Zoloft

Zoloft is a prescription medication used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, social anxiety disorder and premenstrual dysphoric disorder. Zoloft belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs), which change the amount of a chemical in the brain to maintain mental stability.

This medication comes in a tablet and an oral solution (liquid) form, and is usually taken by mouth once a day, with or without food.

Common side effects of Zoloft include nausea, headache, and insomnia. 

This medication may also cause drowsiness. Do not drive or operate heavy machinery until you know how Zoloft affects you.

Zoloft is a prescription medication used to treat major depressive disorder, obsessive compulsive disorder, panic disorder, post traumatic stress disorder, social anxiety disorder and premenstrual dysphoric disorder.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Pfizer U.S. Pharmaceuticals Group

• Roerig

Zoloft may cause serious side effects, including:

• See "Drug Precautions"
• Feeling anxious or trouble sleeping

Common possible side effects in people who take Zoloft include:

• nausea, loss of appetite, diarrhea or indigestion
• change in sleep habits including increased sleepiness or insomnia
• increased sweating
• sexual problems including decreased libido and ejaculation failure
• tremor or shaking
• feeling tired or fatigued
• agitation

Other side effects in children and adolescents include:

• abnormal increase in muscle movement or agitation
• nose bleed
• urinating more often
• urinary incontinence
• aggressive reaction
• heavy menstrual periods
• possible slowed growth rate and weight change. Your child's height and weight should be monitored during treatment with Zoloft.

Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of Zoloft. For more information, ask your healthcare provider or pharmacist.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven);
• antidepressants ('mood elevators') such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil);
• aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn);
• cimetidine (Tagamet);
• diazepam (Valium);
• digoxin (Lanoxin);
• linezolid;
• lithium (Eskalith, Lithobid);
• medications for anxiety, mental illness, Parkinson's disease, and seizures;
• medications for irregular heartbeat such as flecainide (Tambocor) and propafenone (Rythmol);
• methylene blue;
• oral medications for diabetes such as tolbutamide (Orinase);
• medications for migraine headaches such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig);
• sedatives;
• sibutramine (Meridia);
• sleeping pills; 
• tranquilizers

This is not a complete list of Zoloft drug interactions. Ask your doctor for more information.

Zoloft and other antidepressant medicines may cause serious side effects, including:

1. Suicidal thoughts or actions:

• Zoloft and other antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment or when the dose is changed.
• Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions.
• Watch for these changes and call your healthcare provider right away if you notice:
  • New or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe.
  • Pay particular attention to such changes when Zoloft is started or when the dose is changed.
  
  Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
  Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency, especially if they are new, worse, or worry you:
  • attempts to commit suicide
  • acting on dangerous impulses
  • acting aggressive or violent
  • thoughts about suicide or dying
  • new or worse depression
  • new or worse anxiety or panic attacks
  • feeling agitated, restless, angry or irritable
  • trouble sleeping
  • an increase in activity or talking more than what is normal for you
  • other unusual changes in behavior or mood

Call your healthcare provider right away if you have any of the following symptoms, or call 911 if an emergency. Zoloft may be associated with these serious side effects:

2. Serotonin Syndrome or Neuroleptic Malignant Syndrome-like reactions. This condition can be life-threatening and may include:

• agitation, hallucinations, coma or other changes in mental status
• coordination problems or muscle twitching (overactive reflexes)
• racing heartbeat, high or low blood pressure
• sweating or fever
• nausea, vomiting, or diarrhea
• muscle rigidity

3. Severe allergic reactions:

• trouble breathing
• swelling of the face, tongue, eyes or mouth
• rash, itchy welts (hives) or blisters, alone or with fever or joint pain

4. Abnormal bleeding: Zoloft and other antidepressant medicines may increase your risk of bleeding or bruising, especially if you take the blood thinner warfarin (Coumadin, Jantoven), a non-steroidal anti-inflammatory drug (NSAIDs, like ibuprofen or naproxen), or aspirin.

 

5. Seizures or convulsions

 

6. Manic episodes:

• greatly increased energy
• severe trouble sleeping
• racing thoughts
• reckless behavior
• unusually grand ideas
• excessive happiness or irritability
• talking more or faster than usual

7. Changes in appetite or weight. Children and adolescents should have height and weight monitored during treatment.

 

8. Low salt (sodium) levels in the blood. Elderly people may be at greater risk for this. Symptoms may include:

• headache
• weakness or feeling unsteady
• confusion, problems concentrating or thinking or memory problems

Do not stop Zoloft without first talking to your healthcare provider. Stopping Zoloft too quickly may cause serious symptoms including:

• anxiety, irritability, high or low mood, feeling restless or changes in sleep habits
• headache, sweating, nausea, dizziness
• electric shock-like sensations, shaking, confusion

Do not take Zoloft if you:

• are allergic to Zoloft or any of the ingredients in Zoloft .
• take the antipsychotic medicine pimozide (Orap) because this can cause serious heart problems.
• take Antabuse (disulfiram) (if you are taking the liquid form of Zoloft) due to the alcohol content.
• take a Monoamine Oxidase Inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.

People who take Zoloft close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:

• Do not take an MAOI within 2 weeks of stopping Zoloft.
• Do not start Zoloft if you stopped taking an MAOI in the last 2 weeks.
• high fever
• uncontrolled muscle spasms
• stiff muscles
• rapid changes in heart rate or blood pressure
• confusion
• loss of consciousness (pass out)

If you take Zoloft, you should not take any other medicines that contain sertraline.

Zoloft can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how Zoloft affects you. Do not drink alcohol while using Zoloft.

Grapefruit and grapefruit juice may interact with Zoloft and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor.

Before starting Zoloft, tell your healthcare provider if you:

• Are taking certain drugs such as:
  • Medicines used to treat migraine headaches such as triptans;
  • Medicines used to treat mood, anxiety, psychotic or thought disorders, such as:
    • tricyclic antidepressants
    • lithium
    • diazepam
    • SSRIs
    • SNRIs
    • antipsychotic drugs
    • valproate
  • Medicines used to treat seizures such as phenytoin;
  • Medicines used to treat pain such as tramadol;
  • Medicines used to thin your blood such as warfarin;
  • Medicines used to control your heartbeat such as:
    • propafenone
    • flecainide
    • digitoxin
  • Medicines used to treat type II diabetes such as tolbutamide;
  • Cimetidine used to treat heartburn;
  • Over-the-counter medicines or supplements such as:
    • Aspirin or other NSAIDs
    • tryptophan
    • St. John's Wort
• have liver problems;
• have kidney problems;
• have heart problems;
• have or had seizures or convulsions;
• have bipolar disorder or mania;
• have low sodium levels in your blood;
• have a history of a stroke;
• have high blood pressure;
• have or had bleeding problems;
• are pregnant or breastfeeding.

Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Zoloft and some medicines may interact with each other, may not work as well, or may cause serious side effects.

Your healthcare provider or pharmacist can tell you if it is safe to take Zoloft with your other medicines. Do not start or stop any medicine while taking Zoloft without talking to your healthcare provider first.

Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known if Zoloft will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy.

Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Some Zoloft may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking Zoloft.

• Take Zoloft exactly as prescribed. Your healthcare provider may need to change the dose of Zoloft until it is the right dose for you.
• Zoloft tablets may be taken with or without food.
• Zoloft oral concentrate must be diluted before use:
  • Follow the instructions carefully
  • When diluting Zoloft oral concentrate, use ONLY water, ginger ale, lemon/lime soda, lemonade, or orange juice.
  • If you are sensitive to latex, be careful when using the dropper to dispense the Oral Concentrate.
• If you miss a dose of Zoloft, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Zoloft at the same time.

Dosage for Depression or Obsessive-Compulsive Disorder

• Adults: the recommended starting dose is 50 mg once daily.
• Adults: the recommended maintenance dosage range is 50 to 200 mg once daily.
• Children (ages 6 to 12) with OCD: the recommended starting dose is 25 mg once daily.
• Children (ages 13 to 17) with OCD: the recommended starting dose is 50 mg once daily.

Dosage for Panic Disorder, Posttraumatic Stress Disorder and Social Anxiety Disorder

• Adults: the recommended starting dose is 25 mg once daily. After one week, the dose is increased to 50 mg once daily. The maximum recommended dose is 200 mg per day.

Dosage for Premenstrual Dysphoric Disorder

• Adults: the recommended starting dose is 50 mg once daily, either daily throughout the menstrual cycle or during the last 2 weeks of the menstrual cycle. The dose may be increased to 150 mg/day when dosed throughout the menstrual cycle, or 100 mg/day when dosing is limited to the last two weeks of the menstrual cycle.

If you take too much Zoloft, call your local Poison Control Center or seek emergency medical attention right away.

• Store Zoloft at room temperature, between 59°F and 86°F (15°C to 30°C).
• Keep Zoloft bottle tightly closed.

Keep this and all medications out of the reach of children.

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Zoloft or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Zoloft is not approved for use in pediatric patients except for patients with obsessive compulsive disorder (OCD).