Zoloft

Generic Name: sertraline (SER tra leen)

What is Zoloft?

Zoloft is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Zoloft affects chemicals in the brain that may become unbalanced and cause depression, panic, anxiety, or obsessive-compulsive symptoms.

Zoloft is used to treat depression, obsessive-compulsive disorder, panic disorder, anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).

Zoloft may also be used for purposes other than those listed in this medication guide.

Important information about Zoloft

Do not take Zoloft together with pimozide (Orap), or a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate). You must wait at least 14 days after stopping an MAOI before you can take Zoloft. After you stop taking Zoloft, you must wait at least 14 days before you start taking an MAOI.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Zoloft is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Zoloft, do not stop taking the medication without first talking to your doctor.

Before taking Zoloft

Do not use Zoloft if you are using pimozide (Orap), or an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam). Serious and sometimes fatal reactions can occur when these medicines are taken with Zoloft. You must wait at least 14 days after stopping an MAO inhibitor before you can take sertraline. After you stop taking Zoloft, you must wait at least 14 days before you start taking an MAOI.

Before taking Zoloft, tell your doctor if you have:

seizures or epilepsy;

bipolar disorder (manic depression); or

a history of drug abuse or suicidal thoughts.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Zoloft.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment with Zoloft.

FDA pregnancy category C. SSRI antidepressants may cause serious or life-threatening lung problems in newborn babies whose mothers take the medication during pregnancy. However, you may have a relapse of depression if you stop taking your antidepressant during pregnancy. If you are planning a pregnancy, or if you become pregnant while taking Zoloft, do not stop taking the medication without first talking to your doctor. It is not known whether sertraline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. Zoloft is FDA-approved for children with obsessive-compulsive disorder (OCD). It is not approved for treating depression in children.

How should I take Zoloft?

Take Zoloft exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from the medication.

Take the Zoloft tablet with water.

Zoloft may be taken with or without food.

Try to take the medicine at the same time each day. Follow the directions on your prescription label.

The oral liquid form of this medicine must be diluted before you take it. To be sure you get the correct dose, measure the liquid with medicine dropper provided, not with a regular table spoon. Mix the dose with 4 ounces (one-half cup) of water, ginger ale, lemon/lime soda, lemonade, or orange juice. Do not use any other liquids to dilute the medicine. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

It may take 4 weeks or longer before you start feeling better. Do not stop using Zoloft without first talking to your doctor. You may have unpleasant side effects if you stop taking this medication suddenly. Store Zoloft at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take the next one as directed. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have taken too much of this medication. Symptoms of a Zoloft overdose may include dizziness, drowsiness, nausea, vomiting, rapid heartbeat, agitation, tremor, confusion, seizures, and coma.

What should I avoid while taking Zoloft?

Avoid drinking alcohol, which can increase some of the side effects of Zoloft.

Do not take the liquid form of Zoloft if you are taking disulfiram (Antabuse). Liquid Zoloft may contain alcohol and you could have a severe reaction to the disulfiram.

Zoloft can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures or anxiety). They can add to sleepiness caused by Zoloft.

Zoloft side effects

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

very stiff (rigid) muscles, high fever, sweating, fast or uneven heartbeats, tremors, overactive reflexes;

nausea, vomiting, diarrhea, loss of appetite, feeling unsteady, loss of coordination; or

headache, trouble concentrating, memory problems, weakness, confusion, hallucinations, fainting, seizure, shallow breathing or breathing that stops.

Less serious Zoloft side effects may include:

drowsiness, dizziness, tired feeling;

mild nausea, stomach pain, upset stomach, constipation;

dry mouth;

changes in appetite or weight;

sleep problems (insomnia); or

decreased sex drive, impotence, or difficulty having an orgasm.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Zoloft?

Talk to your doctor before taking any medicine for pain, arthritis, fever, or swelling. This includes aspirin and NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), diclofenac (Voltaren), indomethacin, piroxicam (Feldene), nabumetone (Relafen), etodolac (Lodine), and others. Taking any of these drugs with Zoloft may cause you to bruise or bleed easily.

Before taking Zoloft, tell your doctor if you are using any of the following medicines:

tramadol (Ultram, Ultram ER, Ultracet);

digitoxin (Crystodigin);

phenytoin (Dilantin), valproate (Depacon, Depakene);

lithium (Lithobid, Eskalith);

a blood thinner such as warfarin (Coumadin);

any other antidepressant such as amitriptyline (Elavil), citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), or paroxetine (Paxil);

almotriptan (Axert), frovatriptan (Frova), sumatriptan (Imitrex), naratriptan (Amerge), rizatriptan (Maxalt), or zolmitriptan (Zomig); or

heart rhythm medication such as flecainide (Tambocor), propafenone (Rhythmol), and others.

This list is not complete and there may be other drugs that can interact with Zoloft. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.