Zoloft (sertraline) - The Good, The Bad and The Funny. From People Who Have Taken These Crazy Meds...and SCIENCE!
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US Brand Name: Zoloft
A link here will take you to the official website for the drug.

Other Brand Names for Zoloft:

Altruline (Mexico)
Aremis (Spain)
Atruline (Costa Rica; El Salvador; Guatemala; Honduras; Nicaragua; Panama)
Besitran (Spain)
Dominum (Colombia; Peru)
Fatral (Indonesia)
Gladem (Austria; Germany)
Lesefer (Colombia)
Lustral (UK)
Nudep (Indonesia)
Serlain (Belgium)
Sertranex (Bahrain; Colombia; Cyprus; Egypt; Iran; Iraq; Israel; Jordan; Kuwait; Lebanon; Libya; Oman; Qatar; Republic of Yemen; Saudi Arabia; Syria; United Arab Emirates)
Sertranquil (Colombia)
Sosser (Colombia)
Zolof (Colombia)
Zosert (India)
 

Zoloft's Generic Name: sertraline hydrochloride

Other Forms: oral concentrate

What Is Zoloft Zoloft is an Antidepressant, specifically an SSRI.
Read up on these sections if you haven't done so already, because they cover a lot of information about multiple medications that I'm not going to repeat on many pages.  I'm just autistic that way about not repeating myself.

What are Zoloft's FDA Approved Uses: Zoloft is approved to treat:

  • Major Depressive Disorder (30 December 1991)
  •  Obsessive-Compulsive Disorder in both adults (28 October 1996) and children (October 1997)
  • Panic Disorder (July 1997)
  • Post Traumatic Stress Disorder for acute PTSD (7 December 1999), and for chronic, long-term PTSD (just in time 16 August 2001)
  • Premenstrual Dysphoric Disorder (20 May 2002)
  • Social Anxiety Disorder (10 February 2003)

 

 

What Are Some of Zoloft's Off-Label Uses: Zoloft is prescribed unofficially for the following as well: Fibromyalgia, Arthritis, Chronic Fatigue, Multiple Sclerosis, Bipolar Depression, Lupus, Headaches, Irritable Bowel Syndrome (IBS), ADD/ADHD, Eating Disorders, Autistic Spectrum Disorders

Zoloft's pros and cons:

Pros: Zoloft is less likely than any SSRI but Lexapro to give you the common tummy problems. And they often aren't as bad. So if those are an issue and Lexapro is too expensive, you can get generic.

 

Cons: Probably the worst SSRI to take if bipolar is known or suspected. Definitely the worst to have taken if bipolar was a surprise.

 

Zoloft's Typical Side Effects: The usual for SSRIs - headache, nausea, dry mouth, sweating, sleepiness or insomnia, and diarrhea or constipation, weight gain, loss of libido. Most everything but the weight gain and loss of libido usually goes away within a couple of weeks, and Zoloft (sertraline hydrochloride) tends to be a little lighter on everything except those two as well. Like Prozac it can just kill your appetite completely instead of making you gain weight.

For tips on how to cope with these side effects, please see our side effects page.

Zoloft's Not So Common Side Effects: Sweatiness, like really sweaty. Although not uncommon for SSRIs, Zoloft (sertraline hydrochloride) 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.

 These may or may not happen to you don't, so don't be surprised one way or the other.

Zoloft's Freaky Rare Side Effects: Priapism and skin discoloration, so this must be in Michael Jackson's cocktail. Also breast enlargement (there really is no pleasing some people), photophobia, and sleepwalking.

 You aren't going to get these. I promise.

 

 

Interesting Stuff Your Doctor Probably Won't Tell You: Unlike most antidepressants, mixing booze and Zoloft (sertraline hydrochloride)  will get you drunker. Maybe, the PI sheet contradicts itself on this point. In the real world the anecdotal data I've collected is that Zoloft does get you drunker. So of course the oral concentrate is suspended in alcohol and you can't use that if you're taking Antabuse.

 

 

Zoloft's Dosage, How and When to Take Zoloft: I'm just sticking with adults. Zoloft (sertraline hydrochloride) is approved for use by kids with OCD, but it's too tricky for me to deal with.

Depression and OCD - 50mg, once a day, usually in the morning. That's it. No titration. You can try taking more, as Zoloft (sertraline hydrochloride)  is rated up to 200mg a day, but Pfizer's data don't prove it to be effective at more than 50mg a day. In the real world people do get plenty of benefit from taking more than 50mg a day, but give it a month before increasing the dosage. After that increase it by 25-50mg a day each week, as required, until it works or you give up. You should know by six weeks after starting if it's going to do anything or not.

Panic, PTSD and Anxiety disorders - 25mg, once a day, usually in the morning. After at least a week you may increase it to 50mg a day. That's it, just like depression & OCD. You can try taking more, but as above Pfizer states it's not worth it.

PMDD - start at 50mg a day. You'll have to work it out with your OB-GYN as to which days in your cycle will work best. If that doesn't work, up it by another 50mg next month. Then try other days in your cycle. Then try another 50mg a day. There's a bunch of fine-tuning required here.

 

Really, folks, don't go increasing the Zoloft (sertraline hydrochloride)  every week until you've given it 4-6 weeks. You're risking a nasty bout of discontinuation syndrome for something that may not work for you at all. You'll know if it's going to work after a month. If it doesn't do anything at all at the initial dosage after six weeks, give up and move on. If it does something, just not enough, you can discuss a higher dosage with your doctor.

 

 

Days to Reach a Steady State: About a week.

When you're fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you'll have fewer valleys after this point. In theory anyway.

 

How Long Zoloft Takes to Work: Like all SSRIs anywhere from a couple days to over a month. If you don't feel any positive benefit after six weeks, then you should talk to your doctor about either another SSRI or trying a med that hits another neurotransmitter.

 

Zoloft's Half-Life & Average Time to Clear Out of Your System: With a 26 hour half-life it will take five to six days to clear out of your system.

How to Stop Taking Zoloft: Your doctor should be recommending that you reduce your dosage by 25mg a day every week days if you need to stop taking it, if not more slowly than that.   Based on the 26 hour half-life.  For more information, please see the page on how to safely stop taking these crazy meds
If you've worked your way up to a particular dosage, it's usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.

 

How Zoloft Works In Your Brain:  Like all SSRIs Zoloft (sertraline hydrochloride)  doesn't make you produce more serotonin, rather it makes your neurons soak for a longer period of time in the serotonin you already produce.  Serotonin is one of the big three neurotransmitters responsible for depression, along with norepinephrine and dopamine.  My wild-ass guess / rule of thumb is that imbalances of one or more of the three are responsible for 80% of the depression issues.  It's all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.  According to Dr. Stahl in Essential Psychopharmacology and Essential Psychopharmacology of Depression and Bipolar Disorder and Dr. Preskorn's online book on Clinical Pharmacology of SSRI's Zoloft works on dopamine reuptake inhibition enough that it should be classified as a serotonin & dopamine reuptake inhibitor, which explains many of the side effects and the tendencies for dysphoric manias.  Why getting drunker when mixing booze with Zoloft is a triumph of pharmacokinetics (your liver working to process both Zoloft and alcohol out of your system) over pharmacodynamics (how meds work in your brain, in this case the tendency of medications that enhance dopamine to allow you to hold your liquor better).

 

 

Comments: While Zoloft (sertraline hydrochloride)  is no more likely to trigger mania than any other SSRI, for some reason the symptoms it triggers seem a lot worse. Even though Prozac has this reputation for anger & rage, Zoloft just gets you way more agitated and sets of these nasty dysphoric manias in the bipolar. It turns out to be a very harsh way to discover that one is bipolar. The other SSRIs may trigger euphoric manias that will send you on spending sprees or marrying people you just meet, or they may trigger dysphoric manias that make you destroy all the furniture in a room, truly a toss of the coin. But with Zoloft (sertraline hydrochloride)  the odds are heavily in favor of the dysphoric mania. That may be why the poor little Zoloft lozenge is not shilling Zoloft so heavily for depression, but for social anxiety, panic disorder and PMDD. Then again it could be that Zoloft is just testing better in studies for its other approved uses.  Still, if you could make it to the party in the first place like the bouncing ball in the ads did, you don't need an SSRI, you just need therapy and coping skills to deal with your social anxiety.  You need Zoloft or another SSRI if you break out in a cold sweat, start shaking and curl up in a fetal position at the mere thought of going to a party.

 

Have questions about Zoloft?  Want to read about experiences other people have had with Zoloft? Check out our Zoloft Board.

Who Makes Zoloft: Zoloft is manufactured in the US by Pfizer

Sample US of Zoloft Cost:$70 for 30 tablets of whatever size you want, 25mg, 50mg, 100mg, it doesn't matter.

As of 11/04/2003. Full retail for the uninsured. Go ahead and gloat, citizens of civilized countries and all of you with full medical coverage.

Sample Canadian Cost of Zoloft:$180 for 100 100mg tablets of brand name Zoloft, $118 for 100 100mg tablets of generic sertraline.

As of 11/04/2003. In US dollars, for re-importation to the US. Does not include any shipping charges.

 Remedy Find Rating for Depression

 Remedy Find Rating for Anxiety

Check for Drug-Drug Interactions

 

Full Patient/Prescribing/Physician Information Sheet

Canadian Monograph from Internet Mental Health

Please see the section on how to read these sheets. Don't freak out about every potential side effect. Look at the odds of something having happened during the clinical trials.

 

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Zoloft in the News

Depression in the News

 

Dead tree references:

Physicians' Desk Reference Edition 59 Min Ko and Greg Tallis, Drug Information Specialists, et al. ©  2005. Published by Thomson PDR.

 

Dead tree references:

 

Essential Psychopharmacology Stephen M. Stahl, M.D., Ph. D. © 2000.   Second edition.  Published by  Cambridge University Press

 

Essential Psychopharmacology of Depression and Bipolar Disorder  Stephen M. Stahl, M.D., Ph. D. © 2001.   Published by  Cambridge University Press

 

 

The Complete Guide to Psychiatric Drugs blished by John Wiley & Sons, Inc.

 

End of books used for this article.

 

Take care of yourself, and keep taking your crazy meds!

Jerod

If you still have unanswered questions about this or other medications, including which one is, or combination of meds are the best for you, your best bet is to ask on Crazy Meds Talk.  Better yet, if you want to let the world know how they worked out for you and want to help out others in their quest for the correct meds, join the party.
If you 
want to discuss your issues, I suggest checking out one of the various support groups online.  
Otherwise, if you're letting me know about how much you like or hate the site, or  need to let me know about medication effects in private, then just drop a note to jerod23 at gmail dot com  Honestly, I usually don't have a lot of time to answer e-mail these days.  The snide autoresponse message that may or may not hit your mailbox is going to tell you the same thing.
Another problem is that you may not get a response even if I wanted to send you one.  You see, so many dickweeds with malicious intents and too much time on their hands have appropriated the crazymeds.org domain name to use for their spam, viruses and the like.  Subsequently some lazy-ass e-mail protection software authors just go by the domain name, and not the IP address.  So I've been blacklisted because of the actions of others.  Or the software just doesn't like the domain name because of the "crazy" and/or "meds."  Or your question about a particular medication will set off spam flags.  So the e-mail just wouldn't go through regardless.  Sorry.

 

 

 

Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.

 

 

 

Created Friday, November 07, 2003

Last updated Saturday, December 05, 2009

 

Copyright © 2003 - 2007 Jerod Poore. All rights reserved.

 

Almost all of the material on this site is copyright © 2003, 2004, 2005, 2006 and 2007 Jerod Poore. Except, of course, the PI sheets, those are the property of the drug companies who developed the drugs the sheets are about.  And any documents that are written by other people which may be posted to this site will remain the property of the original authors.  You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder.  That's usually me, so just ask first.  That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that's OK to just do.  Go for it!  Please.  As long as you include this copyright notice and the following disclaimer, I'm cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won't necessarily happen to you. Nobody on this site is a doctor, therapist, or a pharmacist. We don't portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don't be a cyberchondriac, thinking you have every disease you see a website about, or that you'll get every side effect from every medication. Self-prescribing is just as dangerous.  All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site.  Know your sources!  As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it.  No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away.  If you didn't get a PI sheet, demand one.  Loudly.  Crazy Meds is not responsible for the content of sites we provide links to.  We like them, or they're paid advertisements, or they're something you should read to make an informed decision about a particular med.  Sometimes they're more than one of those things.  But what's on those sites is their business, not ours.  Very little information about visitors to this site is collected or saved. And from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.

 

"Everything is true, nothing is permitted." - Jerod Poore