What Is Sertraline
Sertraline, also known as Zoloft in brand form, is an antidepressant that belongs to the group of drugs known as Select Serotonin Reuptake Inhibitors (SSRIs). Sertraline is the oral form of the drug and is usually prescribed by a doctor. Being a generic drug, sertraline is cheaper than its brand name equivalent. In certain cases, these medications may not be available in every form or strength as the brand drug. Sertraline is also available in oral solution form.
As previously mentioned, sertraline is an antidepressant, which means that it is used for the treatment of severe forms of mental medical conditions such as panic attacks, depressive disorders, premenstrual dysphoric disorder, obsessive compulsive disorder, and other post-traumatic stress disorders. Sertraline can also be prescribed with other drugs for the treatment of mental disorders.
How Does Sertraline Work?
More research is needed to fully understand how sertraline works. However, what is known is that it increases the levels of the neurotransmitter serotonin in the brain, which helps to reduce panic attacks, helps improve mood, and treats a number of other mental disorders.
Serotonin is a chemical neurotransmitter that transmits electrical impulses from one neuron to another. Serotonin normally reabsorbs quickly, but an SSRI allows the serotonin to remain in the synaptic gap in between neurons for a longer duration of time. This allows the chemical to send additional messages to the receiving neuron, which is believed to improve mood.
What to Avoid While Taking Sertraline
Sertraline should not be used by individuals who are taking pimozide or being treated with methylene blue injections. Additionally, sertraline should be avoided if you have taken MAO inhibitors in the past 14 days, since it can cause a dangerous drug interaction. A few of these MAO inhibitors include rasagiline, isocarboxazid, selegiline, phenelzine, and linezolid.
In some cases, suicidal thoughts have been reported in younger patients taking antidepressants. Therefore, it is important to alert your doctor of any mood changes or related symptoms. Some symptoms to look out for include:
- Getting easily irritated
- Panic or anxiety attacks
- Insomnia
- A tendency to self-injure
- Restlessness
- Hyperactivity (physically or mentally)
- Aggression
Anyone below the age of 18 years should not be given sertraline without a prescription from their doctor. This medication has been approved by the Food and Drug Administration for children suffering with obsessive-compulsive disorder or OCD. However, this drug is not approved for children who are diagnosed with depression.
Avoid drinking alcohol while taking sertraline. Consuming alcoholic beverages while using sertraline may cause sleepiness. Additionally, it can also have an impact on the ability to make decisions, think clearly, and react quickly.
Before Usage
Individuals who are allergic to sertraline, or any ingredients it contains, should avoid taking this drug. Those who are taking pimozide or being treated with methylene blue injection should avoid taking sertraline. To ensure that this medication causes no health problems, it is recommended that you inform your doctor if you are suffering from any of the following medical conditions:
- Epilepsy or convulsions
- Manic depression or bipolar disorder
- Damage to the kidney or liver
- Past history of drug or alcohol abuse
- Past history of suicidal tendencies
- Disorder of blood clotting
For pregnant women, this medication could lead to serious lung issues or complications with their child. Immediately stopping the use of sertraline may cause a relapse in depression. Therefore, it is best to inform your doctor if you are pregnant or planning to conceive. While pregnant, do not start or suddenly stop taking sertraline without prior consent from your doctor. It is still unclear as to whether this medication passes to infants through breast milk; thus, it is important to speak to your doctor in advance before starting sertraline if you are breastfeeding a child.
Usage
Sertraline should be taken exactly as prescribed by your doctor. Ensure that you follow all directions mentioned on the prescription label. It is not recommended to change or alter your dose of sertraline without prior consent from your doctor. For the best results, take your dose of sertraline at the exact same time every day. This drug can be taken with or without food. Upon reviewing your case, the doctor will provide you with the dosing schedule that’s best for you. Some of the factors that the doctor will consider before providing this schedule are:
- What condition you’re being treated for
- The severity of your condition
- Your age
- If you are being treated for any other medical conditions
- If you are experiencing any other side effects prior to taking this drug
Sertraline is available in both oral solution and oral tablets in various strengths. Some of the strengths available are 25mg, 50mg, and 100mg. The oral solution is available in 20mg/ml.
Sertraline can lead to withdrawal symptoms if it is stopped suddenly. When patients discontinue taking sertraline suddenly, they may experience symptoms such as:
- Nausea
- Irritability
- Anxiety
- Sleep habit changes
- Sensations similar to electric shocks
- Confusion
- Aggression
If a dose is missed, it is recommended to take it as soon as you remember that you missed it. However, if it is already time for your next dose, simply skip the missed dose and continue on to the next. Never take a double dose.
Side Effects
There are certain side effects which differ between children and adults. Below are the common side effects which can be experienced by patients of all ages:
- Loss of appetite
- Shaking
- Agitation
- Nausea
- Sexual problems
- Excessive sweating
- Tremors
- Diarrhea
- Fatigue
- Insomnia
- Issues digesting food
- Inability to ejaculate during intercourse
- Weakness
- Reduced sex drive
There are additional side effects which can be experienced by children. These side effects include:
- Bleeding from the nose
- Urine leakage
- Frequent urination
- Heavy bleeding during menstrual cycle
- Aggression
- Changes in weight
- Effects to growth rate
Mild side effects will often subside within a couple of weeks; thus, they are usually nothing to worry about. However, if these side effects worsen or do not subside within a week or two, consult your doctor.
The more serious side effects of sertraline include:
- Suicidal tendencies
- New or worsening depression
- Dangerous impulses
- Low sodium levels
- Violent behavior
- Panic attacks or anxiety attacks
- Insomnia
- Eye pain
- Changes in vision or blurry vision
- Swelling around the eyes
- Abnormal bleeding
- Talking more than usual
- Serotonin syndrome
Serotonin syndrome is a life-threatening condition which can become fatal if not treated in time. Some of the symptoms of serotonin syndrome include:
- Agitation
- Loss of consciousness
- Hallucinations
- Excessive sweating
- Coma
- Irregular heart rate
- Muscle tremors
- Stiff muscles
- Vomiting
- Shaking
- Rigidity in the muscles
Drug Interactions
The oral form of Sertraline tends to interact with other medications, herbs, dietary supplements, and vitamins. Though most interactions are mild, some can be harmful and also hinder the effectiveness of this medication. To avoid such interactions, it is best to inform your doctor of any other medicines or supplements you are taking. Below are drugs which should not be used while taking sertraline:
- Pimozide: Taking this medicine along with sertraline can lead to serious heart problems.
- MAO: Taking these drugs along with sertraline can lead to an increased risk of developing serotonin syndrome.
- Methylene blue injections: Receiving these injections while taking sertraline leads to an increased risk of serotonin syndrome.
- Triptans such as sumatriptan: Taking these drugs along with sertraline can lead to an increased risk of serotonin syndrome.
- Cimetidine: Taking cimetidine with sertraline can cause sertraline to build up in the body. If there is a need for cimetidine, your dosage of sertraline must be lowered accordingly.
- Non-steroidal anti-inflammatory drugs (NSAIDs): Taking NSAIDs with sertraline can increase your risk of bruising. Additionally, it also increases the risk of bleeding.
- Lithium: Taking lithium with sertraline can lead to an increased risk of serotonin syndrome.
- Tricyclic antidepressants: Taking tricyclic medicines with sertraline can lead to a buildup of these drugs in the body.
- Serotonergic such as tramadol and fentanyl: Taking these drugs with sertraline increases your risk of developing serotonin syndrome.
