Brands Names: Zoloft
Price Range: $0.37 – $0.68
Dosage: 100mg / 50mg / 25mg
Zoloft is a medication prescribed to treat anxiety-related disorders. This includes depression, social phobia, post-traumatic stress disorder, and panic and obsessive-compulsive disorders. Zoloft use in these settings is intended to decrease symptoms associated with these conditions. This pharmacotherapy is classified as an antidepressant belonging to the family of serotonin reuptake inhibitors.
Zoloft is used to treat the following:
- depressive states and to prevent depression recurrence in individuals who have had depressive episodes
- obsessive-compulsive disorder in adults as well as children over 6
- panic attacks
- certain manifestations of anxiety (e.g., social phobia, post-traumatic stress disorder, etc.)
Zoloft is marketed in capsule form in 25 or 50 mg strength and is administered orally. The active ingredients in Zoloft are Sertraline and Sertraline hydrochloride. Common additives contained within Zoloft capsules include Corn Starch, Gelatin, Anhydrous Lactose, Magnesium Stearate, Sodium Lauryl Sulfate, and Titanium Dioxide.
Zoloft should not be used in combination with MAOIs or drugs containing pimozide. Use of antidepressants is not recommended for individuals younger than 18 years of age. Studies have shown that use of an antidepressant medication can increase the risk of suicide in adolescents with depression. In children and adolescents under 18 years of age, this treatment is reserved for certain serious cases and requires special medical supervision.
All antidepressant treatments are likely to induce a manic episode in predisposed individuals. In cases where there is the feeling of euphoria and/or unusual excitement or abnormal behavior occurring during treatment, it is important to immediately seek medical attention. When taking Zoloft, extra precautions should be taken in cases of epilepsy, predisposition to hemorrhages, situations favoring torsades de pointes, liver failure, angle-closure glaucoma, and/or diabetes. Although it has been suggested, there are no clear interactions that have been recognized involving Zoloft and alcohol consumption. Nevertheless, it is recommended to avoid alcohol consumption while taking Zoloft or any other psychotropic medication.
Zoloft is not recommended when taking other medications such as:
- MAOIs (e.g., selegiline, moclobemide, linezolid)
- medicines containing pimozide (increases the risk of torsades de pointes)
Zoloft use may interact with enzyme-inducing drugs containing any of the following: carbamazepine, dabrafenib, efavirenz, enzalutamide, fosphenytoin, nevirapine, oxcarbazepine, phenobarbital, phenytoin, primidone, rifabutin, and/or rifampicin. Zoloft in combination with an anti-migraine drug of the triptan family, a drug containing lithium, fentanyl, and/or tramadol increases the risk of developing serotonin syndrome. The prescribing doctor should be immediately informed prior to using Zoloft if you take oral anticoagulants, aspirin, NSAIDs, imipramine antidepressants, neuroleptics, antiarrhythmics (propafenone, flecainide), diuretics, and/or orlistat-containing medicines. Lastly, adverse effects of Zoloft can be increased by grapefruit absorption. Therefore, it is important to avoid the consumption of grapefruit (fruit or juice) during treatment with Zoloft.
Fertility, pregnancy, and lactation
Antidepressants should only be used during pregnancy if they are absolutely necessary. Instead, non-pharmacological treatment (psychotherapy) should be utilized. However, in certain instances it is allowable to use sertraline in pregnant women. Respiratory failure, feeding difficulties, or agitation can sometimes occur in the first days of life in newborns of mothers who were taking Zoloft while pregnant.
Zoloft demonstrates a modest ability to pass into breast milk. Nevertheless, there is no established effect of Zoloft on breastfeeding infants. Therefore, when necessary, the use of sertraline is allowable during breastfeeding.
Instructions for use and dosage
Zoloft capsules should be swallowed with a large glass of water preferably with a meal in the evening or morning.
Adults over 18 years of age:
- The initial dose is 50 mg daily for individuals in a depressive state and/or demonstrating a obsessive-compulsive disorder. However, this dose can be increased if needed up to 200 mg per day
- For those demonstrating panic attacks and/or social phobia, the initial recommended dose is 25 mg per day. However, this dose can be increased if needed up to 200 mg per day.
Child from 6 to 17 years of age:
- For individuals demonstrating a obsessive-compulsive disorder the recommended starting dose is 25 mg daily for children 6 to 12 years of age, whereas 50 mg daily for children 13 to 17 years of age. Dosages can be increased if necessary up to 200 mg per day.
The effect of antidepressants is not usually immediately felt. A delay of up to several weeks is sometimes necessary for the beneficial effects to be experienced. Possible undesirable effects appearing at the beginning of a course of treatment should not lead to premature cessation of therapy.
For an individual suffering from depression, anxiety may be present at the beginning of treatment. Therefore, an anxiolytic may be temporarily prescribed in order to prevent or treat these secondary manifestations.
When symptoms of depression have subsided, treatment must be continued for the prescribed duration to maintain the therapeutic effect. Premature cessation of therapy may lead to a relapse in symptoms. The duration of antidepressant treatment is rarely less than six months.
Disorders, sometimes of severe intensity, can appear when stopping antidepressant treatment. This may include anxiety, guilt, nightmares, vertigo, and/or tremors. It is recommended when deciding to stop treatment to do so gradually by reducing dosages incrementally to avoid adverse effects, which are known to occur in cases where antidepressants are suddenly stopped.
Potential side effects
Adverse events mainly occur during the first few weeks of treatment and usually subside thereafter.
In most cases (1 of 10 patients) where side effects are experienced, individuals experience drowsiness or insomnia, headaches, dizziness, tiredness, diarrhea, nausea, dry mouth, and/or ejaculation disorders.
Also frequently occurring side effects may be depression, nightmares, anxiety, agitation, nervousness, unwanted teeth grinding, tremors, tingling, muscle pain, lack of attention, abnormal taste, vomiting, constipation, abdominal pain, flatulence, yawning, ringing of ears, visual disturbances, rash, excessive sweating, hair loss, increased or loss of appetite, palpitations, decreased libido, and/or erectile dysfunction.
Less commonly occurring side effects may include hallucinations, euphoria, abnormal thoughts, aggression, mental disorders, suicidal ideation, somnambulism, cramps, joint pain, involuntary movements, difficulty urinating or urinary incontinence, dilation of the pupil, convulsions, tachycardia, hypertension, milk discharge through the nipple, irregular menstruation, allergic reaction, low blood sodium levels, and/or elevated transaminases .
Antidepressants that inhibit the reuptake of serotonin may also cause:
- unpleasant agitation and an irrepressible need to move (e.g., unable to sit or stand quietly)
- bleeding such as bruising, nosebleeds, and/or genital or digestive hemorrhages
- rare cases of serotonin syndrome whose main manifestations are tremors, confusion, agitation, exaggerated reflexes, muscular rigidity, vertigo, unexplained fever, and/or sweating.
The appearance of these symptoms requires immediate medical advice.