Sertraline Hydrochloride (Zoloft)

• Type of Drug: Selective serotonin reuptake inhibitor (SSRI) antidepressant.
• Prescribed for: Depression. Sertraline has also been prescribed for obsessive-compulsive disorder.

Sertraline Hydrochloride (Zoloft) General Information

Sertraline Hydrochloride and the other SSRIs (Fluvoxamine, Paroxetine, and Fluoxetine) are chemically unrelated to the older tricyclic and tetracyclic antidepressant medicines. They work by preventing the movement of a neurohormone, serotonin, into nerve endings. This forces the serotonin to remain in the spaces surrounding nerve endings, where it works. Sertraline is effective in treating common symptoms of depression. It can help improve your mood and mental alertness, increase physical activity, and improve sleep patterns. The drug takes about 4 weeks to work and stays in the body for several weeks, even after you stop taking it. This may be important when your doctor starts or stops treatment.

Sertraline Hydrochloride can cause a small (1-2 pounds) weight loss in people taking the drug, but significant weight loss is uncommon with this drug.

Sertraline Hydrochloride (Zoloft) Cautions and Warnings

Do not take Sertraline Hydrochloride if you are allergic to it. Allergies to other antidepressants should not prevent you from taking Sertraline Hydrochloride because the drug is chemically different from other antidepressants.

A 2-week drug-free period should be allowed between the use of Sertraline and the use of a monoamine oxidase (MAO) inhibitor antidepressant.

Sertraline is broken down by your liver; therefore, people with severe liver disease should be cautious about taking this drug and should be treated with doses that are lower than normal.

People with reduced kidney function should take this drug with caution.

Studies in animals receiving doses 10-20 times the maximum human dose revealed an increase in certain liver tumors and reduced fertility. The significance of this information to humans is not known.

A small number of manic or hypomanic patients may experience an activation of their condition while taking Sertraline.

Sertraline should be given with caution to patients who suffer from seizure disorders.

Sertraline causes a reduction of blood level of uric acid but has not caused kidney failure.

The possibility of suicide exists in severely depressed patients and may be present until the condition is significantly improved. Depressed patients should be allowed to carry only small quantities of Sertraline with them to reduce the chances of overdose.

Sertraline Hydrochloride (Zoloft) Possible Side Effects

• Most common: dry mouth, sweating, heart palpitations, chest pain, headache, dizziness, tremors, tingling or numbness in the hands or feet, twitching, muscle spasms, confusion, rash, nausea, diarrhea or loose stools, constipation, upset stomach, stomach gas, appetite changes, abdominal pains, muscle aches, sleeplessness or sleepiness, male (15 percent) or female (1.7 percent) sexual dysfunction, agitation, nervousness, anxiety, yawning, loss of concentration, menstrual disorders, sore throat, runny nose, vision changes, ringing or buzzing in the ears, urinary frequency or disorders, fatigue, hot flushes, fever, back pain, thirst, and weakness.
• Less common: flushing, pinpoint pupils, increased saliva, cold and clammy skin, dizziness when rising quickly from a sitting or standing position, blood pressure changes, swelling around the eyes and in the arms or legs, coldness in the hands or feet, fainting and dizziness, rapid heartbeat weakness, loss of coordination, unusual walk, changes in the general level of activity, migraines, droopy eyelids, acne, hair loss, dry skin, difficulty swallowing, stomach gas, joint pains, muscle pains, cramps and weakness, aggressiveness, abnormal dreaming or thinking, memory loss, apathy, delusions, a feeling of detachment, worsened depression, emotional instability, a “high” feeling, hallucinations, neurosis, paranoia, suicide attempts, teeth grinding, menstrual cramps or pain, bleeding between periods, coughing, bronchospasm, nosebleeds, breathing difficulty, conjunctivitis, double vision, difficulty accommodating to bright lights, eye pain, earaches, painful urination, facial swelling, frequent urination, nighttime urination, loss of urinary control, generalized swelling, a feeling of ill health, weight changes, and lymph swelling.
• Other: many other side effects affecting virtually every body system have been reported by people taking this medicine. They are too numerous to mention here but are considered infrequent or rare and affect only a small number of people. Be sure to report anything unusual to your doctor at once.

Sertraline Hydrochloride (Zoloft) Drug Interactions

Sertraline Hydrochloride may prolong the effects of Diazepam and other benzodiazepine-type drugs in your body.

• Serious, sometimes fatal reactions may occur if Sertraline and an MAO inhibitor are taken together (see Cautions and Warnings).
• People taking the oral anticoagulant (blood-thinning) agent Warfarin may experience an increase in that drug’s effect if they start taking Sertraline Hydrochloride. Your doctor will have to reevaluate your Warfarin dosage.
• Sertraline may affect blood levels of Lithium in patients taking both drugs together.
• Sertraline may decrease the rate at which Tolbutamide (for diabetes) is released from your body.
• Alcohol may increase tiredness and other nervous-system- depressant effects of sertraline.

Food Interactions

Food increases the rate at which Sertraline Hydrochloride is absorbed into the blood and may slightly increase the amount of drug absorbed. For consistent blood levels of this drug, it should be taken on an empty stomach or at least 1 hour before or 2 hours after meals.

Sertraline Hydrochloride (Zoloft) Usual Dose

50 to 200 mg once a day in the morning or at night. Seniors, people with kidney or liver disease, and those taking several different medicines should remain at the lowest possible dosage for their condition.

Overdosage

In the 3 cases of Sertraline Hydrochloride overdose reported, all recovered completely without special treatment. Symptoms of overdose are likely to be the most frequent drug side effects. There is no specific antidote for Sertraline Hydrochloride overdose.

Any person suspected of having taken a Sertraline Hydrochloride overdose should be taken to a hospital emergency room for treatment at once, or you may call your local poison control center for information and directions. If you go to an emergency room, ALWAYS take the medicine bottle with you.

Sertraline Hydrochloride (Zoloft) Special Information

Sertraline Hydrochloride can make you dizzy or drowsy. Take care when driving or doing other tasks that require alertness and concentration.

Do not drink alcoholic beverages if you are taking Sertraline Hydrochloride.

Be sure your doctor knows if you are pregnant, breastfeeding, or taking other prescription or nonprescription medications while taking Sertraline Hydrochloride. Notify your doctor of any unexpected drug effects.

If you forget a dose of Sertraline Hydrochloride, take it as soon as you remember. If it is almost time for your next dose, skip the forgotten dose and continue with your regular schedule. Do not take a double dose of Sertraline Hydrochloride.

Sertraline Hydrochloride (Zoloft) Special Populations

Pregnancy/Breast-feeding
Animal studies using 2 ½ to 10 times the maximum human dose of Sertraline Hydrochloride have shown some effect on a developing fetus. Do not take this drug if you are, or might become, pregnant without first seeing your doctor and reviewing the benefits of therapy against the risk of taking Sertraline Hydrochloride.
It is not known if Sertraline passes into breast milk. Nursing mothers should use caution if they must take this medicine.

Seniors
Older adults tend to clear this drug more slowly from their bodies, but side-effect patterns are unaffected. Any person with liver or kidney disease, problems that are more common among seniors, should receive a lower dose. Be sure to report any unusual side effects to your doctor.