranges to one another, you might be surprised to learn that one medication might require just 10 mg to bring you benefits, while another might require ten times that to be effective.
Many times, people wondering these sorts of things after taking a new prescription from a healthcare provider. It’s the stuff you don’t think about until you get home after the appointment.
In other words, it’s a common experience to have questions about a new medication later.
The good news is that, whether you’ve been prescribed sertraline at 50 mg, 100 mg or 25 mg, the medication is going to work in the same fashion. Dosage simply determines the concentration of that medication in your body, which can intensify or reduce the effects (and the side effects).
As for 50 mg, in particular, there are some common reasons it might be prescribed. To understand why and how, though, we need to cover some 101-level information about sertraline.
Let’s start with the most obvious question: what is it?
Sertraline is a generic version of the antidepressant Zoloft®, and both Zoloft and the other versions of sertraline on the market are what are known as selective serotonin reuptake inhibitors, or SSRIs.
SSRIs are serotonergic drugs that essentially help manage your brain’s supply of serotonin — an important neurotransmitter for the regulation of your mood. Your brain manufactures serotonin and uses it when it needs to keep you from emotionally hitting rock bottom (as well as other bodily processes). It’s sort of like a safety net, in some ways.
The problem is that while the brain is good at manufacturing serotonin, it’s also good at cleaning up unused serotonin on a regular basis. Some brains can overdo it, leaving you with lower or no serotonin supplies.
And that’s where SSRIs and other medications come in: they prevent your brain from cleaning up the unused serotonin. The efficacy of sertraline makes it a great option for some people, and for most people, it and other SSRIs are considered a first-line treatment because their side effects are more mild for most people, as compared with tricyclic antidepressants and monoamine oxidase inhibitors.
People who take medications like sertraline can see reductions in the symptoms of their mental health issues resulting from psychiatric disorders like mood disorders and anxiety disorders.
A regular dose of sertraline in general can treat a variety of mood and mental health disorders, including major depressive disorder, panic attacks and panic disorder, social anxiety disorder, premenstrual dysphoric disorder (PMDD), obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
However, while any of those conditions can benefit from sertraline, not all of them require 50 mg for treatment with sertraline.
For instance, panic disorder, posttraumatic stress disorder, social anxiety and OCD in children and adolescents typically are treated with a dose of just 25 mg of sertraline to start. A healthcare provider may eventually increase the dose to 50 mg or higher, depending on a person’s individual needs.
Meanwhile, premenstrual dysphoric disorder, OCD in adults and major depression are all disorders where you will typically start at 50 mg of sertraline, making it the starting dosage. And, depending on how someone responds to 50 mg, they may have their dose decreased or increased.
For instance, someone who isn’t seeing results from a single dose of 50 mg sertraline might have their dosage increased to 75 mg or 100 mg — and potentially even higher.
Meanwhile, someone might have their daily dose reduced if they experience common side effects that begin to interfere with their health or happiness. We’ll get to those in a second.
A final point about dosage adjustment: there’s really no “good dose” or “bad dose” size — it’s what helps you in a safe way that matters.
People can sometimes worry that they’re different or “more unwell” based on their dosage, but a variety of factors can contribute to what the “right” dose for you looks like, including age, weight, height and various biological factors.
Safety is what matters. And sertraline in patients of mood disorders and other Food and Drug Administration (FDA) approved conditions can be prescribed safely up to a maximum dose of 150 mg or 200 mg per day, depending on what it’s being used to treat.
Of course, just because your adult dosage is safe doesn’t mean you won’t experience adverse effects or adverse reactions. Let’s talk about what you can expect.
At 50 mg a day, your exposure to sertraline is still largely considered a starting adult dosage. All things considered, that means you should be on the lower end of the side effect spectrum.
Now, medication affects everyone differently, but as with the effectiveness of the medication, the side-effectiveness of the medication (if you will) can change from person to person based on various things. That means that you and another person might take the same dose and experience entirely different side effects.
Generally, though, side effects come in the form of gastrointestinal, physical and psychological side effects.
Some of them may go away within a few weeks of beginning to take sertraline, but to be safe, you should talk to a healthcare professional about any symptoms that you notice that affect your quality of life and ability to function normally.
Typical sertraline side effects can include any of the following:
Sexual function issues (for women, decreased orgasm, for men, ejaculation failure)
Reduced libido or sex drive
Loss of appetite
These will typically disappear as your body adjusts to the medication, but if they don’t, talk to your healthcare provider.
The following side effects, meanwhile, should be brought to the attention of a healthcare professional immediately, as they could be very serious:
Severe muscle stiffness
Loss of coordination
These side effects are considered rare, especially at a lower daily dosage. But if they happen, you should seek medical attention. In most cases, sertraline is considered safe and effective, and the side effects are not typically serious enough to undermine the beneficial effects of the medication.
Side effects may also occur from abrupt discontinuation of sertraline (these are known as withdrawal symptoms), so talk with your healthcare provider before you stop taking sertraline.
If you happen to take more than your daily prescription, though, you might be as risk of serotonin syndrome — learn more about the risk for serotonin syndrome in our guide to the side effects of SSRIs.
Whether you’re taking 25 mg concentrations of sertraline or 200 mg sertraline for your medical condition is, in the big picture, irrelevant. Guidelines about things like drug interactions, symptoms of serotonin syndrome, and where yours levels of sertraline should be are there for general understanding, but your mental health may feel its most normal at either extreme — or at 50 mg.
The reality of mental health is that there are sometimes costs to the treatments we’re offered. You may experience some side effects for the medication to work, just the same way you may have to deal with uncomfortable topics in therapy or push yourself out of your comfort zone to give yourself the best care.
One of the smartest things you can do for your mental status, though, is get professional help and medical advice.
Healthcare professionals can be a great way to get not just medication but advice, feedback and further direction for effective treatments.
They may tell you to get more exercise or change up your diet alongside medication and therapy.
You can’t really know what will help you be the best version of yourself until you ask for help.
If you’re ready to get help now, both our medication resources and our online therapy platform can connect you with healthcare professionals that can give you the answers and treatment you need to succeed.
Whether it’s with us or elsewhere, let a professional help you with the numbers — talk to someone today.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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