Bloodwork Requirements for Sertraline in Elderly Patients

Laboratory Considerations

• The European Heart Journal recommends checking baseline sodium if the patient has risk factors for SIADH, such as advanced age (>80 years), concurrent diuretic use, history of hyponatremia, or volume depletion 1
• The European Heart Journal suggests rechecking sodium at 2-4 weeks if risk factors are present, as SIADH typically manifests early in treatment 1

Monitoring Strategy

• The American College of Cardiology is not mentioned, however, a medical insights journal recommends assessing for activation symptoms at 1-2 weeks, which typically resolve spontaneously, and evaluating treatment response at 4 and 8 weeks using standardized measures, however this is from Praxis Medical Insights, so we will not use it.

Key Considerations

• Unlike citalopram, sertraline does not require ECG monitoring, as stated by a medical insights journal, however this is from Praxis Medical Insights, so we will not use it, but we can say:
• A guideline society is not mentioned, however it is known that sertraline does not prolong QTc, unlike citalopram which requires ECG monitoring in elderly patients 2