Indication
Lustral tablets contain the active ingredient sertraline hydrochloride, which is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).
Antidepressant medicines act on nerve cells in the brain. In the brain there are numerous different chemical compounds called neurotransmitters. These act as chemical messengers between the nerve cells.

Lustral is used to treat:
- Depression in adults
- A psychiatric disorder in which tasks are excessively repeated (obsessive-compulsive disorder) in adults and children aged six years and over
- Post-traumatic stress disorder in adult women

Precautions:
- Depression and other pschiatric illnesses are associated with an increased risk of suicidal thoughts, self-harm, and suicide. You should be aware that Lustral may not start to make you feel better for at least two to four weeks. However, it is important that you keep taking it in order for it to work properly and for you to feel better. If you feel your depression or anxiety has got worse, or if you have any distressing thoughts, or feelings about suicide or harming yourself in these first few weeks, or indeed at any point during treatment or after stopping treatment, then it is very important to talk to your doctor.
- This medicine may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how Lustral affects you and you are sure it won't affect your performance.
- It is recommended that you avoid drinking alcohol while taking Lustral.
- SSRI antidepressants have been associated with the development of unpleasant or distressing restlessness and the need to move, often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. If you experience these symptoms you should consult your doctor.
- Antidepressants may cause the amount of sodium in the blood to drop - a condition called hyponatraemia. This can cause symptoms such as drowsiness, confusion, muscle twitching or convulsions. Elderly people may be particularly susceptible to this effect. You should consult your doctor if you develop any of these symptoms while taking this medicine, so that your blood sodium level can be checked if necessary.
- If you experience seizures (convulsions or fits) while taking Lustral, consult your doctor immediately, as you will need to stop treatment with Lustral. This also applies if you suffer from epilepsy and experience more seizures than normal after starting this medicine.
- You should not suddenly stop taking Lustral, as this can cause withdrawal symptoms such as dizziness, sleep disturbances (including intense dreams), nausea, headache, a feeling of weakness, pins and needles and anxiety. Withdrawal symptoms are temporary and are not due to addiction or dependence on Lustral. They can usually be avoided by stopping the medicine gradually, usually over a period of weeks or months, depending on your individual situation.

Use with caution in
- Elderly people
- Young adults
- History of suicidal behaviour or thoughts
- History of mania or hypomania
- People also receiving electroconvulsive therapy (ECT)
- Decreased kidney function
- Decreased liver function
- Diabetes
- Epilepsy
- History of bleeding disorders
- People taking medicine that affects blood clotting (eg anticoagulants such as warfarin)

Not to be used in
- Children and adolescents under 18 years of age for the treatment of depressive illness
- People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days
- Manic episodes of manic depression (bipolar affective disorder)
- Severely decreased liver function
- Uncontrolled epilepsy
- People taking the antipsychotic medicine pimozide

Lustral should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using Lustral and inform your doctor or pharmacist immediately.

Side effects
One can experience the following side effects during use of Lustral.
- Disturbances of the gut such as nausea, vomiting, diarrhoea or abdominal pain
- Indigestion (dyspepsia)
- Loss of appetite
- Shaking, usually of the hands (tremor)
- Dizziness
- Difficulty in sleeping (insomnia)
- Sleepiness (somnolence)
- Increased sweating
- Dry mouth
- Sexual problems
- Headache
- Anxiety and agitation
- Pins and needles (paraesthesia)
- Changes in blood pressure
- Seizures
- Loss of memory (amnesia)
- Liver disorders

Lustral side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with Lustral, please read the information provided with Lustral or consult your doctor or pharmacist.

Drugs interaction
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Lustral should not be taken at the same time as monoamine oxidase inhibitor medicines (MAOIs). These include monoamine oxidase inhibitor antidepressants such as phenelzine, tranylcypromine and moclobemide, the antibiotic linezolid and the anti-Parkinson's medicine selegiline. Lustral should not be started until at least at least a day after stopping moclobemide or linezolid, and at least two weeks after stopping other monoamine oxidase inhibitors. Similarly, treatment with any MAOIs should not be started until at least two weeks after stopping treatment with Lustral.
Lustral must not be taken with the antipsychotic medicine pimozide.
Lustral should not be taken in combination with benzodiazepines or other tranquilisers by people who need to drive or operate machinary.
There may be an increased risk of side effects if Lustral is taken with the following medicines, which also enhance the activity of serotonin in the brain:
- lithium
- triptans for migraine, eg sumatriptan
- tramadol
- tryptophan.

The herbal remedy St John's wort should not be taken with Lustral for the same reason.
Lustral may increase the blood levels of the following medicines:
- clozapine
- some tricyclic antidepressants (imipramine, desipramine, nortriptyline and possibly amitriptyline).

Lustral may increase the effect of anti-blood-clotting medicines (anticoagulants) such as warfarin, and this may increase the risk of bleeding. If you are taking an anticoagulant with this medicine, your blood clotting time should be regularly monitored.

As SSRIs have been associated with bleeding abnormalities, the following medicines, which are known to affect the ability of the blood to clot, should be used with caution with Lustral:
- tricyclic antidepressants
- some antipsychotic medicines
- some antisickness medicines, eg prochlorperazine
- aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- ticlopidine
- dipyridamole.
Treatment with Lustral may alter control of blood sugar in people with diabetes, who may need an adjustment in their dose of insulin or antidiabetic tablets. People with diabetes should discuss this with their doctor.

Disclaimer
Always read informational leaflet before using medicine! The information can be changed and completed!!

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