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What
is Zoloft?
Zoloft (sertraline hydrochloride) is one of the antidepressant
medications known as SSRIs (selective serotonin reuptake inhibitors).
Like other medications in this class (such as Prozac and Paxil),
Zoloft relieves symptoms of depression without the side effects
that many people experience with the older tricyclic antidepressants
and MAO inhibitors.
What
condition does Zoloft treat?
Zoloft is used to treat symptoms of major depressive illness,
bipolar disorder, panic disorder, obsessive-compulsive disorder
(OCD), post-traumatic stress disorder (PTSD), and premenstrual
dysphoric disorder (PMDD). Major depression is a serious medical
illness causing mood and physiological changes that significantly
interfere with a person's daily functioning. A persistent
sad or empty mood accompanies changes in appetite, sleep,
and activity level; loss of interest in usual activities,
decrease in sexual desire, difficulty concentrating and remembering,
slowed thinking and movement, feelings of hopelessness, worthlessness
and guilt; and sometimes suicidal thoughts and actions. Usually
several of these symptoms must be present for at least two
weeks for a diagnosis of depression to be made. Zoloft has
also been shown effective in relieving anxiety, insomnia,
and psychomotor agitation that sometimes accompany depression.
How
does Zoloft work?
Depressive and anxiety symptoms are the result of a biochemical
imbalance in the brain, a disturbance in the brain's chemical
messengers called neurotransmitters. Zoloft acts on the neurotransmitter
serotonin, allowing electrical messages to be processed more
smoothly and efficiently. This helps relieve symptoms of depression.
How
does Zoloft compare with other medications for depression
and anxiety?
Like other medications in its class, Zoloft relieves depressive
and anxiety symptoms while producing fewer side effects than
other classes of antidepressant medication. Usually the side
effects that are experienced are mild and easily managed.
However, people are all different, and some people may have
more favorable results with one medication than another. Zoloft
has a slightly different side effect profile that may make
it more appropriate for some people than other antidepressants.
There is no way
of knowing in advance which psychiatric medication will be
most effective for a given person. Unfortunately, a certain
amount of trial and error is involved in finding the right
medication and the right dose. It is important for a person
to be in close communication with his/her doctor when taking
Zoloft or any other psychiatric medication, and to discuss
symptoms and side effects openly and honestly.
What
is the usual dose of Zoloft?
A standard dose of Zoloft is 50 to 200 mg per day. It is taken
once a day, either in the morning or evening, and may be taken
with or without food.
How
long until it starts working?
Although some symptoms may improve within a matter of days,
it is important to allow four to six or even eight weeks for
the medication to be fully effective. If no improvement is
seen in two to four weeks, another medication can be tried.
What
are the side effects?
The most common side effects of Zoloft include nausea, diarrhea
or loose stools, tremor, insomnia, drowsiness, and dry mouth.
These are usually mild; only a small number of patients have
discontinued treatment because of side effects. Other potential
side effects include increased sweating and sexual problems
(delayed ejaculation/orgasm). Although older antidepressants
often cause weight gain, 1-2 pound weight loss has been noticed
in some people. Zoloft does not seem to cause dizziness upon
standing up, and has few cardiac effects. Patients with epilepsy,
liver, and kidney dysfunction should use Zoloft with caution.
Women should notify their doctor if they become pregnant,
intend to become pregnant, or are breastfeeding an infant.
Can
Zoloft be taken with other medications?
It is very important that Zoloft not be taken in combination
with the antidepressants known as MAOIs (monoamine oxidase
inhibitors), such as Nardil, Parnate, or Marplan. Such combinations
have caused extreme reactions that could be lethal. Therefore,
when switching from an MAOI to Zoloft, or from Zoloft to an
MAOI, one should allow 14 days between stopping one and starting
the other. Since the potential exists for interaction with
over-the-counter drugs, they should be used cautiously while
taking Zoloft.
How
long should one take it?
This should be discussed carefully with the prescribing physician.
Although no one wants to take medication longer than necessary,
the chance of relapse is reduced when antidepressant medication
is continued for several months, perhaps six to twelve, after
the end of the depressive episode. Some researchers estimate
that 80% of people having one depressive episode will have
another, so it is wise to thoroughly discuss with one's doctor
the need for ongoing treatment. When Zoloft is used for long
term treatment, periodic review is recommended.
Should
someone with bipolar disorder (manic depression) take Zoloft?
People with bipolar disorder often need medication during
their periods of depression. Caution must be used when prescribing
antidepressants for this group, however, as these medications
sometimes induce mania. This happened in a very small group
(0.4%) of people taking Zoloft during testing. Mood stabilizers
such as lithium, Tegretol, and Depakote taken with an antidepressant
may reduce the likelihood and severity of manic episodes.
It is recommended that those taking lithium have their lithium
levels monitored after beginning treatment with Zoloft, and
appropriate adjustments made in the lithium dose if needed.
For more in-depth information about mental illness, treatments
and supports, and medications;
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