Each type of antidepressant affects these neurotransmitters in slightly different ways. The first antidepressant you try may work fine. The prescribing information also states that you should avoid alcohol while taking sertraline. Check with a healthcare provider before combining Saint John’s wort and sertraline. Check with your healthcare provider before taking an NSAID if you take sertraline. Lithium is a mood stabilizer used to treat bipolar disorder.
Sertraline
This warning is based on statistical analyses conducted by two independent groups of FDA experts that found a 100% increase of suicidal thoughts and behavior in children and adolescents, and a 50% increase in the 18–24 age group. More severe cases are often successfully treated by temporary reintroduction of the drug with a slower tapering-off rate. It typically occurs within a few days from drug discontinuation and lasts a few weeks. Sertraline has a low level of exposure of an infant through the breast milk and is recommended as the preferred option for the antidepressant therapy of breast-feeding mothers. The large weight gain was observed only among female members of the sertraline group; the significance of this finding is unclear because of the small size of the group.
Of the sertraline group, 4.5% gained a large amount of weight (defined as more than 7% gain). The incidence of diarrhea is higher with sertraline – especially when prescribed at higher doses – in comparison with other SSRIs. Those that most often result in interruption of the treatment are nausea, diarrhea, and insomnia. Due to the slower elimination of sertraline in these groups, their exposure to sertraline may be as high as three times the average exposure for the same dose. Sertraline, when taken daily, can be useful for the treatment of premature ejaculation.
- The authors of the study argued that the improvement achieved with sertraline is different and of a better quality than the improvement achieved with a placebo.
- Somewhat contrary to the above suggestions, a meta-analysis of sertraline clinical trials for PTSD found it to be statistically superior to placebo in the reduction of PTSD symptoms but the effect size was small.
- Fatigue, insomnia, and nausea are common, but usually go away on their own
- Double-blind comparative studies found sertraline to have the same effect on panic disorder as paroxetine or imipramine.
- Over more than six months of sertraline therapy for depression, people showed no significant weight increase.
- Discuss the benefits and risks with your child’s doctor before making a decision.
Common Zoloft Side Effects
During the discussion, Paul Leber, the director of the FDA Division of Neuropharmacological Drug Products, noted that granting approval was a “tough decision”, since the treatment effect on outpatients with depression had been “modest to minimal”. The FDA committee achieved a consensus that sertraline was safe and effective for the treatment of major depression. Desmethylsertraline, while pharmacologically active, is substantially (50-fold) weaker than sertraline as a serotonin reuptake inhibitor and its influence on the clinical effects of sertraline is thought to be negligible.
Other anxiety disorders
The first changes you might notice include improvements in appetite, sleep, and energy levels. In many cases, you may begin to notice a change in your symptoms after about two weeks and greater improvement after about four to six weeks. Like all medications in its class, Zoloft does not perform optimally until you have taken it consistently for several weeks.
There are differences between sertraline and some other antidepressants in their efficacy in the treatment of different subtypes of depression and in their adverse effects. Zoloft can also interact with other medications and substances that increase serotonin levels, including other antidepressants. Some other psychiatric medications, painkillers, antibiotics, supplements, and drugs such as amphetamines, cocaine, and LSD can also increase serotonin. Clinical reports indicate that interaction between sertraline and the MAOIs isocarboxazid and tranylcypromine may cause serotonin syndrome.
Taking multiple antidepressants, especially SSRIs like sertraline, can increase serotonin levels and the risk of serotonin syndrome. Dextromethorphan—a common cough suppressant for colds and flu—can raise serotonin levels and increase the risk of serotonin syndrome when taken with sertraline. Combining opioid pain medications with sertraline can increase the risk of serotonin syndrome. The combination of a triptan with sertraline can increase the risk of serotonin syndrome, especially after starting sertraline or with a dose increase.
Alcohol
According to the prescribing information, people who take sertraline should avoid drinking alcohol. Triptans are a class of drugs used to treat migraine. Taken together, then, the risk of bleeding, including gastrointestinal bleeding, could increase. Sertraline can increase the risk of bleeding, as can NSAIDs.
Zoloft is a medication sometimes prescribed to treat depression, anxiety, and other conditions. Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. Food and Drug Administration (FDA) requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions.
- In 2005, the FDA added a boxed warning concerning pediatric suicidal behavior to all antidepressants, including sertraline.
- Work functioning and physical symptoms, such as swelling, bloating, and breast tenderness, were less responsive to sertraline.
- Both liquid and tablet forms of the medication are available.
- Dilantin, a common brand of phenytoin, is a prescription drug used to prevent certain types of seizures.
- The most potent and selective (+)-isomera was taken into further development and eventually named sertraline.
When to Avoid Sertaline Completely
If you are currently breastfeeding or pregnant, or if you plan to become pregnant, discuss the risks and benefits of treatment with your physician. Your risks from Zoloft may be higher if you have certain medical conditions, including diabetes, low blood sodium levels, seizures, and liver disease. Wait zoloft and pepcid at least 14 days after your last dose of any MAOI before beginning sertraline treatment. Your doctor may start you at a lower dose and gradually increase the amount you take to achieve the desired effects. However, some people have the opposite effect and experience increased energy and sleeping problems.
Antidepressants and risk of suicide
It works by preventing the reabsorption of serotonin (the “feel good” neurotransmitter) so more is available in the system. For example, in some cases, Zoloft may trigger or exacerbate psychiatric symptoms. If you’re experiencing weight gain, don’t stop taking the drug on your own.
Some of its common side effects include fatigue, nausea, sleep issues, and sexual problems. When mothers take sertraline during pregnancy, there is research evidence that the newborn may experience sertraline withdrawal symptoms. However, sertraline can still be used in the UK for the treatment of OCD in children and adolescents. The group had to overcome initial bureaucratic reluctance to pursue sertraline development, as Pfizer was considering licensing an antidepressant candidate from another company.
Taking this supplement with sertraline can increase the risk of serotonin syndrome. Taking lithium with sertraline may increase the risk of serotonin syndrome. Zoloft (sertraline) is an antidepressant used to treat depression and anxiety and one of the most prescribed psychiatric drugs in the U.S. Sertraline used for the treatment of depression in elderly (older than 60) patients is superior to placebo and comparable to another SSRI fluoxetine, and tricyclic antidepressants (TCAs) amitriptyline, nortriptyline and imipramine.
Sertraline may be more efficacious for the treatment of depression in the acute phase (first four weeks) than fluoxetine. Comparative clinical trials demonstrated that sertraline is similar in efficacy against depression to moclobemide, nefazodone, escitalopram, bupropion, citalopram, fluvoxamine, paroxetine, venlafaxine, and mirtazapine. However, it failed to find significant effects on depression in either the mildly or severely depressed, and the clinical relevance and accuracy of the positive effects found have been questioned. A major study of sertraline in a broad primary care population found improvements in general mental health, quality of life, and anxiety. However, as with other antidepressants, the nature and clinical significance of this effect remain disputed.
This interaction also applies to a chemically similar drug called Cerebyx (fosphenytoin). It is known as a narrow therapeutic index (NTI) drug, which means that there is a small window between the drug’s effectiveness and potential toxicity. If you’re on sertraline, avoid these products and consult your healthcare provider for safer alternatives.
Antidepressants: Selecting one that’s right for you
Concomitant intake of sertraline with food slightly increases sertraline peak levels and total exposure. The mood improvement resulting from the treatment with sertraline sometimes counteracted these side effects, so that sexual desire and overall satisfaction with sex stayed the same as before the sertraline treatment. While nefazodone and bupropion do not have negative effects on sexual functioning, 67% of men on sertraline experienced ejaculation difficulties versus 18% before the treatment. Abrupt interruption of sertraline treatment may result in withdrawal or discontinuation syndrome. In children and adolescents taking sertraline for six weeks for anxiety disorders, 18 out of 20 measures of memory, attention, and alertness stayed unchanged.
Similarly, the analysis conducted by the UK MHRA found a 50% increase of odds of suicide-related events, not reaching statistical significance, in the patients on sertraline as compared to the ones on placebo. Over more than six months of sertraline therapy for depression, people showed no significant weight increase. Sertraline has not been approved for the treatment of generalized anxiety disorder; however, several guidelines recommend it as a first-line medication referring to good quality controlled clinical trials. With depression in dementia, there is no benefit of sertraline treatment compared to either placebo or mirtazapine.