GENERIC NAME:

SERTRALINE - ORAL (SER-truh-leen)

BRAND NAME:

Zoloft

Why is Zoloft prescribed?

Zoloft is prescribed for major depression—a persistently low mood that interferes with everyday living. Symptoms may include loss of interest in your usual activities, disturbed sleep, change in appetite, constant fidgeting or lethargic movement, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide.

Zoloft is also used to treat the following:

Premenstrual dysphoric disorder (PMDD), a condition marked by a depressed mood, anxiety or tension, emotional instability, and anger or irritability in the two weeks preceding menstruation.

Obsessive-compulsive disorder (unwanted thoughts that won't go away and an irresistible urge to keep repeating certain actions, such as hand-washing or counting).

Panic disorder (unexpected attacks of overwhelming anxiety, accompanied by fear of their return).

Social anxiety disorder (extreme shyness in social situations that interferes with an individual's work and social life).

Post-traumatic stress disorder (re-experiencing a dangerous or life-threatening event through intrusive thoughts, flashbacks, and intense psychological distress).

Zoloft belongs to a class of drugs called selective serotonin re-uptake inhibitors (SSRIs). Serotonin is one of the chemical messengers believed to govern moods. Ordinarily, it is quickly reabsorbed after its release at the junctures between nerves. Re-uptake inhibitors such as Zoloft slow this process, thereby boosting the levels of serotonin available in the brain.

HOW TO USE:

Take this medication by mouth usually once daily with or without food; or as directed by your doctor. It is recommended that you take your dosage at the same time each day, either in the morning or in the evening. Use this medication regularly in order to get the most benefit from it. The dosage is based on your medical condition and response to therapy. It is important to continue taking this medication as prescribed even if you feel well. Do not stop taking this medication without consulting your doctor. It may take up to 4 weeks before the full benefit of this drug takes effect.

Most important fact about Zoloft

Do not take Zoloft within 2 weeks of taking any drug classified as an MAO inhibitor. Drugs in this category include the antidepressants Marplan, Nardil, and Parnate. When serotonin boosters such as Zoloft are combined with MAO inhibitors, serious and sometimes fatal reactions can occur. In addition, you should not combine Zoloft with the drug pimozide (Orap).

Possible food and drug interactions when taking Zoloft

 

Remember that Zoloft must never be combined with pimozide or an MAO inhibitor (see "Most important fact about this drug").

You should not drink alcoholic beverages while taking Zoloft. Use over-the-counter remedies with caution. Although none is known to interact with Zoloft, interactions remain a possibility.

If Zoloft is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Zoloft with the following:

Antidepressants that boost serotoninOther antidepressants, including tricyclicsCimetidineDiazepamDigitoxin FlecainideLithiumOver-the-counter drugs such as cold remediesPropafenoneSumatriptan TolbutamideWarfarin

If you are using the oral concentrate form of Zoloft, do not take disulfiram.

MISSED DOSE:

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

What other drugs will affect sertraline (Zoloft)?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with sertraline may cause you to bruise or bleed easily.

Before taking sertraline, tell your doctor if you are using any of the following medicines:

• tramadol (Ultram, Ultram ER, Ultracet);
• digitoxin (Crystodigin);
• phenytoin (Dilantin), valproate (Depacon, Depakene);
• lithium (Lithobid, Eskalith);
• a blood thinner such as warfarin (Coumadin);
• any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or paroxetine (Paxil);
• almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or
• heart rhythm medication such as flecainide (Tambocor), propafenone (Rhythmol), and others.

This list is not complete and there may be other drugs that can interact with sertraline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Special warnings about Zoloft

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior 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. Zoloft is only approved for treating obsessive-compulsive disorder in children 6 years and older.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Zoloft and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly—especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior—and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Use Zoloft cautiously and under close medical supervision if you have a history of kidney or liver disorders, heart disease, seizures, or bleeding problems. Your doctor may limit your dosage if you have one of these conditions.

Zoloft could cause weight loss in children. The manufacturer recommends regular monitoring of weight and growth during long-term treatment in children.

SSRI antidepressants could potentially cause stomach bleeding, especially when combined with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and ketoprofen. Consult your doctor before combining Zoloft with NSAIDs or blood-thinning medications.

Like all antidepressants, Zoloft could trigger a manic episode. Let the doctor know if you've ever had this problem.

Zoloft has not been found to impair the ability to drive or operate machinery. Nevertheless, the manufacturer recommends caution until you know how the drug affects you.

As with other SSRIs, Zoloft therapy should be slowly tapered instead of abruptly stopped. If abruptly discontinued, drowsiness, irritability, agitation, anxiety, headache, and insomnia may occur.

If you are sensitive to latex, use caution when handling the dropper provided with the oral concentrate