Articles, DRUGS

Zoloft – Uses, Dosage, Side Effects & Interactions

Zoloft, commonly known as Sertraline in generic terms is a medicinal drug used to treat conditions like depression, obsessive compulsive disorder, panic attacks, post traumatic stress disorder, social phobia and premenstrual dysphoric disorder as well. The anti-depressants benefits the patient by bringing in a change in his mood, brings in positivity, enhances sleep, apetite and energy level alongside bringing back an enthusiastic interest in the patient to live.

From fear to anxiety and unwanted suicidal thoughts, the medicine reduces it all. And aside from these, it increases the urge in a person to complete their daily activities by bettering the mental health, which was until now hampering how the medicine worked. Zoloft is also categorically placed as a selective serotonin reuptake inhibitor ( SSRI ). It is so called since the drug works on restoring the balance on a whole, of a substance that is known as serotonin in the brain.

Zoloft

HOW TO USE ZOLOFT:

Do make sure to go through the patient leaflet information when you want to take the medicine and talk to your medication guide as well about the necessary dosage needed. The medicine should also need a refill once you run out, however you should not get it without the consultancy of your doctor who will solve your doubts and queries before determining if you really do need a refill.

The medicine is to be taken by the mouth as per the instructions of your directing counsellor or doctor. If your dosage is once a day, it is to be taken either early in the morning or in the evening. The tablet form is to be taken with water and there is no restriction on food and it can be taken with or without it in the system. As for the capsule form of Zoloft, it is to be taken with food only either after breakfast or after the evening meal.

In case you are taking the medicine for premenstrual problems, ask your doctor about it and the dose is usually 2 weeks before the starting date of your last period cycle. If your stomach is upset either as a side effect or owing to diarrhoea, you are to take the medicine with food. The doses if it is more than once a day should be at least 6 hours in gap from each other and are never to be taken more than what is prescribed. In case there is hope for your depression and you are getting better without the medicine, do try to stay away from anti-depressants.

DOSAGE:

Your dosage is usually based on the condition being treated and how the drug is responding to the treatment, depending on which the dose is either increased or reduced. Side effects are another reason for a change in Zoloft dosage.  Do make sure you make your doctor know of your situation. Take the medicine regularly and at the same time each day until advised otherwise. The prescription is to be adhered to strictly to benefit from the drug. Continue taking it even if you feel better without it. Sometimes the conditions reappear if the dose is stopped abruptly. Sleep changes, headaches, mood swings are a few of the side effects of the dose that may show up if stopped midway of a dosage. Tell your doctor if your condition persists.

DOSAGE FOR ADULTS INITIAL TREATMENT :-

Depression:

  • For major disorder of depression and obsessive compulsive disorder, the dosage to be given once daily is Zoloft 50 mg.
  • On the other hand, for panic disorders and social anxiety or post traumatic stress disorder, the dose of Zoloft 25 mg is administered once daily initially. If no improvement is seen after a week, the dosage is increased to 50 mg daily.
  • There is no particular relationship that has been established between a dose and its effects. Which is why, it is recommended to stick to an initial therapeutic dose of a maximum of Zoloft 50 mg.

Premenstrual Dysphoric Disorder:

The treatment of Zoloft 50 mg each day is the initial treatment for PMS, administered in 25 mg dose twice a day throughout the menstrual cycle, or is limited to only the leuteal phase of the cycle, as will be assessed by your physician. The maximum dosage for either should not cross the threshold of 100 mg/day. For this disorder, the dose is given once each day, which can be either in the morning or in the evening.

Dosage for Pediatric Population (Children and Adolescents)

Obsessive-Compulsive Disorder:

The dosage of Zoloft 20 mg is given once daily among children of ages 6 to 12 and a dose of 50 mg is given once in young adults of ages 13 to 17.
There is no relationship between the dose and its effects on OCD patients; hence the starting dose should never exceed 100 mg/day in their initial trial dose. Since the 24 hour half-life elimination of Zoloft is a factor, the dose should not be changed in an interval that is less than 7 days.

Maintenance/Continuation/Extended Treatment:

Major Depressive Disorder:

A general dosage of 50-200 mg Zoloft is administered in this case for a period of 8 weeks. It is not clear if the maintenance phase treatment should be similar to that of the initial dose. The patient should be taken for a monitoring once an 8 week period is over.

Posttraumatic Stress Disorder:

PTSD requires a sustained therapy that extends beyond the first initial treatment the patient signed up for. Systemic evaluation is done after which for 24-28 weeks, Zoloft 50 mg is administered to the patient to achieve a positive response. The patient is of course monitored to check for loopholes in the treatment if any.

Social Anxiety Disorder:

This is a chronic condition and requires months of therapy. An extended maintenance therapy lasts for 20 weeks after the first treatment and a dose within Zoloft 50 mg to 200 mg is given to the patient with constant assessment.

Obsessive-Compulsive Disorder and Panic Disorder:

Beyond Zoloft for depression, it has also found its use in the maintenance and initial treatment of both OCD as well as panic attacks. The maintenance period treatment lasts for up to 29 weeks and the dosage achieved is dependent on the person being treated and his severity.

Premenstrual Dysphoric Disorder:

Controlled trials for 3 menstrual cycles have been so far for the extended maintenance phase. Dose adjustments are done accordingly depending on the flow of pain. Some patoents require constant treatment, while some get better beyond the 3 cycles.

ZOLOFT Oral Concentrate:

Containing about 20 mg/ml of sertraline as the main formulating ingredient, it also has 12% alcohol. A dropper is used to administer the medicine. The concentration is mixed with water, ale of ginger, lemon soda or orange juice only. The mixture is to not be mixed with any other liquid for it risks interaction. The dose is to be mixed right before consumption and people with latex sensitivity need to exercise caution, as the dropper is made of natural dry rubber.

If adverse reactions are noted after an overdose, a call to the poison control center should be carried out right away. The center will work on the dose and try to reverse it as effectively as other. To prevent overdose, do not give away your medicine dose to others. It might so be your condition is different and needs a varying dose much like the other person needs a different dose.

For a missed dose, the medicine should be taken right away when remembered. However, there is no choice but to skip if you are close to your next dose. Resume the next dosage and talk to your doctor about when to catch up with the previous dose. Do not increase up the dose as Zoloft side effects aren’t something pleasing and can get out of hand in case of an over dosage.

PRECAUTIONS:

Being an antidepressant drug in basic, most certainly there are precautions to be exercised much like the others in the market.

  • Antidepressants usually increase the risk of suicide when taken for a short time as it might trigger a major depressive disorder instead of treating it right away. Which is why, there should always be someone closely monitoring the patient, just to be sure.
  • The drug should be weighed out for benefits, especially if being administered to a child or a young adult. Irrespective of the clinical need, it is hard to deny that there is an increased risk when given to a child below 12 or an adult above 65, although for the latter its mostly because of their health. For cases like this, visit the doctor for frequent checkups.
  • The drug is not allowed for paediatric patients in a lot of cases unless for PTSD or OCD, so an alternative should be looked for. If the condition worsens, it is best to get the doctor to look into the matter and decide if a change in the medication is needed.
  • Tablet should not be chewed or split unless advised. In such cases, a score line in the tablet is where the split should be done to make sure the dose stays even.
  • Your medical history should be made known to the doctor, especially if there is a history of mental illness like bipolar disorder, suicide attempts or so on.
  • The medicine might make you drowsy, hence do not drive or stay around machines. Limit all activities when under the influence of the drug, along with alcohol intake.
  • Zoloft may lead to increased heartbeat which should be brought to medical attention right away to avoid risks of QT prolongation.
  • Let your doctor know of your medicine in case you are about to undergo surgery as it might tamper with the condition that needs to be achieved.
  • Do mention about the Zoloft intake before drug tests as it might lead to a false positive otherwise.
  • Pregnancy is a hard time for you and the risks cannot be ignored. Talk to your doctor about your condition to know if it will cause risks. Also check if it is okay to breastfeed your baby while on the medication.

INTERACTIONS:

Other medicines like Pimozide, clopidogrel, ibuprofen and Warfarin can interact with Zoloft. These cause bleeding and bruising internally usually and should be avoided on a whole. MAO inhibitors should be avoided 2 weeks before and after the ongoing dose of Zoloft since these can lead to fatal interactions. The most common inhibitors are Selegiline, Procarbazine, Moclobemide and Phenelzine. This is of course not the full list and you need to check with your doctor and notify him about the drugs you have been taking. Avoid street drugs like MDMA since these risk a sever serotonin toxicity when overdosed. Aspirins are to be avoided as well unless your doctor instructs otherwise, since these risk a heart attack when interacting with Zoloft.

SIDE EFFECTS:

There are many common Zoloft side effects that are triggered. A few of the most common ones are nausea, vomiting, diarrhoea, dizziness, issues with vision, weight changes, a stuffy nose, tastelessness, constipation, loss of sexual interest, dry mouth. Light-headedness is common as well and a little rest should help clear it up.

Even though the medicine might not lead to a serious condition if dosage is taken care of, a major risk is that of serotonin toxicity. This issue causes side effects like hallucinations, coma, and loss of coordination and can even prove to be worse than the initial depression being treatment. Since your doctor has recommended the medicine to you since he thought it to be right, do mention of your side effects to avert fatal consequences. Severe allergies are rare, but a precaution has always proven to be better than cure.

As long as you keep the above guidelines in mind and keep taking the medication as per your doctor’s prescription, the risks are at bay and you will soon be back on your very best mental health. If the medication is for your child, do monitor his habitual changes and keep a note for weight loss to notify your doctor when he asks for it.

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