What are the most common side effects of sertraline. How long do Zoloft side effects typically last. Can sertraline cause sexual dysfunction. Is insomnia a common side effect of SSRIs. How to manage fatigue while taking sertraline.

Understanding Sertraline: A Widely Prescribed SSRI

Sertraline, commonly known by its brand name Zoloft, is a selective serotonin reuptake inhibitor (SSRI) that has been a cornerstone in the treatment of various mental health disorders since the 1990s. This FDA-approved medication is prescribed to millions of people annually for conditions such as major depressive disorder (MDD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder, social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD).

While sertraline is generally considered safe and effective, it’s crucial for patients and healthcare providers to be aware of potential side effects. Most side effects emerge during the initial weeks of treatment and often subside as the body adjusts to the medication. However, some effects may persist or appear later in the treatment course.

Fatigue and Tiredness: Navigating Energy Levels on Sertraline

One of the most frequently reported side effects of sertraline is fatigue and tiredness. This can be particularly challenging for individuals already grappling with depression-related energy deficits. The National Alliance on Mental Illness notes that feeling low in energy is common during the first few weeks of sertraline use.

Managing Sertraline-Induced Fatigue

• Allow time for adjustment: Most patients find that fatigue diminishes as their body acclimates to the medication.
• Maintain a consistent sleep schedule: Prioritize good sleep hygiene to combat daytime drowsiness.
• Exercise regularly: Moderate physical activity can boost energy levels and overall well-being.
• Consult your healthcare provider: If fatigue persists beyond a month, discuss potential dosage adjustments or alternative treatments.

Is sertraline-induced fatigue permanent? In most cases, this side effect is temporary. As the medication reaches a steady state in your system, typically within 4-6 weeks, many patients report improved energy levels. However, if fatigue persists or significantly impacts your daily life, it’s essential to communicate with your healthcare provider to explore solutions.

Sexual Side Effects: Addressing Intimacy Concerns

Sexual side effects are among the most common and potentially distressing issues associated with sertraline and other SSRIs. These effects can manifest in various ways, impacting both men and women.

Prevalence and Types of Sexual Side Effects

Research indicates that between 40% and 65% of individuals taking SSRIs experience some form of sexual side effect. However, it’s worth noting that sertraline has been found to have a lower likelihood of affecting sexual function compared to some other SSRIs.

• For men: Difficulty achieving orgasm, delayed ejaculation, and reduced libido are common.
• For women: Decreased sexual desire is the most frequently reported issue.

How can sexual side effects of sertraline be managed? Several strategies can be employed:

1. Wait for adjustment: Like other side effects, sexual issues may improve as your body adapts to the medication.
2. Dosage adjustment: Your healthcare provider may consider lowering the dose if side effects are significant.
3. Timing of medication: Taking sertraline after sexual activity may help minimize its impact on sexual function.
4. Adding or switching medications: In some cases, adding another medication or switching to a different antidepressant may be beneficial.
5. Psychosexual counseling: Working with a therapist can help address both psychological and physical aspects of sexual function.

Sleep Disturbances: Balancing Rest and Recovery

Sertraline can significantly impact sleep patterns, with some individuals experiencing insomnia while others find themselves more drowsy than usual. A 2017 review of research literature found that the prevalence of insomnia attributed to SSRI treatment was 17% compared to 9% in those taking a placebo.

Strategies for Improving Sleep Quality on Sertraline

• Adjust medication timing: Taking sertraline in the morning may help reduce its concentration by bedtime.
• Practice sleep hygiene: Establish a consistent sleep schedule and create a relaxing bedtime routine.
• Limit caffeine and alcohol: Both can interfere with sleep, especially when combined with sertraline.
• Consider short-term sleep aids: Consult your healthcare provider about temporary use of sleep medications if insomnia is severe.
• Engage in relaxation techniques: Meditation, deep breathing, or gentle yoga can promote better sleep.

Do sleep disturbances from sertraline improve over time? Many patients find that sleep-related side effects diminish within the first few weeks to months of treatment. However, if sleep issues persist, it’s crucial to discuss this with your healthcare provider, as poor sleep can impact both mental health and overall well-being.

Gastrointestinal Effects: Managing Digestive Discomfort

Sertraline can cause various gastrointestinal side effects, particularly during the initial stages of treatment. These may include nausea, diarrhea, constipation, and changes in appetite.

Coping with Gastrointestinal Side Effects

• Take sertraline with food: This can help reduce nausea and stomach discomfort.
• Stay hydrated: Adequate fluid intake is crucial, especially if experiencing diarrhea.
• Eat smaller, more frequent meals: This can help manage changes in appetite and reduce nausea.
• Consider probiotics: Some patients find relief from digestive issues by incorporating probiotic supplements or foods.
• Communicate with your healthcare provider: Persistent or severe gastrointestinal symptoms may require medication adjustments or additional treatments.

How long do gastrointestinal side effects of sertraline typically last? For most individuals, these effects are most pronounced in the first few weeks of treatment and gradually subside. However, if symptoms persist beyond 4-6 weeks or significantly impact your quality of life, consult your healthcare provider for guidance.

Weight Changes: Understanding and Addressing Body Composition Shifts

Weight changes are a potential side effect of sertraline that can cause concern for many patients. While some individuals may experience weight loss, particularly in the short term due to nausea or reduced appetite, others may notice weight gain over time.

Factors Contributing to Weight Changes on Sertraline

• Altered appetite: Sertraline can affect hunger cues and food preferences.
• Changes in metabolism: The medication may influence how the body processes and stores energy.
• Improved mood: As depression symptoms alleviate, some individuals may experience changes in eating habits.
• Fluid retention: In some cases, SSRIs can cause mild fluid retention, leading to slight weight gain.

Is weight gain inevitable with sertraline use? Not necessarily. While some individuals may experience weight changes, many do not. Maintaining a balanced diet, regular exercise, and open communication with your healthcare provider can help manage this potential side effect.

Emotional and Cognitive Effects: Navigating Mental Shifts

While sertraline is prescribed to improve mood and reduce anxiety, it can sometimes cause temporary emotional and cognitive changes as the brain adjusts to altered serotonin levels.

Potential Emotional and Cognitive Side Effects

• Emotional blunting: Some patients report feeling less emotionally reactive or experiencing a sense of emotional numbness.
• Increased anxiety: Paradoxically, anxiety may temporarily increase in the first few weeks of treatment.
• Agitation or restlessness: Known as akathisia, this can manifest as an inability to sit still or a feeling of inner restlessness.
• Cognitive changes: Some individuals report mild memory issues or difficulty concentrating.

How can one manage emotional and cognitive side effects of sertraline? Patience is key, as many of these effects tend to improve with time. However, it’s crucial to monitor these symptoms and communicate any significant or persistent changes to your healthcare provider. They may adjust your dosage or recommend additional strategies to manage these effects.

Rare but Serious Side Effects: When to Seek Immediate Help

While sertraline is generally well-tolerated, there are rare but serious side effects that require immediate medical attention. Being aware of these potential risks is crucial for patient safety.

Serious Side Effects to Watch For

• Serotonin syndrome: A potentially life-threatening condition caused by excessive serotonin levels.
• Severe allergic reactions: Including swelling of the face, tongue, or throat.
• Suicidal thoughts or behaviors: Particularly in young adults and adolescents.
• Unusual bleeding or bruising: SSRIs can affect blood clotting in some individuals.
• Seizures: While rare, sertraline may lower the seizure threshold in some people.

What should you do if you experience serious side effects from sertraline? Seek immediate medical attention if you notice any signs of these serious side effects. In the case of suicidal thoughts, contact emergency services or a mental health crisis hotline immediately.

Sertraline, like all medications, carries both benefits and potential risks. While side effects can be concerning, it’s important to remember that many people take sertraline without experiencing significant adverse effects. The key to successful treatment lies in open communication with your healthcare provider, careful monitoring of your symptoms, and a balanced approach to managing both the therapeutic effects and potential side effects of the medication.

As research in psychopharmacology continues to advance, our understanding of how to optimize SSRI treatment while minimizing side effects improves. Future developments may lead to more personalized approaches to antidepressant therapy, potentially reducing the incidence and severity of side effects for many patients.

Remember, the decision to start, continue, or discontinue sertraline should always be made in consultation with a qualified healthcare professional. They can provide personalized advice based on your individual health profile, symptoms, and response to treatment.

Sertraline Side Effects: A Complete Guide

With tens of millions of prescriptions in the United States alone, sertraline is an FDA-approved and widely used SSRI medication on the market. 

Safe and effective, sertraline has been used since the 1990s by tens of millions of people every year without major side effects. 

Sertraline (often prescribed under the brand name Zoloft) is approved by the Food and Drug Administration for the treatment of many different mental health disorders, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder major depressive disorder (MDD), social anxiety disorder (SAD) or premenstrual dysphoric disorder (PMDD). 

However, like all SSRIs, sertraline side effects do exist, and you should be aware of them before you consider treatment.

Most sertraline side effects occur in the first few weeks of treatment and tend to disappear over time. However, some can last for several months or occur at any time while using the medication.

Although rare, it’s possible to experience several more serious side effects if you use sertraline to treat depression, anxiety or any other condition.   

Below, we’ve listed the common and uncommon side effects of sertraline. We’ve also linked to relevant studies and other data to provide some more context on how common or uncommon these side effects really are.

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Most Common Side Effects of Sertraline

Sertraline belongs to a class of medications known as selective serotonin reuptake inhibitors, or SSRIs. 

Like other SSRIs, it can cause a range of mild side effects that typically occur during the first few weeks of treatment. 

We’ve listed these common side effects below.

Fatigue and Tiredness

Fatigue and drowsiness are two of the most common side effects of sertraline (Zoloft), as well as several other SSRIs.

If you’re using sertraline to treat depression, fatigue and tiredness from the medication can also be compounded by the effects of depression on your mood.  

It’s very common to feel a little low in energy during the first few weeks of taking sertraline, according to the National Alliance on Mental Illness.

Dealing with fatigue and tiredness from sertraline can be a frustrating experience, but it usually passes. 

As the medication reaches a steady state in your body, you’ll generally start to notice a less pronounced effect on your energy levels before this side effect fades completely.

If you have persistent fatigue or drowsiness after starting sertraline that doesn’t disappear within one month, it’s best to contact your healthcare provider.

Sexual Side Effects

Sertraline and other SSRIs can cause a variety of sexual side effects, from difficulty achieving orgasm, to a decreased sex drive and erectile dysfunction.

Sexual side effects are some of the most common side effects of sertraline and other commonly used SSRI medications.

According to a review of certain studies, between 40 percent and 65 percent of people who take SSRIs experience some side effects related to sexual desire and performance.

It’s worth noting the research did find that of the SSRIs, sertraline has one of the lower likelihoods of affecting sexual function.

These side effects can affect both men and women. In men, one of the most common side effects is a higher level of difficulty achieving orgasm and ejaculating. 

Some men also experience a lower general level of interest in sex after using SSRIs such as sertraline.

In women, the most common sexual side effect of sertraline and other SSRIs is a lower level of interest in sex.

Like many other sertraline effects, sexual side effects can often fade over time as your body gets used to the medication. 

If persistent, sexual side effects can be treated by adjusting your dosage or switching to a different medication.

Sleep Disturbances

Insomnia and a general reduction in sleep quality are both common side effects of SSRIs and other antidepressants. 

People who use sertraline may find that they now have trouble sleeping, or find themselves waking up frequently throughout the night. Sertraline can also cause you to be more sleepy than usual.

While it doesn’t list the effects of sertraline specifically,a 2017 review of research literature notes that it’s common for antidepressants to affect sleep. 

This review found that the prevalence of insomnia attributed to treatment with SSRIs was 17 percent compared to nine percent taking placebo. 

Like many other SSRI side effects, the study states that these effects are most common in the short term.

There are several ways to deal with sleep disturbances from sertraline. The first is to wait it out, as this side effect tends to fade away as the medication reaches a steady-state in your body. 

It’s also possible to take sertraline in the morning to reduce its concentration by the time you sleep.

Finally, it’s important to avoid caffeine and other stimulants that could prevent you from falling asleep in a normal amount of time. 

Try to only consume coffee, caffeinated soda and energy drinks before noon to avoid them affecting you when it’s time to fall asleep.

Dizziness

It’s not uncommon to feel dizzy during the first few weeks of using sertraline. Like other common side effects, this is thought to be a result of your body adjusting to the medication. 

Dizziness is a short-term side effect of sertraline that usually doesn’t persist for longer than two to four weeks.

Interestingly, sertraline is linked to lower levels of dizziness in the long term in studies, indicating that it could help you feel less dizzy once the medication stabilizes in your body.

If you notice frequent dizziness or lightheadedness after using sertraline that lasts for more than four weeks, it’s important to contact your healthcare professional to discuss the potential of low blood pressure caused by your sertraline dose. 

This side effect, like most, may be managed by using a lower dose of the medication. However, if this side effect doesn’t get better after a few weeks, speak to your healthcare provider.

Weight Gain or Weight Loss

Sertraline and other SSRIs are associated with weight fluctuation, although not all people who take these medications will gain or lose weight.

Most of the weight gain caused by antidepressants is mild, with a 2017 study from Australia by BMJ Open finding that, on average, high-dosage antidepressant users gain 0.28kg (about 0.6lbs) per year.

According to a 2018 BMJ UK study, researchers concluded that antidepressants may contribute to a long-term increased risk of weight gain.

Another study by Nutrients found that antidepressant use is associated with a higher total calorie intake.

However, a known side effect of sertraline (discussed more in-depth below) is, in fact, loss of appetite. 

There’s also some research out there to suggest that — at least in the short term — sertraline may actually cause you to lose weight. Especially if you’re diabetic. 

In one smaller study from Primary Care Diabetes involving 33 patients with type 2 diabetes, for instance, researchers found at the end of the 12-week observation period a decrease in overall weight, body mass index and waist circumference, overall.  

If you’re concerned about weight gain or weight loss from sertraline, it’s best to talk to your healthcare provider. 

Most of the time, you can avoid changes in your body mass and composition by monitoring your food intake and maintaining your pre-treatment eating habits while using sertraline.

Loss of Appetite

Sertraline could potentially cause you to have a reduced appetite.

Like other side effects of sertraline, this is usually temporary and should wear off after the first few weeks on the medication. 

The key to avoiding weight loss from sertraline is to talk to your healthcare provider and monitor your food intake. 

By staying consistent with your eating habits and activity level, it’s easier to maintain your body mass and composition while using sertraline or any other SSRI.

Diarrhea

Diarrhea is a common side effect of sertraline.In comparative studies of sertraline and other SSRIs, about 14 percent of people who were prescribed sertraline at a typical dose experienced diarrhea compared to those on other SSRIs.

Like many other Zoloft side effects, diarrhea usually occurs in the first few weeks of treatment. 

Most of the time, diarrhea becomes less frequent and disappears completely as your body adjusts to the medication and your dosage of sertraline reaches a steady state.

If you have persistent diarrhea from sertraline, the best approach is to contact your healthcare provider. 

This side effect, like others, may often be managed by reducing your dosage of sertraline or switching to a different antidepressant, such as paroxetine or fluoxetine, which are both less likely to cause diarrhea.

Headaches

It’s possible that you may experience headaches after you start using sertraline, particularly in the first few weeks of treatment. 

Like other common side effects, Zoloft headaches usually disappear after two to four weeks of use as the medication stabilizes in your body.  

The link between sertraline and headaches is a complicated one. 

While headaches have been reported to be a side effect of taking sertraline, according to Journal of the Association of Physicians of India (in a study of 50 people), sertraline has been shown to be effective in treating chronic tension-type headaches.

While some painkillers can interact with sertraline, it’s safe to take Tylenol® if you experience headaches after starting sertraline. 

Be aware that Tylenol may reduce the effectiveness of sertraline in your body.  It is important to discuss what medications you’re taking with your healthcare provider before you start on sertraline.

If you have persistent or severe headaches from sertraline that don’t improve over time, it’s best to talk to your healthcare provider. 

Simple changes to your sertraline usage such as taking your medication at a different time of day or reducing your dosage can help to limit or get rid of headaches.

Dry Mouth

Finally, dry mouth is a common side effect of sertraline and other antidepressants. While there’s no clear reason for this, researchers believe that the effects of sertraline and other SSRIs on the brain can also affect your gastrointestinal system.

According to the FDA, 14 percent of people prescribed antidepressants experience some level of dry mouth compared to 9% in placebo.  

Although SSRIs like sertraline are less likely to cause dry mouth than other antidepressants  (in one study published in Oral Diseases: Leading in Oral, Maxillofacial, Head and Neck Medicine, it affected about 14 percent of people), it’s still fairly common.

There are several ways to treat dry mouth from sertraline. Like other side effects, dry mouth is often temporary, meaning it should go away on its own over the course of several weeks as the medication reaches a steady state in your body.

It’s also possible to reduce the severity of dry mouth by avoiding caffeine, alcohol, tobacco, any spicy foods and other substances that can cause dehydration. 

Sugar-free gums can also help to stimulate saliva production and keep your mouth and throat properly hydrated. 

It is also recommended that you avoid using mouthwash products that contain alcohol as they can make the problem worse.

Finally, if you have persistent dry mouth from sertraline, you should talk to your healthcare provider.  

Just like many other side effects of sertraline, dry mouth can often be avoided by adjusting your dosage or switching to a different SSRI medication.

Serious Side Effects of Sertraline

People who use sertraline may not experience any side effects, or may only experience a few of the mild side effects listed above. 

However, it’s also possible for sertraline to cause a variety of potentially serious adverse effects in some users.

Below, we’ve listed some of the serious potential side effects of sertraline. If you experience any of these side effects, you should contact your healthcare provider as soon as possible for medical assistance.

Fainting and Extreme Dizziness

According to the FDA, fainting is not frequently reported, but is still a potential side effect of sertraline. 

A small percentage of people who use sertraline may also experience severe dizziness and lightheadedness. 

If you feel faint, weak or severely dizzy, or feel differences in your heart rate after taking sertraline, you should seek medical help as soon as possible.

Chest Pain

A small number of people who use sertraline have reported severe chest pain after taking the medication.

If you experience severe or unusual chest pain after taking sertraline, you should seek medical help as soon as possible.

It’s important to point out that this side effect is very rare. Overall, sertraline is a safe and effective drug that’s widely used successfully, including by people with certain heart problems that make other SSRIs unsuitable.

Persistent Bleeding

Sertraline is one of several SSRIs that may increase the chance of bleeding.

This means that if you injure yourself in a way that results in bleeding while using sertraline, your body might have difficulty forming a normal blood clot.

Clotting issues from sertraline use can potentially occur as a result of taking sertraline together with other medications, such as blood thinners. 

If you use other medications that could affect your clotting ability, it’s essential that you inform your healthcare provider before considering sertraline.

Priapism

According to a study published in Federal Practitioner, Sertraline and other antidepressants have the potential to cause priapism, a condition that can result in a long-lasting, painful erection that is not associated with sexual stimulation. 

Priapism can cause the penis to stay erect for hours at a time, resulting in severe discomfort and potentially causing damage to penile tissue.

Priapism is a rare side effect of sertraline and other SSRIs. If you experience a persistent, painful erection after taking sertraline or any other antidepressant, you should seek immediate medical assistance.

Suicidal Thoughts

Sertraline and several other widely used antidepressants can increase your risk of experiencing suicidal thoughts. 

The risk of suicidal thoughts appears to be the highest in young adults under the age of 25 who take antidepressants.

If you experience suicidal thoughts after you start using sertraline, it’s important to seek medical assistance as soon as possible.

Allergic Reaction 

Like any other medication, it is important to seek immediate medical advice if you experience an allergic reaction to sertraline. 

Warning signs of allergic reaction include hives, swollen face, sore throat, and anaphylaxis. 

Learn More About Sertraline

While many of the side effects listed above can look alarming, it’s worth remembering that most people who use sertraline either experience no side effects at all, or light, transient side effects that disappear as they become accustomed to the medication. 

You should not take sertraline if you have glaucoma, history of heart problems, or are breastfeeding.

For the vast majority of users, it’s a safe, effective and important medication that provides real benefits.

However, in addition to the side effects listed above, sertraline can potentially have drug interactions with a wide range of other medications and substances, like combining alcohol and sertraline, monoamine oxidase inhibitors (MAOIs), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or even St. John’s Wort.

Use of sertraline with other SSRIs could lead to an increased risk of a life-threatening condition called serotonin syndrome. Our Sertraline 101 Guide goes into more detail on sertraline interactions. 

Be sure to discuss all drugs you are taking, including over-the-counter medicine, with your healthcare professional before taking sertraline.

Do not stop taking sertraline without seeking medical advice. 

Abruptly ending sertraline before your next dose could lead to serious withdrawal symptoms, including eye pain, nausea, headaches, irritability, nightmares, or suicidal thoughts.

Read 25 more facts about sertraline here.

Side Effects of Antidepressants You Don’t Expect

Side Effects of Antidepressants You Don’t ExpectSkip to main content< Back to the article list

She thought she was prepared for all the side effects of antidepressants, but there was one big one no one told her about

I’m a 20-something female who lives in Somerville, MA, with a cute husband, two cute cats, and anxiety and depression (which is not so cute). I started taking medication a little over a year ago to treat my mental health issues, and I wanted to share my story about a side effect of my medication that I wasn’t expecting.

I’m doing this because mental health still seems stigmatized in the U.S, and I believe there should be more dialogue around possible treatments. My hope is that this story will help others be a bit more prepared before they start treating their mental health issues with medication.

I Was Prepared For Some Side Effects, but Not Dry Mouth

After talking to my doctor about my anxiety and depression, and agreeing to try a low dose of a certain antidepressant, I did some research into the side effects that may come with it. After a few days of poking around the internet, I thought I was prepared for just about any and every random side effect out there, from trouble sleeping to weight gain. But the one side effect I didn’t expect was dry mouth.

Dealing With Dry Mouth

Within the first week or so of managing my medication, the dry mouth symptoms became apparent. Swallowing — something we all do about a million times a day — felt like work. It got so bad that I would sometimes have trouble speaking because it felt like my tongue was stuck to my throat. I would also wake up in the middle of the night insanely thirsty, and could almost taste how bad my breath was. It got to the point where I didn’t even want to talk to my husband first thing in the morning because I was afraid of how bad my breath smelled.

I tried treating this issue on my own by drinking tons of water, chewing gum to increase the saliva in my mouth, and sadly avoiding my favorite snack, pretzels with peanut butter.

Relieving Dry Mouth

Unlike some of the other side effects I ended up experiencing, I realized that there’s actually something out there designed to specifically relieve dry mouth symptoms. Biotene Dry Mouth Oral Rinse is a gentle, alcohol-free rinse that soothes and moisturizes your mouth for up to four hours , and Biotene Moisturizing Spray helps relieve symptoms on-the-go. Finding relief for this side effect meant I had one less thing to worry about, which was extremely helpful during an otherwise stressful period of my life.

Whether you’re someone who has just started taking antidepressants, or who has been taking them for awhile, I highly recommend talking to your doctor about any side effect you might be experiencing. You never know: there might be a product out there that helps treat it, and chances are that there’s a whole group of people who are experiencing the same thing.

Related articles

Association of dry mouth with prescription drugs | Dry mouth

Prescription drugs and dry mouth

Over the past 20 years, most Americans believe that prescription drugs improve people’s quality of life (73 percent of those surveyed), as well as their quality of life relatives and friends (63 percent). More than half of the adult population is now taking prescription drugs, and one in five people take four or more drugs a day. 1.

Dry mouth or xerostomia is a condition that occurs when a person’s salivary glands do not function properly, resulting in insufficient secretion of saliva into the mouth. There are three pairs of major salivary glands in the mouth, and prescription drugs can affect each of them. If you are taking prescription drugs, please tell your doctor and dentist.

Which drugs cause dry mouth?
More than 500 different drugs cause dry mouth, and if a patient takes several different drugs, the likelihood of dry mouth increases. 2, 3 The following classes of prescription drugs affect the salivary glands:

• Antihistamines: Drugs in this category affect saliva production. They include: diphenhydramine, claritin, zyrtec, etc.
• Antidepressants: People taking antidepressants will also experience dry mouth. These types of drugs affect the amount of saliva produced. These include Zoloft, Flexeril, and Amitriptyline.
• Antiemetics: These are drugs given to prevent nausea and vomiting during chemotherapy or radiation therapy, and for motion sickness (eg anzemet, domperidone).
• Antihypertensive drugs: Antihypertensive drugs (eg, salbutamol aerosol, Norvasc, and Prinivil) are taken to control blood pressure.
• Antiparkinsonian drugs: Drugs in this category are prescribed to relieve symptoms of Parkinson’s disease and other forms of parkinsonism (eg, levodopa, cyclodol).
• Antispasmodics: These drugs are used to treat and relieve colic and spasms of the stomach, small intestine, colon, and bladder (eg dicyclomine).
• Antipsychotics: Drugs used for psychiatric disorders, anxiety and depression (eg Zoloft, Lexapro).
• Sedatives: These are drugs that induce sedation, reduce agitation and irritability, and relieve anxiety (for example: amytal, valium, lunesta).

If you are taking any of these drugs, talk to your doctor and dentist about ways to manage dry mouth. There are prescription and over-the-counter medications to help relieve dry mouth. Just check with your doctor or dentist.

Bibliography:
1 USA Today/Kaiser Family Foundation/Harvard School of Public Health, The Public on Prescription Drugs and Pharmaceutical Companies, January 3-23,2008.
2 Porter SR, Scully C, Hegarty AM: An Update of the etiology and management of xerostomia, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 97:28-46, 2004.
3 Sreebny LM, Schwartz SS: A reference guide to drugs and dry mouth, ed 2, Gerodontology 14: 33-47, 1997.

© Copyright Colgate-Palmolive, 2011

Zoloft Antidepressant in the Physician’s Practice

Choice of Antidepressant. Patient Needs Focused Topic Topic

12/29/2016

Antidepressant Zoloft in the practice of a therapist The work of a doctor of any profile has its own characteristics. The specifics of the work of a general practitioner is determined by a wide range of his diagnostic and therapeutic activities, sometimes without clear boundaries. In the diagnosis and treatment of diseases of the cardiovascular system, the therapist interacts (collaborates, and sometimes competes) with a cardiologist, in the treatment of diseases of the digestive system – with a gastroenterologist, in the treatment of kidney diseases – with a nephrologist and urologist, etc. Therapists along with traumatologists and rheumatologists often treat patients with osteochondrosis, arthrosis and arthritis. It is the therapist who can be the main doctor for patients with several concomitant diseases, since he has to put into practice the principle “to treat not the disease, but the patient” and sometimes draw up the final comprehensive treatment plan, taking into account the appointments of narrow specialists.

The therapist is rightly called the “primary link” of the health care system and the “family doctor”, since he has to deal with the issues of primary diagnosis and treatment of many diseases. Many patients, regardless of the identified pathology, remain under his supervision, and the treatment of the rest (referring to narrow specialists) can subsequently be carried out with his participation. And of course, for each patient, the therapist should ideally be a personal psychotherapist.
In his work, the therapist often encounters certain manifestations of depression, which are detected in many patients with a therapeutic profile. According to statistics, 80% of all patients with depressive disorders first turn to a therapist, which is due to both objective and subjective reasons.
Among the objective reasons, one can single out the mutual influence of the pathogenetic mechanisms of mental disorders and organic diseases (including internal diseases).

On the one hand, depression can create conditions for the formation of organic diseases, aggravate and change their course. This is mediated through a variety of neuroendocrine and immunological mechanisms, regarding the interaction of which there is no consensus today. However, it is believed that they are realized through significant violations of autonomic functions, which leads to the formation of “organ neuroses”. Pathological enhancement of sympathoadrenal influences may be accompanied by the formation of persistent arterial hypertension, hyperthyroidism, reduced glucose tolerance, and an increase in the content of inflammatory enzymes in the synovial fluid.

Parasympathetic pathological influences contribute to the formation of bronchospastic syndrome and hypersecretion of gastric juice.
On the other hand, the pathogenesis of long-term chronic somatic diseases involves the formation of certain psychological changes that create prerequisites for the development of depression. The so-called psychosomatic disorders include not only organ neuroses (syndrome of “irritable stomach”, “irritable intestines”, “irritated bladder” and other “irritated” organs, functional coprostasis, esophageal achalasia), but also angina attacks that occur as a conditioned reflex , bronchospasm, etc. Such disorders are often accompanied by phobias (fear of gas incontinence, inability to use the toilet) and psychoreactive states (neurotic syndromes, affective and pathocharacterological reactions).

Thus, one group of patients with depression at the therapist’s appointment is made up of “dispensary” patients who have new symptoms, and the other is new patients who turned to the therapist with somatic manifestations of depression.
It should be noted that in these difficult conditions, the timely diagnosis of depressive disorders largely depends on the qualifications of the doctor: the appearance of somatic symptoms in a patient with depression is often mistakenly perceived as vegetative manifestations of psychogenic disorders, and the addition of symptoms of depression to the clinic of a somatic disease is considered as astheno-vegetative or ” hypochondriacal “syndrome (as part of the clinic of the underlying disease).

The diagnostic principle of searching for one disease that explains the fullness of the symptoms in a particular patient (correct in most cases) often plays a cruel joke with the doctor when diagnosing depression. In addition, the primary appearance of depressive symptoms or its addition to somatic pathology significantly reduces the patient’s adherence to treatment.
As for the subjective reasons for such a high frequency of patients with depression visiting a therapist, it can be noted that a significant part of patients, even suspecting the nature of their condition, under the influence of subjective factors, prefers to seek help not from a psychiatrist (some fear publicity about the fact of observation by a psychiatrist and related social restrictions, others the alleged negative side effects of psychotropic drugs).

The specificity of the medical activity of a general practitioner also determines the features of the choice of drugs. As their own observations show, general practitioners prefer to start treatment with broad-spectrum drugs with a proven therapeutic effect, without pronounced side effects and adverse interactions with other drugs, which have a positive effect on the most common comorbidities, which have a convenient mode of administration – then There are first-line drugs that are safe and effective in most patients. Thus, in the treatment of arterial hypertension, we often begin therapy with the use of modern calcium antagonists (amlodipine) or angiotensin-converting enzyme inhibitors (quinapril, lisinopril). When choosing antibiotic therapy, we often start treatment with broad-spectrum antibiotics. Selective serotonin reuptake inhibitors (SSRIs), in particular sertraline (Zoloft, Phizer), occupy such a place in the arsenal of a general practitioner for the treatment of depressive conditions.

As a characteristic representative of the SSRI group, Zoloft has all the main advantages of this group of antidepressants. From other drugs used in the treatment of depression, SSRIs differ in fewer and less severe side effects. They do not increase the effect of alcohol and tranquilizers when taken at the same time. The drugs of this group, unlike sulpiride, do not affect the level of prolactin.
If you look at the list of side effects of SSRIs, then it becomes uncomfortable (for both the doctor and the patient): anxiety, sleep disturbances, vision, gait, digestive disorders, sexual function and endocrine system organs are possible. However, in our clinical practice, only parasympathicotonic effects of SSRIs were encountered: sweating, hypotension and dizziness, dry mouth, and the frequency of these effects was rather low.

Indications for the appointment of Zoloft are depression (including accompanied by a sense of anxiety) with or without a history of mania; obsessive-compulsive disorders (OCD) in adults and children; panic disorder, with or without agoraphobia; post-traumatic stress disorder; social phobia (social anxiety disorder). With a satisfactory result of treatment, continuation of sertraline therapy is an effective means of preventing recurrence of the initial episode of depression and its development in the future; recurrence of the initial episode of obsessive-compulsive disorder; panic disorder, initial episode of post-traumatic stress disorder, social phobia.

Sertraline does not cause drug dependence; does not have the stimulating and disturbing effects characteristic of D-amphetamine, or the sedative effect and psychomotor disturbances characteristic of alprazolam; does not have a stimulating, sedative or anticholinergic effect, and also does not show a cardiotoxic effect in the experiment.
A wide range of indications and significant therapeutic possibilities, high and predictable efficacy, ease of administration (reception and control), an insignificant frequency of side effects determine the choice of Zoloft as a treatment for depression, as well as concomitant psychogenic and autonomic disorders in general therapeutic practice.