side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
Table of Contents (hide)
- 1. Brand & Generic Names; Drug Class
- 2. What is Zoloft (sertraline) Used For?
- 3. When Will Zoloft (sertraline) Start Working?
- 4. Will Zoloft Really Work for What You Have?
- 5. How to Take Zoloft (sertraline)
- 6. How to Stop Taking Zoloft (sertraline)
- 7. Zoloft (sertraline) Pros and Cons
- 8. Zoloft (sertraline) Side Effects
- 9. What You Really Need to be Careful About with Zoloft (sertraline)
- 10. Zoloft (sertraline) Half-Life & How Long Until Zoloft Clears Your System
- 11. How Zoloft (sertraline) Works
- 12. Zoloft (sertraline) Ratings, Reviews, Comments, PI Sheet, and More
|US brand name: Zoloft|
|Generic name: sertraline|
|What is Zoloft (sertraline)?|
|Zoloft (sertraline) is in the Antidepressants class of drugs.|
Major Depressive Disorder (MDD), Obsessive-Compulsive Disorder (OCD), Panic Disorder, Posttraumatic Stress Disorder (PTSD), Premenstrual Dysphoric Disorder (PMDD), Social Anxiety Disorder
Generalized Anxiety Disorder (GAD), Eating Disorders, Depression in people with a variety of coronary problems, Menopause symptoms
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.
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.
In the PI sheet Pfizer recommends:
50mg a day for MDD and OCD. That’s where you start, that’s where you stay.
For PTSD, panic & social anxiety disorders - start at 25mg a day and after a week increase it to 50mg 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.
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.
The slight, but noticeable, dopamine action Zoloft has is often enough to get you out of bed and back to work within a couple of days. You might still be depressed for another two-four weeks, but at least you don’t have to lie in bed staring at the ceiling and ruminating on how much your life sucks. It also makes weight gain less likely.
The slight dopamine action Zoloft has makes it the worst Serotonin-[sorta-]Selective Reuptake Inhibitor to take if bipolar is known or suspected. Definitely the worst to have taken if bipolar was a surprise. While the dopamine action is in the right place to make you sweaty and nervous (like Wellbutrin) it’s nowhere near the right place to prevent sexual side effects.
If you take the tablets with food you’ll get a 25% increase in Zoloft’s peak plasma - the most you’d have in your blood - and it will happen faster, dropping from 8 hours to 5.5.
If you take the oral concentrate with food you won’t get any more out of it, but it will take longer to reach that peak amount, from 5.9 to 7 hours.
Increased and/or delayed peak plasma when taking meds with food happens all the time. But these numbers only make sense if the volunteers were professional lab rats.
The ad campaign featuring rolling blobs. Letting people know they’re bipolar with a big, fat, dysphoric mania.
In-Depth Pros & Cons
The usual for SSRIs - headache, nausea, dry mouth, sweating, insomnia, diarrhea or constipation, and loss of libido. Most everything, except the loss of libido, usually goes away within a couple of weeks.
Sweatiness, like really sweaty all the time. Although not uncommon for SSRIs, Zoloft is a very “nervous” drug, as it can sometimes make you sweaty, shaky and generally uncomfortable in your own skin, more so than the others in this class. Which I find hilariously ironic, as it’s approved and fairly effective for panic disorder and social anxiety disorder, and used off-label for generalized anxiety disorder.
While every antidepressant was slapped with a warning about suicidal thoughts and behavior during the height of anti-psychiatry hysteria, Zoloft is actually one you need to be especially careful with. Like a large number of the instances when that sort of thing happened, it was due to the person being bipolar. It doesn’t help that Zoloft is the only SSRI where you can actually kill yourself with a month’s supply of pills (assuming an especially high dosage of 150–200mg a day, which some people actually take).
Half-life: 26 hours, clearance: five to six days.
sertraline Pharmacokinetics Information Overload
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on the pharmacokinetics page.
the current best guess at any rate
Sertraline is the second-most potent SSRI on the US market (Paxil is the most potent)3. With its action as a dopamine reuptake inhibitor and its effect on the 5HT1A receptors, Zoloft probably affects dopamine enough, directly and indirectly, to have a meaningful impact, both good and bad, on side effects. Zoloft may also work on the sigma 1 receptors, and that would explain why it’s so effective for anxiety disorders.
More about How Zoloft Works than You Probably Ever Wanted to Know. AKA sertraline mechanism/method of action, or pharmacodynamics.
While Zoloft is no more likely to trigger mania than any other SSRI, due to that dopaminergic kick the symptoms it triggers are a lot worse. Zoloft just gets you way more agitated and sets of these nasty dysphoric manias in the bipolar, which can be a very harsh way to discover that one is bipolar. With the other SSRIs and SNRIs it’s a coin toss as to whether they’ll trigger euphoric manias that will send you on spending sprees or marrying people you just meet, or trigger dysphoric manias that make you destroy all the furniture in a room. But with Zoloft the odds are heavily in favor of the dysphoric mania. That may be why the poor little Zoloft lozenge quit shilling Zoloft so heavily for depression, and now primarily touts its efficacy for social anxiety, panic disorder, PTSD, and PMDD. Then again it could be that Zoloft is just testing better in studies for its other approved uses. In any event, that’s you need to be extra careful with Zoloft, more than most others antidepressants, when it comes to watching out for suicidal thoughts and behavior.
An overall zero-to-five rating is absolutely useless information regarding medications. It is little more than a purely emotional and subjective value judgment on a med that has no bearing on how effective a drug is or, more importantly, if Zoloft (sertraline) is the right drug for you. So why do I have it? Mainly because it’s cathartic for anyone who is taking or has taken Zoloft (sertraline)4. Love it? Hate it? Here’s your chance to let everyone know. You don’t need to be a forum member or anything like that. You get all of one vote which can’t be changed, so make sure it’s what you want.
Get all judgmental about Zoloft (sertraline)
Rating 3.2 out of 5 from 122 criticisms
Vote Distribution: 13 – 12 – 12 – 10 – 45 – 30
Extended Comments As if I didn’t go on long enough here.
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
If you have any questions about Zoloft (sertraline), please see the Crazy Meds’ Zoloft (sertraline) discussion board. I rarely answer questions about meds via e-mail.1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 In terms of sheer raw power of pure sertraline at serotonin transporter binding sites. All sorts of other factors are involved in determining a drug's potency. As I write all over the place "potency" and "efficacy" are two completely different things. See the pages on SSRI & SNRI Dosage Equivalents and Pharmacokinetics for more information.
4 At some point I may have multiple one-to-ten ratings for individual aspects of medications, such as efficacy and side effects. That could be potentially useful.
5 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
|Date created Wednesday, 06 April, 2011 at 14:28:09||Page Author: JerodPoore||Last modified on Wednesday, 04 December, 2013 at 23:44:50 by some med critic.|
Zoloft is a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]