This treatment plan is focused on daily sertraline — how it works and how to effectively and safely use it to treat premature ejaculation. You will also receive a physical document called a drug monograph or patient drug information in the package with your medication when it arrives from the pharmacy which contains full information about sertraline— you should read all of the information that comes with your prescription shipment before taking your medication.
How sertraline works
Sertraline belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medications work by changing serotonin levels and signalling in the brain. Most were developed and approved to treat mental health conditions including depression, obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, posttraumatic stress disorder, and social anxiety disorder.
Sertraline for premature ejaculation
Although SSRIs like sertraline were not specifically developed for the treatment of premature ejaculation, healthcare providers noticed that patients on SSRI treatment for mental health conditions were experiencing delayed orgasms. Healthcare providers then began to study and use these drugs to treat premature ejaculation. The use of SSRIs like sertraline to treat premature ejaculation is now supported by many clinical studies and recommended in guidelines from medical societies such as the International Society for Sexual Medicine and the American Urological Association. However, SSRI treatment for PE is still “off-label” in the United States (when medicine is used for a different reason than the FDA-approved uses).
Sertraline works best when taken every day at the same time. You can take it either in the morning or at night, whichever is easier for you. Missing doses affects blood levels and can set you back.
Ramp it up as needed, follow your prescription
Be sure to follow the instructions on your prescription. For many patients just starting out with treatment, that means doubling your dose if the desired effect isn’t achieved within 3 weeks. NEVER take higher doses than recommended on your prescription
Give it a chance to work
It takes 2-3 weeks for your brain and body to adjust to sertraline, and even then anxiety can get the better of you the first few times you have sex after starting treatment. Don’t rush to conclusions about effectiveness until you’ve been on treatment for at least 3 weeks and had a few sexual experiences.
If you miss a dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Be consistent
Paroxetine works best when taken every day at the same time. You can take it either in the morning or at night, whichever is easier for you. Missing doses affects blood levels and can set you back.
Give it a chance to work
It takes 2-3 weeks for your brain and body to adjust to paroxetine, and even then anxiety can get the better of you the first few times you have sex after starting treatment. Don’t rush to conclusions about effectiveness until you’ve been on treatment for at least 3 weeks and had a few sexual experiences.
Ramp up if needed, follow prescription
It takes 2-3 weeks for your brain and body to adjust to paroxetine, and even then anxiety can get the better of you the first few times you have sex after starting treatment. Don’t rush to conclusions about effectiveness until you’ve been on treatment for at least 3 weeks and had a few sexual experiences.
If you miss a dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Warnings
WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Sertraline and other antidepressant drugs may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when sertraline is started or when the dose is changed.
Do not take sertraline if:
Take a Monoamine Oxidase Inhibitor (MAOI), including linezolid or methylene blue, or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 2 weeks of stopping sertraline. Ask your doctor or pharmacist if you are not sure if your medicine is an MAOI. People who take sertraline close in time to an MAOI may have serious or even life threatening side effects. Get medical help right away if you have any of these symptoms:
high fever
uncontrolled muscle spasms
stiff muscles
rapid changes in heart rate or blood pressure
confusion
loss of consciousness (pass out)
Take Orap® (pimozide) because this can cause serious heart problems
Take MELLARIL® (thioridazine) because this can cause serious heart rhythm problems or sudden death.
Are allergic to sertraline or any of the inactive ingredients in sertraline.
Sertraline and other antidepressant medicines may cause serious side effects. Call a doctor right away if you or a person you know who is taking sertraline has any of the following symptoms, especially if they are new, worse, or worry you:
Attempts to commit suicide
Acting aggressive or violent
New or worse depression
Feeling agitated, restless, angry, or irritable
An increase in activity or talking more than what is normal for you
Acting on dangerous impulses
Thoughts about suicide or dying
New or worse anxiety or panic attacks
Trouble sleeping
Other unusual changes in behavior or mood
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Before taking sertraline, tell your doctor and pharmacist about all prescription and over-the-counter medications and supplements you take or plan to take including, those to treat migraines, psychiatric disorders (including other antidepressants or amphetamines) to avoid a potentially life-threatening condition called serotonin syndrome; aspirin; other NSAID pain relievers; other blood thinners because they may increase the risk of bleeding; drugs used to treat irregular heartbeat; drugs used to treat HIV infection; and drugs used to treat epilepsy.
Before taking sertraline, tell your doctor your complete list of medical conditions, including if you have liver problems, kidney problems, heart problems, seizures or convulsions, psychiatric disorders including bipolar disorder or mania, low sodium levels in your blood, history of a stroke, high blood pressure, bleeding problems, or glaucoma (high pressure in the eye).
Tell your healthcare provider immediately if you
Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
Have seizures or convulsions
Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
Do not stop sertraline without first talking to your healthcare provider. Stopping sertraline may cause serious symptoms, including anxiety, irritability, high or low mood, feeling restless or sleepy; headache, sweating, nausea, dizziness; electric shock-like sensations, shaking, and confusion.
Some people are at risk for visual problems such as eye pain, changes in vision, or swelling or redness around the eye. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Sertraline can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you.
Drinking alcohol while taking sertraline is not recommended.
The most common side effects in adults treated with sertraline include:
Nausea, loss of appetite, diarrhea, or indigestion
Increased sweating
Tremor or shaking
Agitation
Change in sleep habits including increased sleepiness or insomnia
Sexual problems including decreased libido and ejaculation failure
Feeling tired or fatigued
Weakness
Dizziness
Sexual problems
Dry mouth
Constipation
Infection
Feeling anxious or trouble sleeping
Contact your healthcare provider if any of these side effects continue or if you have questions about them. Your healthcare provider or pharmacist can tell you if it is safe to take sertraline with your other medicines. Do not start or stop any medicine while taking sertraline without talking to your healthcare provider first.
