Zoloft

US Brand Name: Zoloft
Other Brand Names:
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)
Generic Name: sertraline hydrochloride
Other Forms: oral concentrate

Class: Antidepressant, specifically 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.
FDA Approved Uses: Major Depression, Obsessive-Compulsive Disorder (adults and children), Panic Disorder, Post Traumatic Stress Disorder, Premenstrual Dysphoric Disorder, Social Anxiety Disorder.
Off-Label Uses: 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 sertraline from Canada.
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 side effects:

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.

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.

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 and How 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.

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.

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.

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