Brand & Generic Names; Drug Classes
|US brand name: Zoloft|
|Generic name: sertraline|
|Primary drug class: Antidepressants|
|Additional drug class(es): SSRIs, Anxiolytics/Anti-anxiety|
Approved & Off-Label Uses (Indications)
Zoloft’s US FDA Approved Treatment(s)
- Major Depressive Disorder (MDD) approved 30 December 1991
- Obsessive-Compulsive Disorder (OCD) in both adults (approved 28 October 1996) and children (approved October 1997)
- Panic Disorder (July 1997)
- Post Traumatic Stress Disorder (PTSD). Zoloft was approved for short-term (acute) use on 7 December 1999 (fitting date), and for chronic (long-term) use on 16 August 2001 (just in time!).
- Premenstrual Dysphoric Disorder (PMDD) (approved 20 May 2002)
- Social Anxiety Disorder (approved 10 February 2003)
Uses Approved Overseas but not in the US
Off-Label Uses of Zoloft
- Generalized Anxiety Disorder (GAD), although the numbers aren’t all that great in that study or this one. Which probably explains why Zoloft was never approved for GAD.
- Major Depression in people with various chronic heart problems, including
- acute myocardial infarction or unstable angina
- Acute Coronary Syndrome
- Depression and panic after a heart transplant
- In spite of the clever acronym (SADHART: Sertraline AntiDepressant Heart Attack Randomized Trial) and having one of the lowest rates of cardiovascular side effects of all antidepressants, Zoloft didn’t really help all that much.
- Eating Disorders, including
- Menopause symptoms, especially hot flashes.
- Sometimes it works.
- Sometimes it doesn’t, or makes it worse.
- Basically it’s an equal chance that Zoloft will make it better, worse, or do nothing.
- And if it does do anything, it’s just as likely to be a big change or a small change.
When & If Zoloft Will Work
Zoloft’s Usual Onset of Action (when it starts working)
Like all SSRIs anywhere from a couple days to over a month, although you should more awake and energetic in two to four days. If you don’t feel any positive benefit after four-six weeks, then you should talk to your doctor about either another SSRI or trying a med that hits another neurotransmitter.
Likelihood of Working
Zoloft is better for conditions in the anxiety spectrum than those in the depression spectrum. Which is funny given how agitated and nervous it makes a lot of people feel. Zoloft does work well for depression defined by sleeping too much, eating too much, and withdrawing from the world.
Taking and Discontinuing
How to Take Zoloft
In the PI sheet Pfizer recommends:
50 mg once a day for adults with MDD and OCD. That’s where you start, that’s where you stay.
For adults with PTSD, panic & social anxiety disorders - start at 25 mg once a day and after a week increase it to 50 mg a day.
- Everybody starts at 12.5–25mg and waits at least two weeks, if you can, before increasing by 12.5–25mg a day.
- And increase the dosage only if you need to.
How to Stop Taking Zoloft (discontinuation / withdrawal)
The usual way with SSRIs. Reduce your dosage by 12.5–25mg each week. If the discontinuation syndrome is too harsh you have two options, getting a prescription for the oral solution and reducing your dosage by whatever you can tolerate, or getting a prescription for 10mg fluoxetine capsules and take 20mg a day (if you’re at 25mg of Zoloft) for two weeks and 10mg a day for another two weeks.