Zoloft (sertraline) is an antidepressant that is used to treat a number of conditions, such as post-traumatic stress disorder (PTSD) and social anxiety disorder (SAD) . It is also used off-label to treat a variety of medical problems, from neuropathic pain to certain types of sexual dysfunction.
Zoloft is considered a safe drug, but it can cause side effects such as decreased appetite and tremors, and certain precautions should be taken before taking Zoloft.
Sertraline is the generic name for Zoloft. It is available as a tablet and an oral solution.
Zoloft is approved for use in adults 18 years of age and older for the treatment of a variety of behavioral and mood conditions. It is also approved for use in children over 6 years of age for the treatment of obsessive compulsive disorder (OCD) .
Zoloft is used to relieve symptoms but it does not cure any disease. It may take several weeks before Zoloft begins to have a noticeable therapeutic effect.
Conditions under which Zoloft is officially approved by the FDA:
Zoloft is a selective serotonin reuptake inhibitor (SSRI). Serotonin is a neurotransmitter that plays a role in the regulation of mood, pain, and other neurological and psychological functions. The reuptake of serotonin by nerve endings stops its action.
Zoloft prolongs the action of serotonin by preventing its reuptake by nerve endings .
Use not indicated on the label
Zoloft is often used off-label. As with its approved indications, when taken off-label, it generally needs to be taken every day for at least a few weeks before its full effect is seen.
Zoloft is prescribed for children not only for OCD, but also for depression. For adults, Zoloft is sometimes used off-label to prevent neuropathic pain and prevent migraines.
Sertraline, the generic form of Zoloft, has been investigated as a possible treatment for some of the cognitive symptoms associated with cerebrovascular disease. It has also shown some beneficial effects in treating certain symptoms of a traumatic brain injury .
Tell your doctor if you have had a bad reaction to an antidepressant. Although Zoloft is sometimes used in children, its only official FDA indication for this age group is in children with OCD aged six years or older.
This drug may cause side effects or withdrawal symptoms in a newborn if a pregnant mother uses it later in the pregnancy.
Precautions and contraindications.
You may be at high risk for side effects from taking Zoloft if you have certain conditions.
Use Zoloft with caution if you have:
- Liver problems : you may need less than the standard dose of Zoloft if you have liver dysfunction.
- Bipolar disorder : Zoloft can cause mania. Before taking Zoloft, your doctor + may monitor you for signs of bipolar disorder or alert you to signs of mania and hypomania.
- Epilepsy : Zoloft can increase your risk of seizures if you are predisposed to seizures.
- Angle-closure glaucoma : Zoloft can make this condition worse, especially if it is not treated. If you are at risk, you may need to have a glaucoma test.
Other SSRIs include Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram), Luvox (fluvoxamine), and Lexapro (escitalopram). Other types of antidepressants include tricyclic antidepressants like elavil (amitriptyline) and monoamine oxidase inhibitors (MAOIs) like eldepril (selegiline).
Zoloft is available in 25, 50 and 100 mg tablets. The oral solution has a concentration of 20 mg per milliliter. The dosage of Zoloft is different for each condition it is used to treat.
|The manufacturer’s recommended dose of Zoloft|
|State||Initial dose||Maximum recommended dose|
|Depression||50 mg per day||200 mg per day|
|OCD (over 13 years old)||50 mg per day||200 mg per day|
|OCD (6 to 12 years old)||25 mg per day||200 mg per day|
|Panic disorder||25 mg per day||200 mg per day|
|Post-traumatic stress disorder||25 mg per day||200 mg per day|
|Social anxiety disorder||25 mg per day||200 mg per day|
|Premenstrual dysphoric disorder||50 mg per day||150 mg per day|
Your healthcare provider may prescribe a different dose for you. After starting Zoloft, your healthcare provider will usually gradually increase your dose until your symptoms are optimally resolved or side effects appear.
How to take and store
Make sure you take Zoloft at the same time every day. If you miss an appointment, you can get it back in a few hours. However, if you miss a dose and it is almost time for the next one, just take the regularly scheduled dose, do not take both at the same time.
Zoloft tablets can be taken with or without food.
The oral solution must be diluted before use, but should not be prepared in advance. To prepare Zoloft oral solution:
- Use the supplied pipette.
- Mix the required amount of Zoloft with 4 ounces (1/2 cup) of water, ginger ale, lemon-lime soda, lemonade, or orange juice.
Do not mix Zoloft Oral Solution with anything other than these liquids.
Zoloft tablets and oral solution should be stored between 68 degrees Fahrenheit (F) and 77 F.
Zoloft is generally considered a safe drug, but it can cause side effects. Most side effects are mild and can improve over time or with a modified schedule, but serious side effects can also occur.
If you experience side effects, you should speak to your doctor. You and your doctor can weigh the benefits of taking Zoloft against the side effects to decide whether to continue taking it.
The most common side effects that result from taking Zoloft are:
- Diarrhea / loose stools
- Tremors or spasms
- Decreased appetite or weight loss.
- Hyperhidrosis (increased sweating)
- Ejaculation / orgasm problems
- Decreased libido
- Muscle pain
Some life-threatening side effects can result from taking Zoloft. If you develop serious side effects, you should seek immediate medical attention.
Serious side effects of Zoloft include:
- Serotonin Syndrome – Diarrhea, confusion, seizures, palpitations can occur due to excess serotonin in the body.
- Suicidal thoughts
- Changes in heart rate
- Behavior changes
- Hepatic injury
Zoloft can cause an increase in suicidal thoughts, especially in young people. You should seek immediate medical attention if you begin to have thoughts of harming yourself.
Warnings and interactions
If you plan to stop taking Zoloft, it is important to discuss the schedule with your healthcare provider.
If you stop smoking abruptly, you can develop withdrawal effects, including confusion, dizziness, disturbed dreams, nausea, and agitation.
Zoloft interacts with some prescription drugs. Your healthcare professional or pharmacist can tell you if any of the medicines you are taking interact with Zoloft.
Zoloft drug interactions include:
- Antidepressants : Taking Zoloft with other SSRIs, MAOIs, or tricyclic antidepressants may increase the likelihood of serotonin syndrome.
- Blood thinners : taking Zoloft with blood thinners may increase the risk of bleeding.
- Pimozide : Zoloft increases the concentration of pimozide (an antipsychotic) and can cause arrhythmias (irregular heart rhythm) as a result of this interaction.
- Phenytoin : Zoloft can increase the concentration of phenytoin, an anticonvulsant.
- Disulfiram : The combination of disulfiram and Zoloft oral solution containing alcohol can cause serious reactions.