Zoloft - instructions for use of tablets, analogues, reviews, price

The synthetic drug Zoloft is used to effectively treat depression and other nervous system disorders. The drug contains sertraline, which is used as a powerful antidepressant. Even with long-term use, the medicine does not have stimulating, anticholinergic or sedative effects.

Numerous reviews from patients who took the drug confirm that the carefully selected composition is not addictive. The drug is actively used for the prevention and treatment of social phobia, depressive states of various etiologies, panic attacks, and post-traumatic nervous disorders.

Before using an antidepressant, you should consult with your doctor, who will select an appropriate treatment regimen and eliminate the likelihood of adverse reactions.

Release form and composition

Zoloft is produced in the form of film-coated tablets: oblong, white, with the inscription “Pfizer” embossed on one side, “ZLT|50” on the other side for a dose of 50 mg, “ZLT|100” for a dose of 100 mg (according to 14 pcs in blisters made of aluminum foil and opaque polypropylene, 1 or 2 blisters in a cardboard pack).

Composition of 1 tablet:

Active ingredient: sertraline – 50 or 100 mg (in the form of sertraline hydrochloride);
Auxiliary components: microcrystalline cellulose, calcium phosphate, hydroxypropylcellulose, magnesium stearate, sodium starch glycolate, hydroxypropylmethylcellulose, polysorbates, polyethylene glycol, titanium dioxide (E171).

Pharmacological properties

Pharmacodynamics

The antidepressant sertraline is a powerful selective serotonin (5-HT) reuptake inhibitor and at the same time has a very small effect on the reuptake of dopamine and norepinephrine.

When used in therapeutic doses, sertraline can block the process of serotonin reuptake in human platelets. Controlled clinical studies indicate the absence of anticholinergic, sedative or stimulant effects, as well as cases of psychomotor dysfunction in volunteers. With long-term use of sertraline, there is no development of drug dependence, and long-term treatment with this substance does not lead to weight gain.

Animal studies have shown that, due to the selective inhibition of 5-HT uptake, sertraline has no affinity for muscarinic (cholinergic), dopaminergic, adrenergic, serotonergic, histaminergic, benzodiazepine or GABA receptors, and does not enhance catecholamine activity and does not have a cardiotoxic effect.

Taking sertraline does not lead to drug abuse. A placebo-controlled, double-blind, comparative study designed to examine the abuse potential of sertraline, dextroamphetamine, and alprazolam did not reveal the abuse potential of sertraline. At the same time, patients receiving dextroamphetamine and alprazolam were more likely to develop drug abuse compared to the placebo group. To assess the abuse potential, indicators such as the drug's ability to induce abuse, euphoria, and positive emotions were measured. In rhesus monkeys habituated to self-administration of cocaine, sertraline was not a positive stimulus (unlike dextroamphetamine and phenobarbital).

Pharmacokinetics

When using sertraline at a dose of 50–200 mg, the increase in Cmax and AUC is proportional to the dose and is linear. When taking sertraline at a dose of 50–200 mg once a day for 14 days, Cmax was observed 4.5–8.4 hours after administration. Absorption is high and occurs slowly. When taken simultaneously with food, the bioavailability of the drug changes slightly (by 25%).

Sertraline binds well to plasma proteins (approximately 98%).

During the first passage through the liver, active biotransformation of sertraline occurs. The main metabolic pathway is N-demethylation. The main metabolite N-desmethylsertraline is found in plasma, the activity of which is approximately 20 times less than the activity of sertraline in vitro. In addition, this metabolite has virtually no activity in in vivo models of depression. The half-life of N-desmethylsertraline is from 62 to 104 hours.

Sertraline and N-desmethylsertraline undergo oxidative deamination and subsequent reduction, hydroxylation and glucuronidation. When labeled sertraline is administered to healthy volunteers, less than 5% of radioactive sertraline is detected in the blood plasma. After 9 days, approximately 40–45% of the administered dose was found in urine, another 40–45% in feces (including 12–14% unchanged sertraline). Unchanged sertraline is excreted in small amounts (<0.2%) by the kidneys.

AUC (0–24 hours), Cmax and Cmin of N-desmethylsertraline increases depending on time and dose from days 1 to 14 by approximately 5–9 times.

The mean elimination half-life of sertraline in both young and elderly patients is 22 to 36 hours. When taking Zoloft once a day for 1 week, an approximately twofold cumulation of the drug is observed before the onset of equilibrium concentrations. The half-life of N-desmethylsertraline is 62–104 hours. Sertraline and N-desmethylsertraline are actively biotransformed, the resulting metabolites are excreted through the intestines and kidneys in equal quantities. The pharmacokinetic profile in patients aged 18–65 years is no different from that in adolescents and the elderly.

The pharmacokinetics of sertraline in children with OCD (obsessive-compulsive disorder) are similar to those in adults, although the metabolism of sertraline in children is slightly more active. At the same time, the body weight of children (especially those aged 6 to 12 years) is lower, so during therapy it is necessary to use smaller doses of the drug.

Repeated administration of sertraline by patients with mild liver cirrhosis leads to an increase in the half-life of Zoloft and an almost threefold increase in Cmax and AUC (compared to values in healthy people). There were no significant differences in the binding of sertraline to plasma proteins in these two groups. When treating patients with impaired liver function with the drug, it is necessary to evaluate the advisability of reducing the dose or extending the interval between doses of the drug.

With repeated administration of sertraline in patients with mild to moderate renal failure (creatinine clearance from 30 to 60 ml/min) and patients with moderate or severe renal failure (creatinine clearance from 10 to 29 ml/min) the Cmax and AUC of the drug did not differ significantly from the control group . The half-life of sertraline was similar in all groups. Also, no differences in binding to plasma proteins were observed. Sertraline excretion by the kidneys is negligible, so dose adjustment of Zoloft is not required in case of renal failure.

Indications for use

Prevention and treatment of depressive conditions of various origins.
Panic and obsessive-compulsive disorders.
Mood disturbances due to traumatic stress disorders.
Phobias, fears, increased anxiety.

Contraindications

Absolute:

Concomitant use of sertraline with monoamine oxidase inhibitors (MAO) and pimozide;
Age up to 6 years;
Hypersensitivity to the components of the drug.

With caution (due to the increased likelihood of complications):

Epilepsy;
Marked loss of body weight;
Organic brain damage (including mental retardation);
Renal and/or liver failure.

There have been no controlled studies on the use of sertraline during pregnancy, therefore the drug can be prescribed to pregnant women only if the expected benefit to the mother significantly outweighs the potential risk of developing fetal pathologies. Women of reproductive age who are to be prescribed Zoloft for therapy should use effective contraception.

Sertraline passes into breast milk. Taking Zoloft during breastfeeding is not recommended, since the safety of use in this case has not been reliably confirmed. If treatment is necessary, then breastfeeding should be stopped for a while.

As a result of the use of sertraline during pregnancy and breastfeeding in combination with antidepressants from the SSRI group (selective serotonin reuptake inhibitors), including serotonin, some newborns may experience symptoms similar to a withdrawal reaction.

Zoloft and side effects

First, let’s remember why and when it is used at all. These are not “vitamins”, right?

For example, for prostate cancer, sometimes medical or surgical castration is used... That is, we come to the question of priorities!

Depression, real, “medical”, is an extremely serious illness. It may well “ruin” a person who has fallen into despair. It can “ruin” the taste of life, making them gray and unpleasant.

I don't want to compare this to pancreatic cancer or prostate cancer! But death is not that far away after a couple of years of hellish mental torment - from death from bodily torment.

Conclusion - we must make every effort to get rid of such a prospect as quickly as possible! Maximum - this means that we temporarily do not pay attention to less serious losses! That is, first we will get out of the swamp, and only then we will count how much gasoline and labor it took.

And here, of course, it’s better to get out quickly on an adequate dose of an adequate drug than to take “harmless weed” or “easy pills.” The efficiency criterion comes first, precisely in this case.

Instructions for use of Zoloft: method and dosage

Zoloft is taken orally, regardless of food intake, 1 time per day, in the morning or evening:

OCD and depressive states of various etiologies: initial dose – 50 mg per day;
PTSD, social phobia, panic disorder: initial dose – 25 mg per day, after 1 week the dose is increased to 50 mg per day (this regimen allows to reduce the frequency of early undesirable effects from therapy characteristic of panic disorder).

If the use of sertraline at a dose of 50 mg per day is not effective enough, the dose can be increased. It is recommended to increase the dose at intervals no more than once a week, without exceeding the maximum recommended - 200 mg per day.

Initial results may be observed within 7 days of starting Zoloft, but the maximum effect is usually achieved after 2-4 weeks (in the case of OCD, this usually takes longer).

For a course of long-term maintenance treatment, Zoloft is prescribed in the minimum effective dose, which can be changed depending on the achieved clinical result.

Recommended dosage regimen for the treatment of OCD in children and adolescents, depending on age:

6-12 years: initial dose – 25 mg per day, after 1 week it is increased to 50 mg per day; in the future, if the effect is insufficient, the dose can be increased in steps of 50 mg to 200 mg per day;
13-17 years: initial dose – 50 mg per day.

Based on the results of clinical studies, the pharmacokinetic profile of sertraline in patients with depression and OCD aged 6 years to 17 years was found to be similar to that in adults. In order to avoid overdose, increasing the dose of Zoloft to more than 50 mg, it should be taken into account that children have less body weight than adults.

Instructions for use, dosage

It is forbidden to divide the daily dosage of the drug into several doses. The antidepressant should be taken once a day at any time. Greater effectiveness can be achieved if the patient takes the tablets with meals.

The manufacturer identifies the starting dose, which is prescribed at the first stage of treatment, as well as the average therapeutic dosage, which has the best therapeutic effect. There is also a maximum dose that must not be exceeded even in a situation where the expected positive effect has not been achieved.

To combat obsessive thoughts and depression, you need to take 50 mg of the drug once a day. After 7 days, the dosage can be increased to 100 mg. After another week, you can take 150 mg of antidepressant. The maximum daily dosage should not exceed 200 mg.

To effectively combat anxiety-phobic disorders, it is best to start treatment with 25 mg of the drug per day. Only after 7 days can the dosage be increased to 50 mg. This is quite enough to achieve a positive therapeutic effect. Otherwise, the dosage can be increased to a maximum of 75 mg.

The medicine will begin to act within a week after regular use. A significant improvement in emotional state will occur after 14 days. The standard therapeutic course lasts 3 months. Abruptly stopping taking the drug is strictly prohibited, as withdrawal syndrome may develop, which will negatively affect the general condition of the patient.

For the treatment of children aged 13 to 17 years with obsessive-compulsive disorders, 50 mg of the drug per day should be used. The treatment regimen must be prescribed by the attending physician.

For children from 6 to 12 years old, the dosage of the drug should be reduced to 25 mg per day. If necessary, the psychiatrist can increase or decrease the dose of the drug. The maximum concentration of the drug should not exceed 200 mg per day.

Side effects

Cardiovascular system (CVS): tachycardia, rapid heartbeat, arterial hypertension;
Digestive system: abdominal pain, dry mouth, pancreatitis, dyspeptic disorders (nausea, vomiting, flatulence, diarrhea, constipation);
Musculoskeletal system: muscle cramps, arthralgia;
Respiratory system: yawning, bronchospasm;
Central and peripheral nervous system: paresthesia, fainting, migraine, headache, dizziness, tremor, drowsiness, insomnia, anxiety, hypomania, mania, agitation, hallucinations, euphoria, psychosis, decreased libido, nightmares, suicide, coma, extrapyramidal disorders ( akathisia, bruxism, dyskinesia, gait disturbance);
Urinary system: enuresis, urinary retention or incontinence;
Reproductive system and mammary gland: galactorrhea, gynecomastia, sexual dysfunction (decreased potency, delayed ejaculation), menstrual irregularities, priapism;
Visual organs: mydriasis, visual impairment;
Endocrine system: hypothyroidism, hyperprolactinemia, syndrome of inappropriate secretion of antidiuretic hormone (ADH);
Hepatobiliary system: jaundice, hepatitis, liver failure;
Allergic reactions: itching, urticaria, anaphylactoid reaction;
Other: weakness, ringing in the ears, flushing of the face or redness of the skin, alopecia, facial swelling, angioedema, periorbital edema, photosensitivity reaction, increased sweating, purpura, decreased appetite, up to anorexia (rarely increased), increased or weight loss, bleeding (including gastrointestinal, nasal or hematuria), peripheral edema, rarely Steven-Johnson syndrome and epidermal necrolysis;
Laboratory data: in case of long-term use, an asymptomatic increase in transaminase activity in the blood serum rarely occurs (when the drug is discontinued, enzyme activity normalizes); possible development of thrombocytopenia and leukopenia, increased serum cholesterol levels; In rare cases, discontinuation of sertraline therapy may cause a withdrawal syndrome accompanied by paresthesia, hypoesthesia, symptoms of depression, hallucinations, aggressive reactions, psychomotor agitation, anxiety, or symptoms of psychosis that cannot be distinguished from signs of the underlying disease.

With an overdose of sertraline, no significant side effects have been identified, even in the case of high doses. Using Zoloft with other substances/drugs or alcohol can cause severe poisoning, including coma and death.

Signs of overdose are serotonin syndrome, accompanied by psychomotor agitation, nausea, vomiting, tachycardia, agitation, drowsiness, dizziness, diarrhea, increased sweating, hyperreflexia and myoclonus. There are no specific antidotes; intensive supportive care with constant monitoring of vital functions is required. Provoking vomiting is not effective; taking activated charcoal may be more effective than gastric lavage. It is important to maintain a patent airway. Due to the large volume of distribution of sertraline, and the resulting increased diuresis, dialysis or hemoperfusion, as well as blood transfusion, may be ineffective.

Overdose

In case of an overdose of Zoloft, the following adverse effects may develop:

ventricular ari;
serotonin syndrome with prolongation of the QT interval;
tachycardia;
nausea, vomiting, diarrhea;
agitation, psychomotor agitation;
tremor;
drowsiness;
dizziness;
increased sweating;
myoclonus;
hyperreflexia;
coma (in some cases).

Also, in case of an overdose of the drug, severe poisoning may occur, including coma and death (with monotherapy or simultaneous use with other drugs and/or alcohol), therefore any overdose of Zoloft should be accompanied by intensive therapy.

There are no specific antidotes, so intensive supportive care and constant monitoring of vital body functions are recommended (for example, ECG monitoring due to the possibility of prolongation of the QT interval when using sertraline). Inducing vomiting is not recommended, and it is advisable to replace gastric lavage with the administration of a laxative along with activated charcoal. Measures must be taken to maintain airway patency. Due to the large volume of distribution of sertraline, forced diuresis, blood transfusion, hemoperfusion, or dialysis may be unsuccessful.

special instructions

Sertraline is not used in conjunction with MAO inhibitors; between courses of taking these substances, a break of at least 2 weeks should be observed.

When using SSRIs, cases of the development of serotonin syndrome and NMS (neuroleptic malignant syndrome) have been described, the likelihood of which increases with the combined use of third-generation antidepressants with other serotonergic substances (including triptans), as well as drugs that affect the metabolism of serotonin (including MAO inhibitors), antipsychotics and other dopamine receptor antagonists. Signs of serotonin syndrome may include: changes in mental status (hallucinations, agitation, coma), autonomic lability (fluctuations in blood pressure, tachycardia, hyperthermia), changes in neuromuscular transmission (impaired coordination of movements, hyperreflexia) and/or disorders of the gastrointestinal tract ( diarrhea, nausea, vomiting). Some symptoms of serotonin syndrome, including hyperthermia, muscle rigidity, autonomic lability with the possibility of frequent fluctuations in vital signs, and changes in mental status, are similar to the symptoms that develop in NMS. It is necessary to monitor the development of clinical effects of serotonin syndrome and NMS in patients in order to provide timely medical care.

The concomitant use of sertraline with other drugs that enhance serotonergic neurotransmission (for example, fenfluramine, tryptophan or 5-HT agonists) should be done with caution, as there is a potential for pharmacodynamic interaction.

There is insufficient experience with concomitant use of sertraline in patients undergoing electroconvulsive therapy. There is no data on either positive results or undesirable effects of such combinations. There is also no experience with the use of Zoloft for the treatment of convulsive syndrome, so the drug cannot be used for unstable epilepsy, and in the case of controlled epilepsy, careful monitoring of patients is necessary (if seizures occur, the drug should be discontinued).

When switching to Zoloft from other SSRIs, anti-obsessive drugs or antidepressants, caution should be exercised, especially if you have previously used long-acting drugs, such as fluoxetine. There are no data on the length of the required interval that must be observed between stopping one SSRI drug and starting another similar drug.

Constant monitoring from the start of the course until the period of sustained remission is necessary when treating patients with depression with Zoloft, due to the increased risk of suicide.

There is a slight likelihood of activation of mania/hypomania in patients treated with sertraline and in patients with manic-depressive psychosis who used other anti-obsessive or antidepressant drugs.

Considering the active biotransformation of sertraline in the liver and data from a pharmacokinetic study, it should be used with caution in case of liver dysfunction: it is recommended to reduce the dose or increase the interval between doses of the drug.

Based on the results of studies of the use of Zoloft in patients with renal failure, it was revealed that, given the insignificant renal excretion of sertraline, dose adjustment depending on the severity of renal failure is not required.

Pathological hemorrhages/bleeding are possible when selective serotonin reuptake inhibitors are prescribed with drugs that have an established ability to change platelet functions, as well as in patients with a history of hemorrhagic pathologies.

Transient hyponatremia often develops in elderly patients, as well as when taking sertraline with diuretics or a number of other drugs. A similar adverse reaction is associated with the syndrome of inappropriate ADH secretion. In this case, Zoloft should be discontinued and appropriate therapy should be prescribed to correct sodium levels in the blood. Symptoms and signs of hyponatremia: headache, memory impairment, impaired concentration, weakness and vestibular disorders, which can lead to falls; in more complex episodes, the following are possible: fainting, convulsions, hallucinations, coma, respiratory arrest and death.

Sertraline therapy is usually not accompanied by impaired concentration and a decrease in the speed of psychomotor reactions, but its use with other substances/drugs can lead to impairment of coordination and attention. Therefore, while taking Zoloft, it is not recommended to drive special equipment, vehicles or engage in activities associated with increased risk.

Use during pregnancy and lactation

Pregnancy

There are no data from controlled studies of the use of sertraline during pregnancy, so the use of Zoloft during this period is possible only after a thorough analysis of the possible risk to the child and the expected benefit to the mother.

Analysis of a significant amount of data did not lead to the conclusion that the use of sertraline induces birth defects. Animal studies have provided information about the possible effects of sertraline on reproductive function. There is a possibility that this effect is associated with maternal toxicity, which is caused by the pharmacodynamic effects of sertraline on the fetus.

Some newborns whose mothers took sertraline during pregnancy experienced symptoms resembling withdrawal reactions.

Women of reproductive age taking sertraline should use reliable contraceptives.

Lactation

Sertraline and N-desmethylsertraline are found in small amounts in breast milk. In most cases, insignificant concentrations of sertraline were found in the blood plasma of newborns. The exception is one case when 50% of the concentration of sertraline in the mother's blood plasma was found in the blood plasma of the newborn (there was no noticeable effect on the health of the newborn). When prescribing Zoloft during lactation, it is recommended to stop breastfeeding.

Infants whose mothers were treated with Zoloft and other SSRIs or SSRIs during pregnancy experienced complications that required additional hospitalization, tube feeding, and respiratory support. Newborns whose mothers received sertraline during late stages of pregnancy require careful monitoring: such children may develop respiratory distress, cyanosis, seizures, apnea, instability of body temperature, vomiting, feeding difficulties, hypoglycemia, hypo- or hypertonicity, hyperreflexia, twitching muscles, tremors, as well as prolonged crying, increased excitability, drowsiness, lethargy, difficulty falling asleep. The described symptoms may indicate the development of a withdrawal syndrome or may be associated with direct serotonergic effects. Often these complications begin immediately after birth or shortly (less than 24 hours) after birth. It should be borne in mind that in some cases the clinical picture may resemble the symptoms of serotonergic syndrome.

Newborns whose mothers took SSRIs during pregnancy may also have an increased risk of developing persistent pulmonary hypertension of the newborn (PPHN), which accounts for 5 cases per 1000 pregnancies and is one of the causes of morbidity and mortality in newborns. Several recent epidemiological studies have found a possible association between the development of PPHN and the use of SSRIs (including Zoloft).

Fertility

One of two studies in mice showed a decrease in fertility when taking sertraline at a dose of 80 mg per 1 kg of body weight (4 times the maximum recommended dose for humans when calculated mg/m2).

The reported clinical cases indicate that some SSRIs may have a reversible effect on sperm quality.

Use in childhood

According to the instructions, Zoloft should not be used to treat children under 6 years of age.

In children aged 13 to 17 years suffering from OCD, the initial daily dose of the drug should be 50 mg. When treating OCD in children aged 6 to 12 years, the initial daily dose of Zoloft should be 25 mg. After 1 week, the daily dose can be increased to 50 mg, and if there is no sufficient effect - up to 200 mg (no more than 50 mg per day is allowed). To avoid overdose, when increasing the dose to more than 50 mg, one must take into account the fact that body weight in children is less than that in adults. The minimum interval between dose changes is 1 week.

How to take Zoloft

Zoloft is taken orally once a day in the morning or evening, without strict connection with meals. When treating obsessive-compulsive disorder or depression, therapy begins with a dose of 50 mg per day. For panic disorders, social phobias, and psychotraumatic situations, the dosage starts at 25 mg per day with a gradual increase after a week to 50 mg. If there is no or weak effect, the 50 mg dose may be increased at intervals of at least one week. The maximum dosage is 200 mg. The recommendations are valid for young and elderly patients.

Children and adolescents from 13 to 17 years of age suffering from OCD are prescribed a dosage of 50 mg per day. In children with OCD from 6 to 12 years of age, therapy begins with 25 mg per day, increasing after a week to 50 mg. Depending on the clinical effect, the dosage may be increased to 200 mg (taking into account body weight). Caution should be exercised in patients with liver disease (smaller doses or longer periods between doses).

When does it take effect?

The first effect begins to be felt a week after starting treatment. A significant and marginal effect is usually achieved two to four weeks after the start of the course. With obsessive-compulsive disorder, it can sometimes take longer to reach the maximum effect (much depends on the simultaneous psychological impact).

Drug interactions

Class IC antiarrhythmic drugs (flecainide, propafenone), tricyclic antidepressants: long-term use of sertraline at a dose of 50 mg per day increases their concentration in plasma, since the CYP2D6 isoenzyme is involved in metabolism;
Indirect anticoagulants (warfarin): there is a slight but statistically significant increase in prothrombin time; in these cases, prothrombin time should be monitored at the beginning of treatment with sertraline and after its discontinuation;
Antipyrine: when taken together with sertraline (at a dose of 200 mg per day) leads to a slight (5%) but significant decrease in T1/2 of antipyrine;
Atenolol: Sertraline has no effect on its β-adrenergic blocking effect;
Digoxin and glibenclamide: no drug interactions with sertraline (at a dose of 200 mg per day) have been identified;
Selective inhibitors of neuronal serotonin reuptake (including lithium preparations): increased caution is required when used together with sertraline (the pharmacokinetics of lithium does not change, but tremor is more often observed in patients);
MAOIs, including those with a reversible type of action (linezolid, moclobemide) and selectively acting (selegiline): severe complications are possible (development of serotonin syndrome with rigidity, myoclonus, hyperthermia, lability of the autonomic nervous system (rapid fluctuations in cardiovascular and respiratory parameters activity)), changes in mental status (including severe agitation, increased irritability, confusion, which in some episodes can develop into delirium or coma). Similar complications, sometimes fatal, occur when MAOIs are prescribed during treatment with antidepressants that inhibit the neuronal uptake of monoamines, or immediately after their withdrawal;
Drugs metabolized by isoenzymes CYP3A3/4, CYP2C9, CYP2C19, CYP1A2: sertraline minimally inhibits or has virtually no effect on these isoenzymes;
Pimozide: its level may increase with a single dose of low dose (2 mg). Since the mechanism of this interaction has not been determined, and pimozide has a different target therapeutic index, simultaneous use of pimozide with sertraline is contraindicated;
Drugs that bind to blood proteins (diazepam, tolbutamide): sertraline affects their concentration in the blood plasma, reducing clearance (it is necessary to control blood glucose levels);
Sumatriptan: in extremely rare episodes, weakness, increased tendon reflexes, confusion, anxiety and agitation are noted; in case of simultaneous use with sertraline, monitoring of patients is recommended;
Tryptophan, fenfluramine: simultaneous use with sertraline should be avoided;
Phenytoin: sertraline (at a dose of 200 mg per day) does not suppress metabolism and does not have a clinically significant effect on phenytoin, but despite this, from the start of their simultaneous use, it is necessary to carefully monitor the content of phenytoin in the blood plasma for subsequent dose adjustment;
Cimetidine: significantly reduces the clearance of sertraline;
Ethanol and substances/drugs that depress the central nervous system: no potentiation of the effect of carbamazepine, phenytoin, haloperidol or ethanol on psychomotor and cognitive function in healthy people was noted, but the combined use of Zoloft and alcohol is not recommended.

Zoloft. Indications for use

Why is this drug prescribed?

Depression is a rather painful condition. In which the taste of food, sex and other joys of life is largely lost.

And so, sometimes the following happens. All life's joys are blocked or covered with a gray fog, except one! For example, a depressed person finds his satisfaction only in food... Or in sex, in this very libido. Thus, by the way, really helping yourself with the antidepressant effect of sexual contacts, in any form.

They began to treat - and suddenly this joy disappeared or decreased! Really unpleasant.

However, let me remind you that this does not happen often, the reduction effect is temporary, and there are alternative methods. From another drug (with a different mechanism of action) to non-drug methods.

Use other drugs

Another drug may have more side effects than the one described by Zoloft, but will not affect libido! Here you have to choose. I personally chose Zoloft, along with a couple of others, for optimal harmlessness.

Non-drug treatments for depression

A completely separate conversation. And it’s not suitable for everyone, and it requires more strength. But there are also advantages, undoubtedly. Everyone interested is carefully studying the book by V. Levi “People are lucky!” - IMHO the best on this topic, the basic one. Undoubtedly, this technique can and should be expanded.

Reviews about Zoloft

Reviews of Zoloft indicate that this drug is often used in the treatment of various phobias, depression and other disorders of the nervous system.

In most reviews, users note the effectiveness of Zoloft (normalization of sleep and psychological state), but its effect can manifest itself quite slowly.

There is also information about the development of side effects such as insomnia or severe drowsiness during therapy. In addition, some users report developing diseases affecting the liver and kidneys.

According to doctors, Zoloft is a highly effective drug that improves the condition of the nervous system. At the same time, it must be taken into account that treatment with this drug should be carried out with strict dosage control and only under the supervision of a specialist.

Adequacy of Zoloft prescription by doctors

Rough, but quite accurate about the adequacy of the drug prescription

Sometimes it happens that a person does not need an antidepressant, but it helps.

I took sertraline under the trade name Torin. 14 days and no visible effect. I know that antidepressants do not work immediately, but apparently nothing helps me except fluoxetine (the results of which I feel on the first day of taking it).

I tried many ADs. Yes, by the way, my libido was absent from sertraline as such compared to fluoxetine. It even appeared from the latter (apparently as a consequence of weakening symptoms of depression).

Antidepressants do not help a person! And what helps is a “side effect” of one of them, Fluoxetine! I won’t go into detail, but this is a fact.

In total, a completely different drug or combination of drugs will help him much better, faster and more reliably!