Generic name: sertraline (SER tra leen)
Brand name: Zoloft
Drug class: Selective serotonin reuptake inhibitors
Zoloft (sertraline) is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms.
Zoloft is used to treat major depressive disorder, (obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD).
Zoloft is also used to treat premenstrual dysphoric disorder (PMDD).
Warnings
You should not use Zoloft if you also take pimozide, or if you are being treated with methylene blue injection.
Do not use Zoloft if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Before taking this medicine
You should not use Zoloft if you are allergic to sertraline, or if you also take pimozide. Do not use Zoloft oral solution if you take disulfiram (Antabuse).
Do not use Zoloft within 14 days before or 14 days after using an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.
Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with sertraline could cause a serious condition called serotonin syndrome.
To make sure Zoloft is safe for you, tell your doctor if you have ever had:
- bipolar disorder (manic depression);
- heart disease, high blood pressure, or a stroke;
- liver or kidney disease;
- seizures;
- glaucoma;
- bleeding problems, or if you take warfarin (Coumadin, Jantoven);
- long QT syndrome; or
- low levels of sodium in your blood.
Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Zoloft is approved for use in children at least 6 years old, only to treat obsessive-compulsive disorder but not depression.
Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop Zoloft without asking your doctor.
Ask a doctor if it is safe to breastfeed while using Zoloft .
How should I take Zoloft?
Take Zoloft exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Take Zoloft with or without food, at the same time each day.
Zoloft liquid (oral concentrate) must be diluted with a liquid right before you take it. Read and carefully follow all mixing instructions provided with your medicine. Ask your doctor or pharmacist if you need help.
Measure the mixed medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon).
Sertraline may cause false results on a drug-screening urine test. Tell the laboratory staff that you use Zoloft.
Do not stop using Zoloft suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine.
Store tightly closed at room temperature, away from moisture and heat.
Dosing information
Usual Adult Dose for Depression:
Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day.
Usual Adult Dose for Obsessive Compulsive Disorder:
Initial dose: 50 mg orally once a day
Maintenance Dose: 50 to 200 mg orally once a day.
Usual Adult Dose for Panic Disorder:
Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day.
Usual Adult Dose for Post Traumatic Stress Disorder:
Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day.
Usual Adult Dose for Social Anxiety Disorder:
Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day
Maintenance dose: 50 to 200 mg orally once a day.
Comments:
-Dose adjustments may be made at intervals of at least one week.
-These conditions generally required several months or longer of sustained pharmacological therapy beyond initial treatment.
Usual Adult Dose for Premenstrual Dysphoric Disorder:
Continuous regimen:
-Initial dose: 50 mg orally once a day during the menstrual cycle
-Maintenance dose: 50 to 150 mg orally once a day during the menstrual cycle
Cyclic regimen:
-Initial dose: 50 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle
-Maintenance dose: 50 to 100 mg orally once a day.
Comments:
-The dose may be increased in increments of 50 mg per menstrual cycle, increased at the onset of each new cycle; dosage adjustments may also include changes between regimens.
-If a 100 mg once daily dose has been established with the cyclic regimen, a titration step of 50 mg per day for three days should be used at the beginning of each dosing period (luteal phase of the menstrual cycle).
-The effectiveness of Zoloft for longer than three months has not been systematically evaluated in controlled trials.
Usual Pediatric Dose for Obsessive Compulsive Disorder:
6 to 12 years:
-Initial dose: 25 mg orally once a day
-Maintenance dose: 25 to 200 mg orally once a day
13 to 17 years:
-Initial dose: 50 mg orally once a day
-Maintenance dose: 50 to 200 mg orally once a day.
Comments:
-The dose may be increased at intervals of at least one week.
-The potential risks versus clinical need should be assessed prior to using this drug in children and adolescents.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while taking Zoloft?
Drinking alcohol with this medicine can cause side effects.
Avoid driving or hazardous activity until you know how Zoloft will affect you. Your reactions could be impaired.
Zoloft side effects
Get emergency medical help if you have signs of an allergic reaction to Zoloft: skin rash or hives (with or without fever or joint pain); difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.
Call your doctor at once if you have:
- a seizure;
- vision changes, eye pain, redness, or swelling;
- low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or
- manic episodes - racing thoughts, increased energy, unusual risk-taking behavior, extreme happiness, being irritable or talkative.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Sertraline can affect growth in children. Your child's height and weight may be checked often.
Common Zoloft side effects may include:
- indigestion, nausea, diarrhea, loss of appetite;
- sweating;
- tremors; or
- sexual problems.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Zoloft?
Zoloft can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.
Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with Zoloft may cause you to bruise or bleed easily.
Other drugs may interact with sertraline, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.