Brand Name: Zoloft
Generic Name: sertraline
Drug Class: Antidepressants, SSRIs
What is sertraline? What is its mechanism of action?
Sertraline belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). Other drugs in this class are:
- fluoxetine (Prozac, Sarafem)
- paroxetine (Brisdelle, Paxil, Paxil CR, Pexeva)
- citalopram (Celexa)
- fluvoxamine (Luvox CR)
Zoloft
What doses are available for sertraline?- Fluoxetine is available in capsules: 10, 20, and 40 mg.
- Capsules (delayed release): 90 mg.
- Tablets: 10, 20 and 60 mg.
- Oral suspension: 20 mg/5 ml
Fluoxetine should be stored at room temperature 15 C to 30 C (59 F to 86 F).
What is sertraline used for?
Sertraline is used for treating:
What are the side effects of sertraline?
Sertraline warning:
- As demonstrated in short-term studies, antidepressants increased the risk of suicidal thinking and behavior (suicidality) in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of sertraline or any other antidepressant in a child or adolescent must balance this risk with the clinical need for the antidepressant. Patients who are started on therapy should be closely observed for clinical worsening, suicidal thoughts, or unusual changes in behavior.
Sertraline side effects:
The most common side effects of sertraline are:
- Sleepiness
- Nervousness
- Insomnia
- Dizziness
- Nausea
- Tremor
- Skin rash
- Constipation
- Upset stomach
- Loss of appetite
- Headache
- Diarrhea
- Abnormal ejaculation
- Decreased interest in sexual activity
- Dry mouth
- Increase in sweating, known as diaphoresis
- Weight loss
Possible serious side effects of sertraline include:
- Irregular heartbeats
- Serious allergic reactions
- Worsening of depression
- Serotonin syndrome
- Hyponatremia
- Abnormal bleeding
- Priapism (prolonged erection)
- Decreased liver function
- Suicidality
- Activation of mania in patients with bipolar disorder
Important side effects are irregular heartbeats, allergic reactions, and activation of mania in patients with bipolar disorder.
If sertraline is discontinued abruptly, some patients experience side effects such as:
- Abdominal cramps
- Fatigue
- Nausea
- Vomiting
- Diarrhea
- Headaches
- Lightheadedness
- Dizziness
- Diminished appetite
- Flu-like symptoms
- Sweating
- Chills
- Sleep disturbances
- Memory impairment
A gradual dose reduction of sertraline is recommended when therapy is discontinued.
What is the dosage for sertraline?
- The recommended dose of sertraline is 25-200 mg once daily.
- Treatment of depression, OCD, panic disorder, PTSD, and social anxiety disorder is initiated at 25-50 mg once daily.
- Doses are increased at weekly intervals until the desired response is seen.
- The recommended dose for PMDD is 50-150 mg every day of the menstrual cycle or for 14 days before menstruation.
- Sertraline may be taken with or without food.
QUESTION
Depression is a(n) __________ . See AnswerWhich drugs or supplements interact with sertraline?
All SSRIs, including sertraline, should not be taken with any of the monoamine oxidase inhibitor (MAOI) class of antidepressants, for example
- isocarboxazid (Marplan),
- phenelzine (Nardil),
- tranylcypromine (Parnate),
- selegiline (Eldepryl, Emsam, Elazar), and
- procarbazine (Matulane).
Other drugs that inhibit monoamine oxidase include
- linezolid (Zyvox) and
- intravenous methylene blue.
Such combinations may lead to confusion, high blood pressure, tremor, hyperactivity, coma, and death. (A period of 14 days without treatment should lapse when switching between sertraline and MAOIs.) Similar reactions occur when sertraline is combined with other drugs, for example, tryptophan, St. John's wort, meperidine (Demerol, Meperitab), tramadol (ConZip, Synapryn FusePaq, Ultram) that increase serotonin in the brain.
Cimetidine (Cimetidine Acid Reducer, Tagamet HB ) may increase the levels in the blood of sertraline by reducing the elimination of sertraline by the liver. Increased levels of sertraline may lead to more side effects.
Sertraline increases the blood level of pimozide (Orap) by 40%. High levels of pimozide can affect electrical conduction in the heart and lead to sudden death. Therefore, patients should not receive treatment with both pimozide and sertraline.
Through unknown mechanisms, sertraline may increase the blood-thinning action of warfarin (Coumadin, Jantoven). The effect of warfarin should be monitored when sertraline is started or stopped.
Is sertraline safe to use during pregnancy or while breastfeeding?
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Summary
Sertraline(Zoloft) is a medication prescribed for the treatment of depression, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). Side effects include skin rash, constipation, upset stomach, loss of appetite, headache, diarrhea, abnormal ejaculation decreased interest in sexual activity, and dry mouth. Drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
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- Posttraumatic Stress Disorder (PTSD)
- Chronic Fatigue Syndrome
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- Teen Depression
- Huntington's Disease
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- Premenstrual Dysphoric Disorder
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- Generalized Anxiety Disorder
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- Separation Anxiety
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