Sertraline side effects and interactions, and how to avoid them

Sertraline, most commonly known by its brand name, Zoloft, is a popular prescription medication used to treat depression, anxiety, post-traumatic stress disorder, social anxiety disorder, panic disorder, and premenstrual dysphoric disorder (PMDD). It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), meaning it works by increasing the amount of serotonin in the brain. As with many antidepressants, people who take sertraline may experience some adverse effects. Continue reading to learn about sertraline side effects, warnings, and possible drug interactions. 

RELATED: Sertraline details | Zoloft details

Common side effects of sertraline

With any medication, there is always a risk of experiencing potential adverse effects. To know when you’re experiencing side effects, it helps to understand how the drug should make you feel when it’s working correctly. In the case of sertraline, patients can expect to feel improvements in mood, appetite, sleep quality, energy level, and interest in daily life. In other words, an easing of symptoms like depression and anxiety. 

“Sertraline, just as all other SSRIs, increases circulating serotonin levels in the human body, promoting a sense of well-being and allowing persons with depression and anxiety to cope better with their current situation or condition,” says to Raul Perez-Vazquez, MD, a primary care physician of Tenet Florida Physician Services and West Boca Medical Center.

These are the most common sertraline side effects:

• Nausea
• Diarrhea
• Constipation
• Difficulty falling asleep or staying asleep
• Dry mouth
• Heartburn or indigestion
• Loss of appetite
• Weight loss or weight gain
• Dizziness
• Excessive tiredness
• Headache
• Nervousness
• Changes in sex drive
• Erectile dysfunction, including delayed ejaculation
• Excessive sweating

When do Zoloft side effects go away?

Many of the common side effects listed below can go away after a few weeks while the body adjusts.  

“Sertraline itself takes about a month to start working, and many of the mild side effects diminish after your body has adjusted to the medication,” says David Nazarian, MD, a primary care physician at My Concierge MD in Beverly Hills. 

It’s a good idea to track side effects that you experience and keep your healthcare professional updated so your physician can effectively monitor reactions and adjust medication as needed. Most importantly, tell a doctor if side effects are severe, worsening, or do not go away.

Serious side effects of sertraline

There are some less common, but severe side effects of sertraline. The following symptoms require immediate medical attention:

• Abnormal bleeding or bruising
• Agitation
• Confusion
• Fever, sweating, shivering
• Hallucinations
• Hives or rash
• Loss of coordination
• Muscle stiffness or twitching
• Nausea, vomiting, or diarrhea
• Rapid heartbeat
• Seizures
• Swelling
• Suicidal thoughts
• Trouble breathing
• Uncontrollable shaking of a part of the body

Zoloft withdrawal

Although most of the side effects are reversible, you should not stop taking sertraline abruptly. Instead, speak with a healthcare provider before discontinuing this medication to avoid withdrawal symptoms. A doctor can devise a plan to slowly taper the medication.  Withdrawal symptoms include: 

• Irritability/mood swings 
• Nausea
• Dizziness
• Vomiting
• Insomnia
• Nightmares
• Headache
• Paresthesias (prickling, tingling sensation on the skin)

Collectively, these symptoms are called antidepressant discontinuation syndrome, which requires immediate medical assistance. 

Sertraline warnings

Other FDA warnings include restrictions for:

• Patients who are allergic to sertraline or any of its inactive ingredients
• Pregnant women or those who may become pregnant, as sertraline may cause problems in newborns following delivery
• Women who are breastfeeding since sertraline may pass through breast milk
• Those with preexisting eye problems that may make them susceptible to develop angle-closure glaucoma, which can cause severe eye pain or even blindness. An eye test may be required before receiving a sertraline prescription. 
• Those with bipolar disorder. If sertraline is taken without a mood stabilizer, a patient may be at risk for shifting into a manic or hypomanic episode.

Suicidal thoughts

Perhaps the most significant warning to be aware of when taking sertraline is the potential for suicidal thoughts or actions, especially in young adults. All antidepressants, in fact, have a boxed warning (the strongest warning required by the FDA) about antidepressants and suicidal thoughts and behaviors. 

According to the drugmaker Pfizer, a patient may become suicidal, especially at the beginning of treatment and any time that the dose is increased or decreased. Pfizer advises patients to call a healthcare provider right away if you notice new or sudden changes in mood, behavior, or thoughts. Patients and their families should be made aware of this rare but possible effect. Otherwise, all patients should regularly follow up with a doctor and call between appointments if experiencing any of the following symptoms:

• Feeling agitated, restless, angry, or irritable
• An increase in activity or talking more than usual
• New or worsening depression
• New or worsening anxiety or panic attacks
• Trouble sleeping
• Acting on dangerous impulses
• Acting aggressive or violent
• Thoughts about suicide or dying
• Attempts to commit suicide
• Other unusual changes in behavior or mood

Drowsiness

A common side effect of sertraline is sleepiness, which could affect your ability to react quickly or make clear decisions. For this reason, there is a strong warning not to drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you. 

Serotonin syndrome

Serotonin syndrome is a life-threatening condition that can be caused by taking sertraline with other medications that increase the production of serotonin in the body. These medications include:

• Monoamine oxidase inhibitors (MAOIs—don’t use Zoloft within 14 days of these medications). 
• Other SSRIs (like Prozac, Paxil, Celexa, Lexapro)
• SNRIs (like Effexor, Cymbalta, Pristiq)
• Triptans (Imitrex, Maxalt, etc)
• Tricyclic antidepressants (such as Elavil or Pamelor)
• Fentanyl
• Lithium
• Tramadol
• Tryptophan 
• Buspirone
• St. John’s Wort
• Fanapt (iloperidone)
• Thorazine (chlorpromazine)

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Symptoms of serotonin syndrome include:

• High fever
• Rapid changes in heart rate or blood pressure
• Uncontrolled muscle spasms
• Confusion
• Headache
• Heavy sweating 
• Diarrhea
• Stiff muscles
• Loss of consciousness (passing out)

Sertraline interactions

Before taking a new prescription drug, you should disclose all medications that you’re currently taking. Over-the-counter, prescription drugs, and even natural remedies like supplements have the potential to cause harmful drug-drug interactions.

Certain antipsychotics

Mixing sertraline with antipsychotics increases your risk of heart conditions, including cardiac arrest. One example is Orap (pimozide), an antipsychotic medication often prescribed to people with Tourette syndrome. Geodon (ziprasidone) and droperidol are other antipsychotics that could interact with sertraline.

Blood thinners

Taking sertraline with blood thinners (aspirin, Plavix, heparin, warfarin) can increase your risk of bleeding, including nosebleeds as well as stomach and intestinal bleeding. 

Non-steroidal anti-inflammatory drugs (NSAIDs)

Combining sertraline with NSAIDs, like ibuprofen or naproxen, can also increase the risk of severe stomach issues, including life-threatening bleeding, and low sodium levels.

Alcohol

You should not drink alcohol while taking sertraline as both affect chemicals in the brain. Alcohol may alter the effectiveness of sertraline and lead to side effects, including sleep problems and excessive drowsiness. 

Additionally, Antabuse (disulfiram), which treats alcoholism, cannot be combined with the liquid form of sertraline because of the alcohol content in liquid sertraline.

How to avoid sertraline side effects

The best way to prevent sertraline side effects is to take the medication exactly as prescribed by a doctor and in alignment with the drug manufacturer’s instructions. 

The starting dose of sertraline is 25 to 50 mg per day, which can be slowly tapered up if necessary. Sertraline dosages can be adjusted by the physician through close monitoring of the patient and your response to the medication. “Always begin sertraline at the lowest dose, and increase slowly, reevaluating symptoms periodically, and using the lowest effective dose,” says Dr. Perez-Vazquez.

Sertraline can be taken with or without food, according to Pfizer. However, if the liquid concentrate form of sertraline is prescribed, it must be diluted with water, ginger ale, lemon or lime soda, lemonade, or orange juice.

There are a few other steps you can take to help minimize sertraline side effects while you’re waiting for your body to adjust to the new medication. “Some small lifestyle modifications can assist with sertraline side effects, like taking the medication at night to prevent lethargy or eating small frequent meals to avoid nausea,” says Dr. Nazarian. “By listening to your body, noticing the side effects, and making appropriate interventions early on, discomfort can be minimized.” 

Another sometimes overlooked step in ensuring the medication acts as it should is to follow manufacturer instructions on how to store the prescription carefully. Regarding sertraline, the bottle should be tightly closed, kept out of the reach of children, and stored at room temperature, 68°F to 77°F (20°C to 25°C).

Sertraline FAQs: 24 Common Questions Answered

As a commonly used SSRI medication, sertraline is used by millions of people in the United States to treat major depressive disorder, anxiety and a range of other conditions.

Below, we’ve answered 30 of the most common questions about sertraline, covering everything from the medication’s benefits to side effects, common dosages, and more.

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How Long Has Sertraline Been Available?

Sertraline was developed throughout the 1970s and 80s. The medication was approved by the FDA in 1991 to treat major depressive disorder (MDD, or depression) and has since been used as a common treatment for depression and other mental health and mood disorders.

Although sertraline was originally sold exclusively by Pfizer, today it’s commonly available as a generic medication from a range of different companies.

What Drug Class Does Sertraline Belong To?

Sertraline belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. It works by increasing levels of serotonin, a hormone that’s involved in regulating certain aspects of your moods and behavior, in your brain and body.

Like other SSRIs, sertraline is used for a variety of purposes. It’s approved by the FDA to treat major depression, post-traumatic stress disorder, obsessive-compulsive disorder, premenstrual dysphoric disorder and social anxiety disorder.

How Many People Use Sertraline?

Sertraline is one of the most widely used antidepressants, as well as one of the most common prescription medications in the United States. Currently, tens of millions of people in the United States have prescriptions for sertraline. 

According to research published in the journal Pharmacy, sertraline ranks in the 20 most widely used prescription medications in the country.

According to one study using data from the 2013 Medical Expenditure Panel Survey, sertraline was by far the most commonly prescribed antidepressant in the United States.

How Does Sertraline Work?

As a selective serotonin reuptake inhibitor (SSRI), sertraline works by slowing down the rate at which your body reabsorbs serotonin, an important neurotransmitter. This leads to higher levels of serotonin activity in your brain.

This increase in serotonin levels can help to improve and regulate your moods, resulting in an improvement in the symptoms of depression, obsessive-compulsive disorder and certain types of anxiety.

How Long Does it Take for Sertraline to Work?

Although sertraline is effective, it doesn’t always work immediately. Most of the time, it takes six to eight weeks for the full benefits of sertraline to take effect.

This is the amount of time required for sertraline to reach a steady state in your body, meaning it’s fully absorbed and active at a steady dosage every day.

It’s normal to experience some improvements from sertraline during the first one or two weeks of use. For example, you may notice that your sleep, appetite and energy levels improve after using sertraline for just a few weeks. 

It’s common for symptoms of depression, such as a low mood and a lack of interest in activities, to improve after using sertraline for six to eight weeks.

Make sure to inform your healthcare provider if you don’t notice any improvements after eight or more weeks of treatment with sertraline. 

What is Sertraline Used For?

Sertraline is a versatile medication that’s used to treat a variety of conditions. The most common uses for sertraline include treating:

• Major depressive disorder (MDD) 

• Obsessive-compulsive disorder (OCD) 

• Posttraumatic stress disorder (PTSD) 

• Body dysmorphic disorder (BDD) 

• Social anxiety disorder (SAD) 

• Premenstrual dysphoric disorder (PMDD)

Sertraline is also prescribed off-label to treat other conditions, including premature ejaculation (PE).

Is Sertraline the Same as Zoloft®?

Zoloft is the name for a specific brand of sertraline manufactured and marketed by Pfizer. When sertraline first came onto the market, it was only available as Zoloft.

The active ingredient in Zoloft is sertraline hydrochloride — the exact same ingredient that’s used in unbranded, generic versions of sertraline. Today, sertraline is available under the brand name Zoloft and as a generic medication.

So, whether you’re using a Zoloft 100 mg pill or a sertraline 100 mg pill, or a Zoloft 25mg and a sertraline 25mg, your body will react similarly to each. 

Is Zoloft Safe?

Yes. Zoloft/sertraline is a safe and effective medication that’s been thoroughly tested in a wide range of clinical trials. It’s safely used by people of all ages, from young children to teenagers, adults and the elderly.

Like all medications, sertraline can cause some side effects. It can also interact with some other medications, supplements and natural substances. 

We’ve provided more information about these side effects and interactions in the four questions below.

What Are the Side Effects of Sertraline?

Like other SSRIs, sertraline can cause a range of side effects. Most side effects from sertraline are mild and transient, although some may be persistent or bothersome.

Potential side effects of sertraline include:

• Lightheadedness

• Syncope (fainting or passing out)

• Nausea

• Diarrhea

• Dizziness

• Sweating

• Dry mouth

• Tremor

• Confusion

• Hallucinations

• Fatigue

• Somnolence (drowsiness)

• Rhinitis (nasal congestion)

• Erectile dysfunction

• Difficulty ejaculating

• Reduced sexual desire

Like other antidepressants, sertraline may contribute to an increased risk of suicidal thoughts or behavior in children and young adults with depression. It may also cause some additional side effects in people above the age of 65.

For most people, sertraline only causes minor side effects. If you develop severe or bothersome side effects from sertraline, it’s important to inform your healthcare provider.

What If I Miss a Dose of Sertraline?

If you miss a dose of sertraline, take it as soon as you remember. The exception here is if it’s closer to your next dose. In that case, call your healthcare provider.

However, never double up on doses of sertraline, or consume more than what’s prescribed by your healthcare provider.

Can Sertraline/Zoloft Cause Side Effects in the First Week?

Antidepressants can potentially cause side effects at any time, including in the first few weeks of treatment. In fact, it’s far from uncommon for people to experience side effects in the first month of treatment with an antidepressant, only to have these side effects decline over time.

It’s common for your body to “get used to” an antidepressant over time, meaning the side effects you experience during the first week of treatment with sertraline may not continue forever.

Are Sertraline Interactions With Other Medications Possible?

Yes. Sertraline and other antidepressants can interact with other medications. In certain cases, drug interactions that involve sertraline may produce a risk of serotonin syndrome, a condition that can be life-threatening.

Make sure to inform your healthcare provider about any other medications, supplements and/or natural treatments you use before starting treatment with sertraline.

What Medications Should I Avoid While Using Sertraline?

Sertraline should not be taken with other medications that increase serotonin levels, including other antidepressants. It’s especially important not to use sertraline with monoamine oxidase inhibitors (MAOIs), an older class of antidepressants known for interactions.

MAOIs can cause interactions several weeks after the end of treatment. Make sure to let your healthcare provider know about any MAOIs or other antidepressants that you’ve recently used or are currently using, including medications taken in the last two weeks.

Other medications that may interact with sertraline include thioridazine, pimozide, linezolid and methylene blue. To keep yourself safe, inform your healthcare provider about any medications and supplements you use prior to starting treatment with sertraline.

​​How Long Does Diarrhea From Sertraline Last?

Diarrhea is a common side effect of sertraline. In fact, research shows that sertraline is slightly more likely to cause this side effect than other commonly used antidepressants.

As with many other sertraline side effects, diarrhea may develop during your first few weeks of using sertraline. If you have persistent diarrhea from sertraline, make sure that you drink plenty of fluids to keep your body hydrated.

Contact your healthcare provider for help if you have persistent diarrhea that doesn’t improve on its own.

Can Sertraline Cause Nausea?

Yes. Nausea is a common side effect of sertraline, as well as other antidepressants. Like many other common side effects, it tends to occur during the first few weeks of use and become less severe over time. 

Research suggests that between 17 and 26 percent of people who use antidepressants develop nausea at some point.

Of these people, 83 percent experience nausea after two weeks, with 32 percent continuing to experience nausea after using antidepressants for three months.

How Long Do Other Side Effects From Sertraline Last?

Like nausea and diarrhea, most side effects from sertraline occur during the first few weeks of using the medication.

It’s common for side effects to gradually become less apparent over the course of the first few weeks, as your body adjusts to the consistent dose of sertraline. If you have side effects from sertraline that don’t improve, it’s best to discuss them with your healthcare provider.

Is it Safe to Drive After Taking Sertraline?

If you feel dizzy, sleepy or fatigued after taking sertraline, you should not drive a car, ride a bike or operate any kind of motor vehicle after you take your medication. 

Like other side effects of sertraline, issues like dizziness and sleepiness often occur during the first few weeks of use. 

What About Sertraline Dosage, Forms and Strengths?

Sertraline is available as a tablet and as an oral solution. The tablet is the most common version of the medication.

In tablet form, the sertaline dosage range is usually 25mg, 50mg and 100mg. The typical starting dose for most conditions is 50mg per day, although a dose of 25mg per day may be used for children and people with certain anxiety disorders.

In oral solution form, sertraline is typically dosed at 20mg per milliliter. Make sure to follow your healthcare provider’s instructions and only use sertraline at the prescribed dose.

What’s a Normal Sertraline Dosage for Anxiety?

Sertraline is typically prescribed at a dosage of 25mg per day as a treatment for panic disorder, social anxiety disorder and post-traumatic stress disorder. For obsessive-compulsive disorder, it may be prescribed at a slightly higher starting dosage of 50mg per day.

Since anxiety disorders can vary in severity, your healthcare provider may adjust your dosage of sertraline based on your symptoms and response to the medication. 

Is Sertraline Available Over the Counter?

No. Sertraline is a prescription medication. Both the tablet and the solution versions of sertraline are only available with a prescription, meaning you’ll need to talk to a healthcare provider before you can purchase and use them. Sertraline is not sold over the counter in the United States.

What is Considered a High Dose of Sertraline?

A normal dosage is sertraline 50mg to sertraline 100 mg per day, which is typically prescribed to adults as a treatment for depression and some anxiety disorders.

Currently, the highest dose of Zoloft approved by the FDA is 200mg per day. A slightly lower maximum dosage of 150mg of sertraline per day (or 100mg daily during the luteal phase) is used to treat premenstrual dysphoric disorder.

If you’re prescribed sertraline at a high dose, your healthcare provider may instruct you to slowly increase your dosage over the course of several weeks.

Sertraline should only be used at the dosage recommended by your healthcare provider. Do not increase your sertraline dosage without first consulting your healthcare provider. 

When is the Best Time to Take Sertraline?

Two of the most common questions new patients have is: when is the best time to take Zoloft or sertraline? Should I take Zoloft in the morning or at night?

This drug is designed for use once per day. It’s safe to take it at any time of day, with or without food. Many people who experience nausea and other side effects from sertraline opt to take it at night in order to limit these adverse effects.

Since sertraline can interfere with sleep in a small percentage of users, many people also opt to take sertraline in the morning.

​​There’s no “perfect” time of day to take your tablet. Instead, it’s best to take it whenever it’s most convenient for you.

Does Food Affect Your Body’s Absorption of Sertraline?

You can take sertraline with or without food. Some research suggests that your body may better absorb sertraline if you consume it with a meal. It’s best to take sertraline at approximately the same time of day to ensure it maintains a steady state in your body.

How Long Does Sertraline Stay in Your System?

Sertraline has a half-life of approximately 24 hours, meaning it will typically reach half of its total concentration about one day after you take it.

It takes approximately 5.4 days for your body to get 99 percent of a standard sertraline dose out of your system.

How Long Can You Stay on Sertraline?

Clinical trials of sertraline show that it’s safe to use for the long-term, with many cases of people using sertraline for years at a time.

Your healthcare provider will advise you about how long you should continue using sertraline or other medication to treat your depression or anxiety. You may need to continue after you start to experience improvements in order to reduce your risk of relapse.

Many people who use sertraline for the long term (and most other antidepressant medications) are advised to gradually taper their dosage of the medication as they stop taking it, rather than stopping treatment abruptly.

It is important to discuss going off your medication with your healthcare provider prior to changing how you take it. 

What Should You Do if Sertraline Isn’t Working?

Antidepressants such as sertraline are generally effective, but not for everyone. Since everyone responds differently to medication, it’s entirely possible that you might not experience the same results from sertraline as other people.

If you don’t feel that sertraline is working effectively for you, the best approach is to talk about it with your healthcare provider. Your healthcare provider might recommend adjusting your sertraline dosage or switching to another type of antidepressant medication for better results.

How Long Does it Take for an Increased Dose of Sertraline to Work?

If you’re advised to increase your sertraline dosage, it may take several weeks before you start to experience improvements. Make sure to inform your healthcare provider if you don’t develop any improvements after adjusting your dosage of sertraline.  

What Happens When You Stop Taking Sertraline?

If you’re wondering how to ween off Zoloft 25 mg, 50 mg, 100 mg or any of the sertraline equivalents, it’s important to understand that you can’t just stop taking it. Sertraline has a relatively short half-life, meaning it will leave your body quickly if you decide to stop taking it abruptly.

Because of this, some people notice discontinuation symptoms such as insomnia, nausea and anxiety after stopping sertraline. These symptoms are commonly referred to as antidepressant discontinuation syndrome — an issue that affects about 20 percent of people who abruptly stop using antidepressants.

To avoid these symptoms, your healthcare provider will recommend tapering down your dosage of sertraline over the course of several weeks. This helps you to gradually reduce the amount of sertraline in your body and reduce your risk of experiencing discontinuation issues. 

You should not abruptly stop taking sertraline because it doesn’t feel effective, or because you’d like to use a different medication. Instead, it’s always best to talk to your healthcare provider and let them know about your concerns.

Is it Possible to Overdose on Sertraline?

So, what happens if you take too much Zoloft or sertraline? Like with other SSRIs, taking too much sertraline can result in a range of potentially serious side effects.

Taking too much sertraline may cause serious symptoms, including the following:

• Drowsiness

• Dizziness

• Agitation

• Skin rash

• Mania

• Nausea

• Vomiting

• Seizures

• Loss of consciousness

• Hallucinations

• Sweating

• Fever

• Confusion

• Rapid heartbeat

• Twitching and/or muscle stiffness

• Loss of coordination

Sertraline overdoses can occur if you take too much sertraline at once, or if you combine your dose of sertraline with other drugs.  

Do not ever take more than your prescribed dose of sertraline. If you forgot to take sertraline on one day, do not take two tablets at once.

If you are concerned about a potential overdose situation, seek emergency medical assistance immediately.

Is it Possible to Lose Weight on Sertraline?

Yes. Although sertraline and other SSRIs are usually linked to weight gain, monitoring your food intake and activity can allow you to either lose weight or maintain your current body weight while you’re using sertraline.

Although experts aren’t yet fully aware of what causes weight gain on SSRIs, some researchers claim that SSRIs can interfere with people’s ability to “switch off” their urge to eat.

Despite this, there’s no evidence that sertraline affects your body’s metabolism and causes you to use fewer calories than normal. This means that you may lose or gain weight as you normally would by adjusting your calorie intake or activity level.

If you notice weight gain after starting sertraline and feel worried, it’s best to let your healthcare provider know when you next see them.  

Can Sertraline Treat Premature Ejaculation?

Yes. Although sertraline isn’t designed specifically to treat premature ejaculation, studies show that it can increase ejaculation latency —  the amount of time required for a man to orgasm and ejaculate during sex — in men.

If you have premature ejaculation, your healthcare provider may prescribe sertraline off-label to help you control your symptoms and improve your sexual function. 

Our guide to sertraline and premature ejaculation goes into more detail about how and why PE occurs, as well as how SSRIs such as sertraline are often effective at delaying ejaculation and improving sexual stamina. 

Learn More About Antidepressants

Sertraline is one of several common antidepressants used to treat depression, anxiety disorders and other mental health conditions.

You can learn more about these medications in our full list of antidepressants, which covers the most widely-used drugs for depression and anxiety.  

Concerned about your mental health? You can connect with a mental health provider online and access treatment from home using our range of mental health services, including psychiatry and online counseling. 

You can also learn proven strategies for dealing with depression, anxiety and other issues using our free mental health resources. 

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Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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Zoloft instructions for use, price: Side effects, analogues, contraindications

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED.

Author of the article

Khokhrina Kristina Sergeevna,

pharmacist

All authors

Content of the article

• Zoloft: active substance
• Zoloft: side effects 900 14
• Zoloft: contraindications
• Zoloft and alcohol
• Zoloft: overdose
• Zoloft: how to stop drinking it
• Zoloft: analogues
• Abstract
• Ask an expert on the topic of the article

According to WHO estimates, 3. 8% of the total population, which is 280 million people, suffer from depression. Among them, 5% of adults and 5.7% of persons over 60 years of age. More than 700,000 people die each year from suicide due to depression. Depression is treatable with medication.

Doctors prescribe antidepressants. Zoloft is one of them. We asked pharmacist Kristina Khokhrina to tell us in more detail: what side effects it can cause, what active ingredient, contraindications, overdose, is the drug compatible with alcohol and how to stop drinking it.

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Zoloft: active ingredient

Zoloft contains the active ingredient – sertraline in the form of hydrochloride. It is produced in tablets with a dosage of 50 mg and 100 mg. Zoloft is an antidepressant. It is used to treat and prevent depression caused by various causes. And also when:

• obsessive-compulsive disorders
• panic disorders
• post-traumatic stress disorder
• social phobias

How Zoloft works

Zoloft helps to eliminate depressive manifestations:

• relieves anxiety
• normalizes sleep
• reduces somatic manifestations: palpitations, disruption of the gastrointestinal tract, increased excitability.

Zoloft does not cause dependence on the drug and does not lead to weight gain in humans.

Zoloft side effects

Watch closely while using the medicine. If you experience side effects that are not described or if symptoms worsen, contact your doctor immediately.

Zoloft: side effects

• flatulence, nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth
• increased heart rate, increased blood pressure
• arthralgia, muscle cramps
• gait disturbance, teeth grinding, drowsiness, syncope, headache, migraine, tremor, insomnia, anxiety, hallucinations, psychosis, nightmares, decreased libido, suicide, coma
• yawning, bronchospasm
• bedwetting, urinary retention during the day
• hepatitis, jaundice
• decrease in potency, disruption of the reproductive system, menstrual cycle disorders in women
• visual impairment
• thyroid disorder
• urticaria, pruritus, anaphylactic shock
• flushing, tinnitus, loss of appetite and others

Zoloft: contraindications

• hypersensitivity to any component of the formulation
• concomitant use of monoamine oxidase inhibitors and pimozide
• pregnancy and lactation
• children under 6 years of age

Caution must be taken in: mental retardation, epilepsy, renal and / or liver failure, marked reduced body weight.

Zoloft and alcohol

Alcohol is not recommended to be taken with the medicine. Its action can increase side effects and lead to overdose.

How to recognize depression was described in the article “The Beck Test for Depression”

Zoloft: overdose

Overdose of Zoloft occurs when used simultaneously with alcohol or other incompatible drugs. With such combinations, severe poisoning can occur, up to coma and death. Overdose symptoms are:

• nausea
• vomiting
• drowsiness
• increased heart rate
• dizziness
• psychomotor agitation
• diarrhea
• excessive sweating

Hospital observation and constant monitoring of vital signs will be required. When first aid is not recommended to induce vomiting, it is better to give activated charcoal.

Zoloft: how to stop drinking it

“Withdrawal” syndrome is rare. Nevertheless, it is necessary to discuss with the doctor a decrease in the dosage of the drug. Since the termination of treatment is possible:

• symptoms of depression
• hallucinations
• aggression
• anxiety
• psychosis

Particular attention should be paid to the fact that after the end of the use of Zoloft, within 14 days, you should not take drugs related to monoamine oxidase inhibitors.

Zoloft: analogues

Zoloft has about 10 names of analogues of the active substance. All medicines are prescribed and prescribed by a doctor. Therefore, to choose a remedy or replace your own, consult your doctor first.

Zoloft and Atarax: compatibility

The combined use of these drugs increases the side effects. This manifests itself in the form of dizziness, drowsiness and confusion. Elderly people have difficulty in thinking and coordinating movements.

Summary

• Zoloft is an antidepressant used to prevent and treat depression and other disorders.
• Zoloft may have a significant number of side effects.
• The active substance is sertraline, dosage in tablets of 50 mg or 100 mg.
• Zoloft has contraindications that should be taken into account when prescribing it.
• The use of alcohol in conjunction with Zoloft is not recommended to avoid overdose symptoms.
• An overdose of the drug occurs when used simultaneously with certain drugs and alcohol.
• Zoloft is not usually addictive, but you should consult your doctor before stopping it.
• Zoloft has several analogues, but only a doctor can replace them.

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Treatment and prevention of irritable bowel syndrome

Treatment for irritable bowel syndrome (IBS) depends on symptoms. Your doctor should develop an individual treatment for you. If you are concerned about loose stools, then the treatment for you will not be the same as the treatment for patients with constipation.

If your doctor says the problem is “in your head” or there is nothing you can do, see another doctor. Many patients successfully get rid of IBS. You need a doctor who can explain IBS and is interested in helping you identify the causes of your symptoms.

Your treatment may be based on the physical or psychological causes of your illness. This may be lifestyle changes, pharmacological or psychological treatment. The right treatment for IBS may be found through trial and error, but it will eventually be found. The following are some aspects of the treatment of irritable bowel syndrome.

Nutrition for Irritable Bowel Syndrome

Certain foods can trigger an flare-up/attack. It is advisable to keep a log of all foods so that you can later calculate which ones led to the disorder. To identify the foods that are causing your symptoms, eat regularly and write down the foods you ate before your symptoms began. Look for patterns. Often the symptoms do not depend on any particular food, but on its amount at a time. A dietitian can be consulted to identify foods that cause symptoms and prescribe a treatment plan. A nutritionist will determine how your body reacts to a particular food. Sometimes intolerance to something (for example, lactose intolerance) is revealed.

For example, caffeine, milk, chocolate, nicotine, alcohol and an abundance of fatty foods cause symptoms in someone. However, for some people with IBS, these foods do not cause symptoms.

The traditional treatment for IBS, especially constipation, is to eat fiber-rich foods. Fiber reduces the transit time through the large intestine and reduces pressure on it. You need to eat more fresh vegetables and fruits, eat grains and bran. Your doctor may also recommend soluble fiber supplements.

For some IBS patients, fiber makes symptoms worse because it can be broken down in the colon by bacteria; this will release gas, which will cause bloating. Fiber intake should be discussed with your doctor. You may need to avoid certain types of fiber, particularly gas-producing foods such as cabbage, cauliflower, broccoli, and legumes. But it is not certain that abstaining from certain foods will eliminate the symptoms.

Medications for irritable bowel syndrome

Your doctor may prescribe certain medications to manage your IBS symptoms. Drug therapy recommended by a doctor may include:

• Spasmolytic anticholinergics. These drugs reduce intestinal spasms and can relieve pain, bloating, and discomfort associated with IBS. Examples of such drugs are Dicyclomine (Bentyl) and Hyoscyamine (Levsin). Studies show that these drugs are of limited effectiveness and are best taken if symptoms occur after a meal. Side effects include dry mouth/nose/throat, palpitations, constipation, accommodation disorder (blurred vision of objects), and urinary problems.

• Antidiarrheals, such as Loperamide (Imodium). These drugs are quite effective against diarrhea and are used for frequent loose stools or urgency to defecate.

• Laxatives (such as fiber). They are taken if the main symptom is constipation. Laxatives include psyllium (Metamucil), methylcellulose (Citrucel), and calcium polycarbophil (Equalactin).

• Alocetron (Lotronex) is used to treat symptoms such as severe diarrhea or abdominal pain. Alocetron is a blocker of serotonin 5-HT3 receptors and inhibits the action of serotonin in the intestine. Shortly after Lotronex appeared on the market, it was removed from the market, as it was not 100% safe, but then it was put back on the market and now it is an affordable drug. However, due to its potential side effects, Lotronex is only recommended for use in patients with severe symptoms when prescribed by a gastroenterologist, who should provide the patient with proper instructions for use.

• Tricyclic antidepressants such as amitriptyline (Elavil, Endep, Vanatrip), desipramine (Norpramine), and nortriptyline (Pamelor, Aventil) are often used for symptoms such as pain or diarrhea. They are used in smaller doses in IBS than in depression and reduce pain signals between the gut and the brain. These drugs can also help with sleep disturbances and fibromyalgia, the latter often found among the symptoms of IBS.

• Your doctor may also prescribe selective serotonin reuptake inhibitors (SSRIs) to reduce the depression and anxiety associated with IBS in some patients. SSRI drugs include fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Your doctor may also recommend other types of antidepressants, such as mirtazapine (Remeron), venlafaxine (Effexor), and duloxetine (Cymbalta).

• Sedatives can help reduce anxiety, which can make IBS symptoms worse. Doctors sometimes prescribe sedatives such as diazepam (Valium), lorazepam (Ativan), and clonazepam (Klonopin) for people with short-term anxiety attacks that worsen IBS symptoms. These drugs should only be taken under medical supervision as they are addictive.

• Lubiprostone (Amitiza) is used to increase intestinal secretion. It is prescribed for the treatment of severe constipation in women over 18 who are not responding to other treatments.

• Antibiotics can also be used to treat IBS, but it is not entirely clear what benefit they bring. Antibiotics can help those with IBS caused by an overgrowth of bacteria in the gut, but antibiotics can be dispensed with at present to eliminate the bacteria.

How to eliminate or minimize the symptoms of IBS

In IBS, the gut is sensitive to irritants. Symptoms can be minimized or eliminated by identifying what causes the bowel to malfunction. Here are some guidelines that might help:

– Eat regularly by the clock, chew your food slowly and thoroughly, avoid fatty foods and too much caffeine.

— Get regular physical activity. This can help relieve symptoms and feelings of anxiety, which can improve bowel function.

– Do not delay or hasten a bowel movement.

– Do not strain during bowel movements, try to relax and take your time.

Because the large intestine becomes very sensitive in IBS, the symptoms can be triggered by normal events such as eating or distension due to gas or bowel contents. Following these tips will help you prevent seizures:

Schedule your meals. Eating causes contractions in the large intestine. Usually, within 30 to 60 minutes after eating, there is an urge to defecate. In IBS, the urge may be more frequent, causing cramps or diarrhea.

Eat small meals. The body’s response to food often depends on calories and especially on the amount of fat it contains. Also, large amounts of food can cause cramps and diarrhea in people with IBS. Symptoms are relieved by eating smaller amounts of food, but more often, or just eating small meals. In any case, try to stick to a regular meal schedule.

Change your diet. For some people, a diet of low-fat, high-fiber foods may help. For some, a diet of foods rich in protein and carbohydrates is needed. Fat greatly stimulates the contractions of the large intestine after eating. The use of caffeine in many people, and especially in people with IBS, leads to frequent loose stools. Important – the diet should be made for each individual.

In many cases, eating foods containing fiber can relieve constipation, but not pain. Sources of fiber include cereals, peas, beans, fruits and vegetables, and whole grain breads. Fiber can also be consumed in the form of dietary fiber supplements, which can be found over the counter, but you should consult your doctor before taking.

Some medications (including antibiotics) can trigger IBS attacks in some people. You need to tell your doctor all about your problem so that he can recommend other drugs to treat the symptoms of IBS that will not cause attacks.

Physical, emotional or environmental stress can also cause or worsen symptoms. Stress management and relaxation can reduce or prevent symptoms. Cognitive behavioral therapy, stress prevention, hypnosis, and relaxation can also reduce the symptoms of IBS. Such treatment also reduces anxiety and other psychological symptoms. You can write down what activities trigger your symptoms. Many patients will be better able to control their condition if their IBS symptoms are found to be related to childhood abuse or trauma.

Prevention of irritable bowel syndrome

Irritable bowel syndrome (IBS) is one of those diseases that cannot be “prevented”. This is not a disease that can be avoided by following certain recommendations. However, the symptoms of IBS—chronic crampy abdominal pain, discomfort, bloating, and changes in bowel habits—can be prevented, reduced, and sometimes reversed by addressing its causes.

People with IBS have a more sensitive colon and are very sensitive to both food (even normal gastrointestinal activity) and environmental factors such as stress.

Although doctors don’t know exactly why some people get IBS and some never get it, IBS is a serious functional disorder. Don’t believe if someone tells you that the symptoms are “in your head”.

Lifestyle advice

1. Ask your doctor if you have IBS.

Although over 20 percent of the population suffers from IBS, only 15 percent of people with the condition seek medical attention. If you have severe stomach pain or bowel problems, see your doctor. He will be able to make an accurate diagnosis and begin treatment to relieve symptoms.

2. Keep a journal to identify foods that trigger IBS

People with IBS are encouraged to monitor foods that aggravate the disease. To do this, record the entire diet and note the time of onset or worsening of IBS symptoms. Notes with information about the type and amount of food eaten, as well as the time of eating, should be done for two to four weeks. It is also necessary to record the time of onset of symptoms – disorders, pain, discomfort, etc.

3. Create a personalized diet

You can create a personalized diet to relieve the symptoms of IBS. There is a certain group of foods that exacerbate the symptoms of IBS. These include fatty foods, dairy products, chocolate, alcohol, caffeinated drinks (such as coffee, tea, cola, and energy drinks), sorbitol sweeteners (found in some chewing gums), and gas-producing foods (such as beans and some other vegetables). However, not all people with IBS need to avoid these foods. Many of them also have lactose intolerance, which causes intestinal problems and abdominal pain, which is similar to the symptoms of IBS. For people with lactose intolerance, to improve the condition, it is enough to remove most dairy products from their diet. Women with IBS who suffer from constipation need to drink more water and eat fiber-rich foods. If you decide to see a nutritionist, we recommend that you contact a qualified dietitian who can explain the relationship between food intake and intestinal problems, as well as design a diet for you that minimizes intestinal disturbances.

4. Avoid unnecessary surgery if you have IBS

Be sure to tell your doctor before surgery that you have IBS. According to studies, patients with IBS are more at risk of unnecessary removal of the appendix or gallbladder than others. According to a survey of 90,000 people, hysterectomy and back surgery are also the most common among IBS patients. Studies have found that gallbladder removal is twice as common in people with IBS as in people without the disease. However, studies have shown that operations on the coronary arteries and for gastric and duodenal ulcers occur in almost equal numbers in patients with IBS and in patients without.