What is Zoloft (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)
Is Zoloft available in generic form?
What doses are available for Zoloft?
- Fluoxetine is available as capsules: 10, 20 and 40 mg.
- Capsules (delayed release): 90 mg. Tablets: 10, 20 and 60 mg.
- Oral suspension: 20 mg/5ml
How should Zoloft be stored?
Fluoxetine should be stored at room temperature 15 C to 30 C (59 F to 86 F).
What is Zoloft used for?
Zoloft is used for treating:
- obsessive-compulsive disorder (OCD),
- panic disorder,
- post-traumatic stress disorder (PTSD).
- social anxiety disorder, and
- premenstrual dysphoric disorder (PMDD).
What are the side effects of Zoloft?
ZOLOFT SIDE EFFECTS 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 Zoloft 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.
Zoloft side effects:
The most common side effects of Zoloft are:
- Skin rash
- Upset stomach
- Loss of appetite
- Abnormal ejaculation
- Decreased interest in sexual activity
- Dry mouth
- Increase in sweating, known as diaphoresis
- Weight loss
Possible serious side effects of Zoloft include:
- Irregular heartbeats
- Serious allergic reactions
- Worsening of depression
- Serotonin syndrome
- Abnormal bleeding
- Priapism (prolonged erection)
- Decreased liver function
- 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 Zoloft is discontinued abruptly, some patients experience side effects such as:
- Abdominal cramps
- Diminished appetite
- Flu-like symptoms
- Sleep disturbances
- Memory impairment
A gradual dose reduction of Zoloft is recommended when therapy is discontinued.
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What is the dosage for Zoloft?
- 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.
Depression is a(n) __________ .
Which drugs or supplements interact with Zoloft?
All SSRIs, including Zoloft, 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 Zoloft and MAOIs.) Similar reactions occur when Zoloft 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 blood of Zoloft by reducing the elimination of Zoloft by the liver. Increased levels of Zoloft may lead to more side effects.
Zoloft 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 Zoloft.
Through unknown mechanisms, Zoloft may increase the blood thinning action of warfarin (Coumadin, Jantoven). The effect of warfarin should be monitored when Zoloft is started or stopped.