Striking a balance between safety and efficacy: experience with the SSRI sertraline

Depression is a widespread and serious disorder inflicting an immeasurable toll on the lives of millions of people and affecting their families and colleagues. It is the cause of countless suicides especially in those whose illness has not been detected or given appropriate care. Until recently, effective pharmacotherapeutic management of depression was hampered by the troublesome side effects associated with traditional methods of treatment. In an attempt to circumvent these adverse effects, many antidepressants were prescribed at less than therapeutic doses, resulting in a high probability of inadequate treatment, relapse, or recurrence. The development of the selective serotonin reuptake inhibitors (SSRIs) was guided by the need for an antidepressant that provided both safe and effective therapeutic benefit. Sertraline's potent and highly selective inhibition of serotonin accounts both for its efficacy in a broad spectrum of depression and for its high tolerability and ease of use. Its safety and tolerability have been demonstrated in acute and maintenance phases of treatment and establishes that sertraline provides a viable clinical alternative for acute and long-term care of depressed patients.