Antidepressants: Selecting one that’s right for you

Somewhat contrary to the above suggestions, a meta-analysis of sertraline clinical trials for PTSD found it to be statistically superior to placebo in the reduction of PTSD symptoms but the effect size was small. The National Institute for Clinical Excellence recommends it for patients who prefer drug treatment to a psychological one. Sertraline is effective in alleviating the symptoms of premenstrual dysphoric disorder, a severe form of premenstrual syndrome. The combination of sertraline and cognitive behavioral therapy appears to be more effective in children and young people than either treatment alone. All three major domains of the disorder (fear, avoidance, and physiological symptoms) respond to sertraline. The patients rated as “improved” on sertraline reported better quality of life than the ones who “improved” on placebo.

• Side effects from Zoloft tend to be manageable and often go away on their own as your body adjusts to your medication.
• The first antidepressant you try may work fine.
• Like all medications in its class, Zoloft does not perform optimally until you have taken it consistently for several weeks.
• The combination of sertraline and cognitive behavioral therapy appears to be more effective in children and young people than either treatment alone.
• Weissman and Koe recalled that the group did not set up to produce an antidepressant of the SSRI type—in that sense their inquiry was not “very goal driven”, and the invention of the sertraline molecule was serendipitous.
• All three major domains of the disorder (fear, avoidance, and physiological symptoms) respond to sertraline.

Side Effects of Zoloft (Sertraline)

• Specifically, Palit & Ali 2008 find that sertraline kills almost all promastigotes of Leishmania donovani.
• The group had to overcome initial bureaucratic reluctance to pursue sertraline development, as Pfizer was considering licensing an antidepressant candidate from another company.
• In 2016, sertraline was the most commonly prescribed psychotropic medication in the United States.

It can also increase the risk of long QT syndrome, although the risk is considered low. While specific antipsychotics can cause this risk, other drugs can also have this same effect. People taking NTI drugs must be carefully monitored to ensure the drug is at appropriate levels in the body at which it is effective but not toxic. Serotonin syndrome is a rare but serious condition caused by too much serotonin in the body, often from combining multiple serotonin-boosting medications or supplements. These interactions may raise serotonin levels or cause other effects, some manageable, others best avoided. Sertraline (brand name Zoloft)—an SSRI used to treat depression and anxiety—can interact with other medications and affect how they work.

Comparison with other antidepressants

Serotonin syndrome is a potentially life-threatening condition in which serotonin levels become too high. Zoloft belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). Nausea is the most common side effect of Zoloft, affecting around one in four people who take sertraline. In 2005, the FDA added a boxed warning concerning pediatric suicidal behavior to all antidepressants, including sertraline. In 2003, the UK Medicines and Healthcare products Regulatory Agency issued guidance that, apart from fluoxetine (Prozac), SSRIs are not suitable for the treatment of depression in patients under 18. Other experts emphasized that the drug’s effect on inpatients had not differed from placebo and criticized the poor design of the clinical trials by Pfizer.

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Around one in five people experience insomnia or trouble sleeping as a side effect of Zoloft. To cope with Zoloft-related nausea, you may find it helpful to take the medication with food. Let’s take a closer look at some of these effects and ways to help deal with them. Others are less common but may also be distressing. Your physician may change your dosage or switch you to a different medication.

When to Avoid Sertaline Completely

Nausea is often the greatest when you first begin taking this medication or if your physician increases your dose. Nausea, diarrhea, and insomnia are the most common Zoloft side effects. As with all medications, Zoloft may cause certain unwanted side effects. While severe side effects are less common, they can occur in some individuals.

Premenstrual dysphoric disorder

It works by preventing the reuptake of serotonin, a neurotransmitter that affects mood.

Less Common Zoloft Side Effects

Certain antipsychotic medications are contraindicated with sertraline, meaning they should never be used together. Some people may be prescribed more than one antidepressant. Suddenly stopping your medication can lead to withdrawal or a return of your symptoms. Talk to your physician about your symptoms if you are concerned about side effects.

If you find you are unable to cope with the side effects, call your healthcare provider immediately. They can suggest ways to cope or make medication changes if needed. Most symptoms tend to be minimal and generally improve over time. The type and severity of Zoloft side effects can vary from person to person. It typically takes several weeks for an antidepressant to begin working, so it is important to give it this time.

Obsessive–compulsive disorder

SSRIs are known as second-generation antidepressants since they are newer than monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs). Zoloft is sometimes prescribed for social anxiety disorder and other phobias. Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI). By preventing reuptake, Zoloft can increase the amount of serotonin available in zoloft and pepcid the brain. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your health care provider or get emergency help.

Accordingly, a meta-analysis of antidepressants in older adults found that sertraline, paroxetine and duloxetine were better than placebo. In meta-analyses, sertraline efficacy is similar to that of other SSRI antidepressants, with an odds ratio for response in clinical depression of between 1.44 and 1.67. If serotonin levels become too high, you may experience serotonin syndrome. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood. Most antidepressants help relieve depression by affecting these neurotransmitters, sometimes called chemical messengers, which aid in communication between brain cells. There are many types of antidepressants available that work in slightly different ways and have different side effects.

Alcohol

CYP2C19 inhibitor esomeprazole increased sertraline concentrations in blood plasma by approximately 40%. This effect is dose-dependent; for example, co-administration with 50 mg of sertraline resulted in 20% greater exposure to desipramine, while 150 mg of sertraline led to a 70% increase. Accordingly, in human trials it caused increased blood levels of CYP2D6 substrates such as metoprolol, dextromethorphan, desipramine, imipramine and nortriptyline, as well as the CYP3A4/CYP2D6 substrate haloperidol.

Weissman and Koe recalled that the group did not set up to produce an antidepressant of the SSRI type—in that sense their inquiry was not “very goal driven”, and the invention of the sertraline molecule was serendipitous. In contrast, CYP2B6 poor metabolizers have 1.6-fold higher levels of sertraline and intermediate metabolizers have 1.2-fold higher levels. Relative to CYP2C19 normal (extensive) metabolizers, poor metabolizers have 2.7-fold higher levels of sertraline and intermediate metabolizers have 1.4-fold higher levels. There is an approximate 2-fold accumulation of sertraline with continuous administration and steady-state levels are reached within one week. Following a single oral dose of sertraline, mean peak blood levels of sertraline occur between 4.5 and 8.4 hours. In a placebo-controlled study in which sertraline was co-administered with lithium, 35% of the subjects experienced tremors, while none of those taking placebo did.

In addition to decreasing the frequency of panic attacks by about 80% (vs. 45% for placebo) and decreasing general anxiety, sertraline resulted in an improvement in quality of life on most parameters. The sertraline dosages necessary for the effective treatment of OCD are higher than the usual dosage for depression. Sertraline is equivalent to imipramine for the treatment of depression with co-morbid panic disorder, but it is better tolerated.

Over a two-week treatment of healthy volunteers, sertraline slightly improved verbal fluency but did not affect word learning, short-term memory, vigilance, flicker fusion time, choice reaction time, memory span, or psychomotor coordination. This result compares favorably with placebo, where, according to the literature, 3–6% of patients gained more than 7% of their initial weight. A 30-month-long treatment with sertraline for OCD also resulted in no significant weight gain. The prescribing information recommends that treatment of the elderly and patients with liver impairment “must be approached with caution”.

Most antidepressants are generally safe, but the U.S. Many kinds of antidepressants are available, and chances are you’ll be able to find one that works well for you. But if it doesn’t relieve your symptoms or it causes side effects that bother you, you may need to try another. Antidepressants are a popular treatment choice for depression. The prescribing information for sertraline includes several contraindications, or specific situations where the medication should not be used.