Sertraline Discontinuation and Elimination Guidelines

Clinical Considerations

• The American Academy of Child and Adolescent Psychiatry notes that sertraline is associated with discontinuation syndrome, though to a lesser extent than paroxetine, with symptoms including dizziness, fatigue, nausea, sensory disturbances, and anxiety, typically occurring with missed doses or abrupt discontinuation 1
• When switching from sertraline to a monoamine oxidase inhibitor (MAOI), a washout period is necessary to prevent serotonin syndrome, with a minimum washout of 5-7 days recommended before initiating an MAOI, though some clinicians may extend this to 2 weeks to account for the active metabolite 1
• Serotonin syndrome symptoms can arise within 24-48 hours after combining serotonergic medications, highlighting the importance of careful timing when switching or combining these medications 1