Zoloft (Sertraline)

Alternative Name(s): Daxid or Lustral

    Zoloft (Sertraline) Dosage and Side Effects

    Zoloft is in a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). They work by controlling levels of serotonin (a neurotransmitter) in the brain.  SSRIs are the most prescribed type of antidepressants in the United States today because they are thought to have fewer side effects than other types of antidepressants  In addition to treating major depressive disorders, which affect nearly 7 percent of adults in the United States, Zoloft is given to those suffering from post-traumatic stress disorder (PTSD), premenstrual dysphoric, and obsessive-compulsive disorder (OCD), along with generalized anxiety disorder (GAD), and panic disorder.

    Proper Use of this medication

    Usual dose:

    • It is very important that you take ZOLOFT exactly as your doctor has instructed.

    • Never increase or decrease the amount of ZOLOFT you, or those in your care if you are a caregiver or guardian, are taking unless your doctor tells you to.

    • Do not stop taking this medication without consulting your doctor.

    • As with all antidepressants improvement with ZOLOFT is gradual. You should continue to take ZOLOFT even if you do not feel better, as it may take several weeks for your medication to work. Improvement may be gradual.

    • ZOLOFT should be taken with food either in the morning or the evening. You should swallow the capsule whole, do not divide, crush or chew the capsules.

    REMEMBER: This medicine has been prescribed only for you. Do not give it to anybody else. If you have any further questions, please ask your doctor or pharmacist.

    Overdose:

    In case of overdose, contact your doctor, the regional Poison Control Centre, or the nearest hospital emergency department, even though you may not feel sick. Take your medicine with you.

    Missed dose:

    If you happen to miss a dose, do not take the missed dose. Just take your next dose at the right time. Do not take a double dose to make up for a forgotten dose.

    Side Effects

    Like all medications, ZOLOFT can cause some side effects. You may not experience any of them. For most patients these side effects are likely to be minor and temporary. However, some may be serious. Some of these side effects may be dose related. Consult your doctor if you experience these or other side effects, as the dose may have to be adjusted.

    If you experience an allergic reaction (including red skin, hives, itching, swelling of the lips, face, tongue, throat, trouble breathing, wheezing, shortness of breath, skin rashes, blisters of the skin, sores or pain in the mouth or eyes) or any severe or unusual side effects, stop taking the drug and contact your doctor immediately.

    Some side effects of ZOLOFT are:

    • headache

    • nausea

    • dry mouth

    • diarrhea

    • loss of appetite

    • sleepiness

    • dizziness

    • insomnia

    • sexual problems including decreased libido, erectile dysfunction and ejaculation failure

    • nervousness

    • tremor

    ZOLOFT does not usually affect people's normal activities. However, some people feel sleepy while taking it, in which case they should not drive or operate machinery.

    Cases of loss of blood sugar level control including both higher and lower-than normal sugar level have been reported in patients receiving SSRIs including ZOLOFT, with and without pre-existing diabetes. Symptoms associated with low blood sugar level in your blood include weakness, hunger, anxiety, sweating, numbness or tingling in your extremities. These are early warning symptoms and should not be ignored. Contact your doctor if you experience these symptoms.

    ZOLOFT may raise cholesterol levels in some patients. Blood cholesterol tests may be required by your doctor during treatment with ZOLOFT.

    Discontinuation Symptoms:

    Contact your doctor before stopping or reducing your dosage of ZOLOFT. Symptoms such as dizziness, abnormal dreams, electric shock sensations, agitation, anxiety, difficulty concentrating, headache, tremor, nausea, vomiting, sweating or other symptoms may occur after stopping or reducing the dosage of ZOLOFT. Such symptoms may also occur if a dose is missed. These symptoms usually disappear without needing treatment. Tell your doctor immediately if you have these or any other symptoms. Your doctor may adjust the dosage of ZOLOFT to alleviate the symptoms.

    Warnings and Precautions

    Treatment with these types of medication is most safe and effective when you and your doctor have good communication about how you are feeling.

    ZOLOFT is not for use in children under 18 years of age.

    Changes in Feelings and Behaviour:

    It is important that you have good communication with your doctor about how you feel. Discussing your feelings and treatment with a friend or relative who can tell you if they think you are getting worse is also useful. Some patients may feel worse when first starting or changing the dose of drugs such as ZOLOFT. You may feel more anxious or may have thoughts of hurting yourself or others, especially if you have had thoughts of hurting yourself before. These changes in feelings can happen in patients treated with drugs like ZOLOFT for any condition, and at any age, although it may be more likely if you are aged 18 to 24 years old. If this happens, see your doctor immediately. Do not stop taking ZOLOFT on your own.

    Taking ZOLOFT may increase your risk of breaking a bone if you are elderly or have osteoporosis or have other major risk factors for breaking a bone. You should take extra care to avoid falls especially if you get dizzy or have low blood pressure.

    Before taking ZOLOFT tell your doctor or pharmacist:

    • all your medical conditions, including a history of seizures, liver disease, kidney disease, heart problems or high cholesterol;

    • if you have a bleeding disorder or have been told that you have low platelets;

    • if you have blood pressure problems;

    • any medications (prescription or non-prescription) which you are taking or have recently taken (within last 14 days), especially monoamine oxidase (MAO) inhibitors (e.g. phenelzine sulfate, tranylcypromine sulfate, moclobemide) or any other antidepressants, pimozide (an antipsychotic drug), drugs used to treat diabetes, drugs used to thin the blood (anticoagulant), the antibiotic linezolid, methylthioninium chloride (methylene blue) or drugs that affect serotonin (including but not limited to fentanyl, fenfluramine and tryptophan);

    • if you are pregnant or thinking about becoming pregnant, or if you are breast feeding;

    • if you have a recent bone fracture or were told you have osteoporosis or risk factors for osteoporosis;

    • your habits of alcohol and/or street drug consumption;

    • any natural or herbal products you are taking (e.g., St. John's Wort);

    • if you drive a vehicle or perform hazardous tasks during your work;

    • if you have ever had any allergic reaction to medications, food, etc.

    Effects on Pregnancy and Newborns:

    If you are already taking ZOLOFT and have just found out that you are pregnant, you should talk to your doctor immediately. You should also talk to your doctor if you are planning to become pregnant.

    Some newborns whose mothers took an SSRI (selective serotonin reuptake inhibitor) or other newer antidepressants, such as ZOLOFT, during pregnancy have developed complications at birth requiring prolonged hospitalization, breathing support and tube feeding. Reported symptoms included feeding and/or breathing difficulties, seizures, tense or overly relaxed muscles, jitteriness and constant crying.

    In most cases, the SSRI or other newer antidepressant was taken during the third trimester of pregnancy. These symptoms are consistent with either a direct adverse effect of the antidepressant on the baby, or possibly a discontinuation syndrome caused by sudden withdrawal from the drug. These symptoms normally resolve over time. However, if your baby experiences any of these symptoms, contact your doctor as soon as you can.

    Persistent Pulmonary Hypertension (PPHN) and Newer Antidepressants:

    When taken during pregnancy, particularly in the last 3 months of pregnancy, medicines like ZOLOFT may increase the risk of a serious lung condition in babies, called persistent pulmonary hypertension of the newborn (PPHN), that causes breathing difficulties in newborns soon after birth, making the baby breathe faster and appear bluish. These symptoms usually begin during the first 24 hours after the baby is born. If this happens to your baby you should contact your doctor immediately.

    If you are pregnant and taking an SSRI, or other newer antidepressant, you should discuss the risks and benefits of the various treatment options with your doctor. It is very important that you do NOT stop taking these medications without first consulting your doctor.

    Angle-closure Glaucoma

    ZOLOFT can cause an acute attack of glaucoma. Having your eyes examined before you take ZOLOFT could help identify if you are at risk of having angle-closure glaucoma. Seek immediate medical attention if you experience:

    • eye pain

    • changes in vision

    • swelling or redness in or around the eye

    Interactions with this medication

    Do not use ZOLOFT if you are taking or have recently taken monoamine oxidase inhibitors.

    You should avoid taking St. John's Wort if you are taking ZOLOFT.

    You should tell your doctor if you are taking or have recently taken any medications (prescription, non-prescription or natural/herbal), especially:

    • other antidepressants, such as SSRIs and certain tricyclics

    • other drugs that affect serotonin such as, lithium, linezolid, tramadol, tryptophan, triptans used to treat migraines

    • certain medicines used to treat pain, such as fentanyl (used in anaesthesia or to treat chronic pain), tramadol, tapentadol, meperidine, methadone, pentazocine

    • certain medicines used to treat cough, such as dextromethorphan

    • certain medicines used to treat schizophrenia

    • certain medicines used to treat bipolar depression, such as lithium

    • metoprolol or other medications used to treat high blood pressure and angina

    • certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g. warfarin, dabigatran), acetylsalicylic acid (e.g. Aspirin) and other non-steroidal anti-inflammatory drugs (e.g. ibuprofen)

    • certain medicines used to treat epilepsy

    • cimetidine

    • In general, drinking alcoholic beverages should be kept to a minimum or avoided completely while taking ZOLOFT.

    Other related products

    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.