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Doctors' Answers to "Frequently Asked Questions" - Zoloft


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 08/18/2000]
Question: I have a herniated disk at C5 and C6 and buldging disks at C4 and C5 and C6 and C7. I have had this condition since an attack in August of 1999. In the last 6 months, the pain is unbearable and have been upped in my dosage of Ultram to every three hours plus 2 to 3 Vicodin ES per day. I also could not sleep and take Restoril 30 mg at night to be able to sleep through the pain. My doctor just gave me Zoloft for depression, which I did not want to take and for the last week, I have been having seisures where my tounge feels like it is swelling and going down my throat. I have also realized that I have bitten the inside of my mouth after the seisure went away. After about three days of taking the Zoloft, the seisures started and for a week I have felt like a truck has run me over. I quit the Zoloft three days ago and the seisures are getting less severe. I did not have any problems with the three other drugs before I took the Zoloft. I have read about Zoloft and it says it doesn't make seisures. I have had just the opposite reaction. Can you fill me in on any ideas? Also, my left shoulder and arm became frozen after the third day of Zoloft and I have been in severe pain. Also, can you provide me with options to my herniated disks? I cannot lift more than a coffee cup and cannot live like this for ever. Please provide me with options to get my life back.
Thank you

Answer: The whole class of ssris can change the seizure threshold and make seizures more likely. The discs are a tougher question without some of your xray results and/or emg results.

[posted 08/4/2000]
Question: I have been taking zoloft for almost two months now. I started with
50mg for two weeks and then moved up to 100mg. My depression is subsided significantly, but I am
having trouble with insomnia. I realize that this is a possible side effect of the drug and that with limited
information I cannot say for sure that the zoloft is the cause of my
insomnia. However, this is worse than any insomnia I have had before and occurs almost nightly.
Do you have any suggestions for remedying the insomnia without decreasing the dosage of zoloft?

Answer: Usually, this requires an additional medication. Start with drugs like benadryl. This is available otc and comes in 25 mg dosing. Use one about an hour before sleep and if not ok, then use 50 mg. I would not increase the dosage above 50 without discussing it with your md. After that, you will need Rx type sleeping meds.

[posted 07/12/2000]
Question: When switching from Celexa to Zoloft, should there be a "down-time" or can you make an immediate switch?

Answer: Immediate is ok, you may still have a "withdrawal " type of reaction about 2 weeks after stopping the zoloft.

[posted 06/25/2000]
Question: I have a long history of depression/anorexia nervosa and was put on Zoloft 200mg/day October 1999 when I gave birth to my baby girl. I am concerned about the side-effects on my baby from this medication (I am breastfeeding 5times/day) my psychiatrist changed me from Prozac to Zoloft as it affects my baby less

Answer: There is no clear evidence that children are afffected, but we will not know for 5-10 years. In the meantime, there is nothing you can do about it. But, it looks minimal at this point.

[posted 05/28/2000]
Question: Hi. I am a 28-year old woman. Due to being depressed, I was prescribed 100 mg of Zoloft per day for one and one-half years, from October, 1998 until April, 2000. While on this medication, I gained 25 lbs., even though my diet and activity level did not change. I was somewhat slender prior to the Zoloft. The main reason that I stopped the Zoloft was because of this weight gain. My doctor told me that much of this gain was probably due to the Zoloft. I stopped taking the Zoloft over one month ago. I have been on a fairly strict diet since then, but I have not lost any weight. Should I expect to lose the weight (with diet, as above, and excercise)? If so, when should I expect this to happen? As I said, it has been one month already, and I am really getting concerned. Would the Zoloft have permanently affected my ability to lose the weight? I am very worried about this. By the way, I have had my thyroid tested before and it was normal. Also, I am not currently on any medications. I really appreciate your help with this, and thank you in advance.

Answer: It is not a permanent thing, but weight is very hard to lose for most patients once it is on.

[posted 05/22/2000]
Question: Re. Zoloft
I have been taking Zoloft for post natal depression for the last year. Within this time I have taken myself off Zoloft a couple of times and within a couple of days I have felt extremely depressed again. While I have been taking Zoloft I seem to feel much better for a while then these 'good' feelings seem to plateau so I then think that Zoloft is not working or cannot help me anymore, so I stop taking it. Then I start to feel very depressed again as I earlier described. Also I have been breastfeeding my child during the time I took Zoloft and I am worrired it could affect her. Should my dosage be higher if it feels like it is not working anymore or my depression feels like it has worsened.

Answer: You don't mention your dosage, but sounds like a higher dosage is in order. Most mds would recommend not breast feeding if the zoloft is necessary due to the lack of information on babies exposed to these drugs.

[posted 05/19/2000]
Question: I have episodes of depression. The first major episode started when I was in my 30's.
I was treated with Prozac for a few years. The personality it produced seemed
excessively artificial to me. The next episode was treated with Zoloft. This
produced a less excessive and artificial personality which my husband likes,
but it has had a negative effect on my desire for sex. I have just become aware
of Bupropion. Could Bupropion (dopamine uptake regulator) be used in conjunction
with Zoloft (selective seratonin reuptake inhibitor) or should it be used instead
of Zoloft. I am concerned about gaining sexual libido at the expense of a
stable personality produced by the Zoloft.

Answer: Commonly used with Zoloft to help the sex drive. If this is not successful, try Ritalin or equivalent the day you wish to have sex.

[posted 05/12/2000]
Question: what cough medicine can i take with zoloft that wont cause an interaction

Answer: I don't know of any interaction with any of the OTC medications for cough. Use any of them.

[posted 05/4/2000]
Question: I am a 28-year-old who recently(1 week ago), discontinued the use if zoloft,50mg's daily. I am active, jogging several times weekly, and am medium built. I know body composition may effect the levels remaining in my sysem. How long does it take for the medication to be depleted from my system? (weigh 140\\#s)

Answer: The medication wil usually be gone within about a week to ten days. The withdrawal syndrome(if it occurs)may occur up to three weeks after stopping zoloft. The different SSRIs have different 1/2 lifes which affect both the time to leave your system as well as the potential onset/duration of the withdrawal syndrome. Paxil is the shortest, Prozac the longest and Zoloft is in the middle.

[posted 05/1/2000]
Question: I stopped taking Zoloft 4 days ago because I have been on it for 31/2 years and I am worried that it has contributed to weight gain and who knows what else down the road. I know it is reccomended to "notify my Dr." first but I just wanted to do it cold turkey. So, today, 4 days later I am getting symptoms of shakiness and panic. Is that common and will there be other symptoms. I am not going to go to the Dr. I just want to do this cold turkey.
This may be stupid but I'm doing it and just want to know other problems I may encounter,
When I first started taking it 3 & 1/2 years ago I was in bankruptcy proceedings and also dealing with an unfaithful husband. Also problems with my son messing around with recreational drugs. The zoloft helped me get through all of that. It's over now> I want to get off of it.

Answer: I would expect a flu like feeling, aches, fatigue, nausea to last up to two weeks.

[posted 04/28/2000]
Question: In the past I have had two "grand mal" seizures when withdrawing
from xanax. I have been taking paxil for years, my doctor has
stoped the paxil, and is starting my on zoloft, and after
5 to 6 weeks he wants to add Wellbutrin. My question is, am
I in danger of having seizures when I start the wellbutrin?

Answer: These drugs do increase the risk of seizure, but probaly pretty small if your EEG is normal and these were drug withdrawal seizures(pretty common if you stop the xanax too fast).

[posted 04/26/2000]
Question: My eight year old son has been taking Zoloft for about 4 months. Originally he was on 37.5mg but due to headaches it was lowered to 25mg. He has gained about 10lbs in the past three months (quite a bit for only weighing 72 lbs before meds). My husband and I are very concerned and mentioned it to his dr, although we are not very impressed with her evaluation of him and are having a difficult time finding a good child psychiatrist. She said weight gain is common however, he has had a loss of energy and just mopes around the house, does not want to play with any friends and is eating everything in sight. We feel the affects of the Zoloft will be worse than if he were not taking any medication at all. If we take him off of the Zoloft, will he lose the weight he has gained or should we put him on a diet? Thank you.

Answer: Sounds like you need a new md. If he is not better, you need some other combination of drugs. The weight gain will usually persist while he is taking the medication.

[posted 04/12/2000]
Question: I am a 29 yr. old woman. I have been back on Zoloft for a couple months, and have been experiencing night sweats. I know that excessive sweating is one possible side effect of Zoloft, but I do not find that I am sweating any more during the course of the day, just while I sleep. I have experienced night sweats in the past, and I was taking Zoloft then too, but never associated the two until recently. Are the night sweats probably being caused by the Zoloft? Are there any other anti-depressants that would not have that same side effect? I have heard that Celexa is good.

Answer: Sounds like it although not a usual problem with Zoloft. As to other meds, you would have to try them discuss it with your md.

[posted 04/4/2000]
Question: Does the drug zoloft have any chance of interacting with over-the-counter drugs such as Sudafed that are used to relieve allergies?

Answer: Not usually.

[posted 03/25/2000]
Question: I just started to take Zoloft for depression. Before I started to take it, I had bough some appetite suppressants. I was wondering if taking the Dexatrin would effect the 50 mg. of Zoloft that I take every day. Thank you for your time and you correct answer.

Answer: Probably not, but I would discuss it with your physician.

[posted 03/18/2000]
Question: IS it okay to take Zoloft (100 mg) and Augmentin (500 mg)together? I just want to make sure. I forgot to tell my doctor that I am on ZOloft as well. Thank you

Answer: No problem.

[posted 03/18/2000]
Question: IS it okay to take Zoloft (100 mg) and Augmentin (500 mg)together? I just want to make sure. I forgot to tell my doctor that I am on ZOloft as well. Thank you

Answer: No problem.

[posted 03/7/2000]
Question: Can I take zoloft if I am taking zyrtec for my allergies?
And will I have any side effects?

Answer: Shouldn't be a problem.

[posted 03/2/2000]
Question: I am currently taking Zoloft (30 mg./day), and was interested in taking the weight-loss drug Xenadrine. Is this safe? What are the possible side-effects or potential problems? Thank you

Answer: No data here, but doesn't make a lot of sense.

[posted 02/14/2000]
Question: I am a 30yr old male who recently was diagnosed with episodes where I almost pass out. My doctor has called it "Neuro-cardiogenic syncope / Vaso-vagal syncope" which means when I stand up & my blood pressure drops low, the blood rushes to my legs and my body starts to pass out so I will lay down and get even blood flow. We first tried a beta-blocker but that didn't help. Since December I've been on Zoloft. At first 50mg a day but that was changed to 100mg a day after a recent tilt-table test. I just had the flu and read in a health magazine that some SSRI's (Prozac, Zoloft) mixed with cold treatments containing "dextromethorphan" or "pseudoephedrine" or "phenylpropanolamine" (I found them in Theraflu & Niquil)can result in what they called "serotonin syndrome" characterized by agitation & confusion. Is this a real health risk? Since my dose of Zoloft is fairly small should I be concerned for the 5-8 days of taking the cold medicine?

Answer: Although theorectically possible, I don't think that I have ever seen this problem with my patients on these drugs. In general, these drugs have minimal side interactions with other drugs. Take 1/2 and see, but I doubt that you will see a problem.

[posted 02/8/2000]
Question: I was prescibed Zoloft because Prozac had ceased to be effective for me after taking it for about 2 years. It seemed to be working well, but then I ran out and was unable to get the refill for two days. I have been back on the Zoloft for over a week, but ever since I stopped taking it for those few days, my depression became much much worse, to the point where it is affecting my work and marriage. Can a small gap like this cause Zoloft to stop working, or was it perhaps not working in the first place and the initial improvement due to a placebo effect?

Answer: It would be uncommon for zoloft to work when prozac did not since their mode of action is similar. Secondly, a small time off might give a withdrawal syndrome but not protracted depression. What dosage are you taking? Zoloft can be used up to 200 mg a day in most clinical situations.

[posted 02/7/2000]
Question: Hi,

I have been taking 50mg Zoloft for depression for about two years and recently increased the dosage to 75mg. If it takes three to four weeks before Zoloft takes effect initailly, how long does it take before the dosage increase takes effect?

Answer: Usually.

[posted 01/31/2000]
Question: I have been taking 50 mg of Zoloft for 2 years for what my doctor termed as "situational depression" as a result of a death in my immediate family, the ending a 16 year marriage, and my hysterectomy. All of this happened in about a 12 week time period. I sought therapy about 6 months after all this and started taking Zoloft. I have to say, I feel like a different person today. I have never been a person that takes prescription medication and don't want to continue the use of Zoloft. I have reduced the dosage to every other day for about 1 week and completely stopped taking it 5 days ago. For the past 72 hours I have experienced dizziness , light headedness, fatigue, and extreme irritability. I am a very healthy person so I thought must have had the flu until the "rage" started. (A problem I've never had before!) I began to "search the internet" for what I have found to be my worst nightmare. In the past 6 hours, I have read more stories of people experiencing the same thing I have. It is NOT the flu. I am having "withdrawal symptoms" from discontinuing Zoloft! My doctor assured me this was not an addictive medication when I started taking it. I gave him a lot of opposition about taking an anti-depressant medication and even sought a second opinion. It seems that you have had a lot of folks asking you the same questions too and I don't see a really clear answer. How long will these symptoms last? Is there a way to "wean" yourself off of this drug that is not so unpleasant? I want my husband and children to love me and be able to tolerate this transition. (Please don't say by taking another med!) I have gained weight also and I have NEVER had a weight problem in my life. Do people experience the weight loss after they stop taking this medication? In addition to your answers, can you direct me to another web site, book, toll free number, hotline, etc.? I would really appreciate it. Thank you for your time Please help!

Answer: There is no easy way to wean this medication in withdrawal. We usually cut the dosage slowly for patients who experience the syndrome. But, the severity of the withdrawal does not seem to be always proportionate to the dosage that the patient was taking. Usually the symptoms last 4-6 weeks, decreasing over time. As to the weight, most of my patients who experience weight gain on the SRIs slowly lose it after stopping the medication.

[posted 01/26/2000]
Question: I have been taking 25 mg of zoloft for migraine headaches, for almost 3 days. I have gotten more than enough sleep, yet I still feel very tired. In a week I am supposed to go up to 50 mg. My question is will that side effect wear off, and if not should I consider not uping it to 50 mg as I am having side effects with 25 mg.

Answer: Some patients get better, some stay fatigued. You'll have to try it, give it 3 weeks and see.

[posted 01/20/2000]
Question: Will taking Zoloft decrease the effectiveness of birth control?

Answer: Shouldn't.

[posted 01/23/2000]
Question: I have just stopped takin Zoloft. I tappered off like my doctor said and I have been off for about 2 weeks now. Since I stopped I have been very dizzy, tired, and my moods are severely high and low. Is it due to going off Zoloft?

Answer: Probably, there is a withdrawal syndrome for about 20-30% of patients going off the drug if they have been on it over 4 months or so. Very much like the flu with nausea, aches, diarrhea etc.

[posted 01/11/2000]
Question: I was on Zoloft for 2 years and was up to about 150 mg per day. My work life had become very stressful and I began to experience a stinging sensation, as if I were being pricked with needles. I felt this stinging randomly throughout my body throughout the day although it seemed to be worse at night. I have been off Zoloft for 6 months now and still experience these sensations periodically so I'm not even sure it was the Zoloft. Have you had anyone else mention such a side-effect with Zoloft or any SSRIs?

Answer: Probably not the zoloft, see a neurologist.

[posted 01/15/2000]
Question: I was started on Zoloft 50MG, is this a drug you become hooked on? What are the problems if I take one in the morning and one in the evening? I was started one a day A.M. but I don't feel any less depressed after lunch time. I am a 59 year old Male.

Answer: It is not addictive although patients (20% or so) do experience a withdrawal syndrome after being on it for awhile. The effects will take at least a week and often three before the medication begins to work.

[posted 11/26/1999]
Question: I recently started taking 50mg of Zoloft a day for depression.
My wife and I want to try and have another baby. We have not
started trying yet because we don't know if Zoloft use by the
father poses any danger to the baby. Can I continue taking
the Zoloft while we try to get pregnant?

Answer: Don't know of any problem except it does decrease sexual drive and ability to ejaculate, as long as this is no problem-go for it.

[posted 11/5/1999]
Question: I have been takeing Zolfoft for about 4 months now i started takeing 50mg a day but now i take 150mg a day for about a month now my concern is that i am going to be going to scholl to get my CDL class a license and in the CDL manual it staits that antidepressants will medically diqualify from getting it so i am going to stop takeing it i guess being that part of my depresstion is becouse i am 27 and have no trade and i have a great intrest in driving 18 wheelers my question is will Zoloft show up on a pee test giving by a Dr for a physical exam or will it show up as being a drug as in THC or LSD ect i dont use street drugs and i am scared that it might show up as thator show up perid THANKS

Answer: It depends entirely on whether the test is oriented to the SRI. In general the statement about anti-depressants refers to previous classes of drugs which were sedating. It will not show as THC or LSD. I would list it as a drug that you are using for anxiety or social paranoia. These are both indicated uses and then you would not have to list it as an antideACE)sant.

[posted 11/17/1999]
Question: My dauther was given zoloft for rapid heart beat we thought that zoloft was for depression.Is it safe for her to take? Scence she has been taking zoloft she stays tried all the time.

Answer: It's safe but will do little for tachycardia unless it is due to anxiety.

[posted 11/18/1999]
Question: I am taking Zoloft, Ambien and Serzone. I am wondering how all these medications interact. I am experiencing the normal side effects of Zoloft, sleeplessness and non-interest in sex. So, my dr. put me on Serzone at night to help. I take 100 mg of Zoloft in the a.m. and a gradual increase to the same amount of Serzone at night. Ambien when I need it.
Does this make sense? I have another appt. with my dr. Dec. 30. Can you advise what questions to ask? Thank you.

Answer: Serzone is better for sexual symptoms. But, most physicians would either use Zoloft or Serzone, not both. The combo with Ambien is ok. I'd shoot for all Serzone rather than a mix.

[posted 09/19/1999]
Question: I recently stopped taking my zoloft due to blurry vision-- I had only been on since mid June of this year. I am very nearsighted -- and had an eye exam in March with new contacts and glasses --- I could see well prior to being on the medication for approximately 1 1/2 to 2 months. My vision has become especially poor at night so I decreased the dosage and finally quit taking the medication --- I havent taken it for approximately 2 weeks and my vision is still very blurry. I wanted to know if this could be an effect of the drug or is it just another aspect of being over 30? If it is a side effect -- does it ever correct itself or do I need to go change my contact script?

Answer: Not the drug, ensure your blood sugar level has been checked. If ok, see your eye md.

[posted 11/10/1999]
Question: I have been taking Zoloft 50mg for 1 month. Recently I have experienced an aggravation of acne on my face. Could this be a side effect of the drug? If so is this temporary and can you give me any advice on reducing my breakouts?



Answer: Not likely the Zoloft. Topical Benzoyl Peroxide 5% available OTC is really excellent. 10% used sparingly will help really severe areas. Read the ingredients on the acne gels and get one with this.

[posted 08/28/1999]
Question: I am 22 years old and am 9 weeks pregnant. my question is, is 50 mg of Zoloft safe to take while I am pregnant? I haven't been able to get any straight answers from my doctor. Also, I have been thinking about getting off of Zoloft and would like to know the best way to taper off.

Answer: You can't get straight answers because no one knows for sure. It seems safe in longitudinal studies of women on it, but it is listed in the PDR as a drug to avoid unless the depression won't allow it. Usually you don't need to taper zoloft, but there are some reports of a withdrawal like syndrome.

[posted 08/28/1999]
Question: I recently began taking zoloft for depression and had to stop taking the medicine due to flushing symtoms which have been explained to be rare (<2%). After discontinuing the drug, I have had problems with itching ears. I have been to 3 different ear nose and throat specialists and none have been able to successfully treat my condition. The latest doctor says that I have a minor inflamation of both ear canals very similar to exema. I am currently on a steriod/antibiotic combo and it does not seem to be releiving the symptoms. Has my problem been started by the zoloft? The condition seems to be getting no better and I'm on the 3rd month of problems

Answer: Doubt it.

[posted 10/12/1999]
Question: My Dr. wants to switch me from Pamelor to Zoloft, as I am having some very highs followed by some lows and a very dry mouth & 10lb. weight gain. I am very much afraid to try Zoloft as I was put on Prozac once and became ill enough to want to go to the hospital. I feel I am hypersensitive to sudden serotonin increases. He wants me to start at 1/2 of a 50 mg tablet in the morning for 4 days and then take the full tablet there after. Wouldn't it be better to take 1/4 of a tablet for 4 days, along with 25mg Pamelor, and then the 1/2 tablet (without the Pamelor) for 4 days, then 3/4 tablet for 4 days and then the whole tablet there after. Is Zoloft available in liquid form? I really feel I need a very slow approch with the serotonin. The books tell you the side effects are the same for the SRRI's - I am afraid I will have the same trouble I had with Prozac.

Answer: Why not Effexor or Wellbutrin if you have had problems with the SRIs? If these cause problems, then retrying the SRIs would be ok. But, I'd start with Serzone or Celexa, a more selective drug than Zoloft. Zoloft is nearly identical to Prozac in side effects.

[posted 08/12/1999]
Question: I have been taking 50mg of zoloft for the last 5 weeks. I am experiencing
days where I am depressed for about 10 minutes and then the
depression goes away and I feel normal. I have also been taking
the diet pill metabolife or max 10's. they are bothe over the
counter and are just high doses of ma huang, chromium,cayenne, etc. Can this have some effect on the
zoloft or is my body still just adjusting to the zoloft. I have never
taken any kind of anti-depressants before. The reason why I was depressed
was because of a breakup, so it is not a habitual thing.
Thank you.

Answer: I don't know of an interaction, but I would stop the Metabolife and see if it has any effect. You may also be experiencing situational depression which tends to wax and wane-depressants like Zoloft are less useful here-better with a history of recurrent depression.

[posted 08/11/1999]
Question: I have just started taking zoloft for depression/anxity. I have been taking it for the past 2 weeks 1 50mg in the morning. I was wondering if this would have an effect on my menstral cycle? I am usually very regualr and it lasts for about 4 days. The first 2 days are heavy than it tappers off. I have had my period for the past 7 days with very little blood flow. very little. I wanted to know if the zoloft had anything to do with that and if it would eventually go back to normal. Thanks Dina

Answer: Probably not.

Stoppage of Zoloft [posted 1/11/99]
Question: I have been taking 75 mg of Zoloft per day for about 4 years. Its effectiveness is diminishing to the point that the side effects out-weigh the benefits (50 lb weight gain, always tired, memory problems). I am unable to tolerate a higher dose so I am thinking about stopping taking it. I have tried to stop before, but the withdrawal symptoms were so incredibly bad (incredible rage fits, felt wacko, etc.) that I just ended up starting back on it. Do you think that if I decreased the dosage very, very slowly (like over a month or more), that the withdrawal symptoms would be more tolerable? Also, I have heard that other people have gained a significant amount of weight from anti depressants. When I stop taking them will the weight come off as easily as it seemed to be put on?

Answer: I have been taking 75 mg of Zoloft per day for about 4 years. Its effectiveness is diminishing to the point that the side effects out-weigh the benefits (50 lb weight gain, always tired, memory problems). I am unable to tolerate a higher dose so I am thinking about stopping taking it. I have tried to stop before, but the withdrawal symptoms were so incredibly bad (incredible rage fits, felt wacko, etc.) that I just ended up starting back on it. Do you think that if I decreased the dosage very, very slowly (like over a month or more), that the withdrawal symptoms would be more tolerable? Also, I have heard that other people have gained a significant amount of weight from anti depressants. When I stop taking them will the weight come off as easily as it seemed to be put on?

Zoloft side effects [posted 1/8/99]
Question:What are some side effects from taking this drug for a long period of time?

Answer: No different from short term. Some patients report a type of dependence, most do not.

Zoloft for tiredness [posted 1/7/99]
Question:My husband has been given zoloft by his physician to treat his "blah" moods and tiredness. I have been doing some reading on the drug and what I have read says it is for severe depression and panic disorders. My husband is not "depressed", just can't seem to find energy. He can just be sitting there and all of a sudden can't stop yawning and his eyes get red and watery. He doesn't get motivated about things like he used to. At first we thought it was a thyroid problem, but his blood work came back fine. I am feeling a bit worried about his doctors choice to give him, what seems to me to be a serious drug, based purely on a guess. What would be the normal uses for Zoloft, and would his symptoms fit those uses?

Answer: I'd try it and see what happens. If it corrects his blahs it wouldn't be the first time. The side effects are pretty minimal.

Zoloft Concerns [posted 11/11/98]
Question:  I have been taking Zoloft for about 1 1/2 years now. Usually I take 100 mg every morning, although sometimes it was increased to 150 mg. One week ago, I stopped taking any Zoloft whatsoever. I am now experiencing nausea and dizziness, and feel too tired to do much of anything. Are these symptoms possibly related to the discontinuation of Zoloft? If so, could I get quick relief from taking small doses again, and then titrating off it? Thanks for any info you might provide.

Answer: Hard to know. There are clearly patients who feel a withdrawal syndrome, although the literature is pretty sparse about this problem. In general, I "wean" patients from higher dosing;but, it can be a problem.

Zoloft Concerns [posted 11/11/98]
Question: Just a quick question about Zoloft. I was diagnosed by a rheumatologist five years ago with fibromyalgia and have been on the following meds since. Desipramine and Imovane with Tylenol #3 used to control my headache and hip pain. My family doctor and I wondered after the birth of my son if a trial of Zoloft would be helpful because my fibro really flared up and with post-partum it was a bit tough to handle. I am on Desipramine 250mg and Imovane 15mg at night. When I went on the meds a week ago (I had only taken if for four days) when I had a grand mal seizure and had to be taken to the ER and treated for that. My family doctor is currently booking me an appointment with a neurologist but I wondered if you have heard about that occurring before? I immediately stopped the meds! Thanks for your help!

Answer: Zoloft has been implicated in some patients in causing seizures, possibly the answer.

Zoloft Concerns [posted 11/11/98]
Question:I'm taking zoloft for the first time and never taken anything else for depression. But after reading some of the things they say about zoloft I'm afraid take it. I just started taking it, is this something to be worried about?

Answer: Not usually, it is usually well tolerated, does not cause physical dependence and has minimal side effects. The one that bothers most women is difficulty reaching orgasm.

Can Zoloft Treat Rage Attacks [posted 11/3/98]
Question:I had a "rage attack" and was prescribed Zoloft. Is this the best drug, in this case? I am diabetic and my evening meal was late due unforeseen circumstances. The house was hot and busy with a lot of family members. When the attack struck, I felt completely out of control. I verbally attacked two family members over a very petty matter. The exchange of words quickly escalated into a physical confrontation, stopping just short of life threatening violence. This has completely alienated some of our family members who don't consider our family doctor's prescription for zoloft enough treatment. They continue to ask when I am going to see someone, a psychiatrist, I presume. I would like to know if any of my medications could have caused this or if being diabetic and not eating on time would more likely have been to blame. I was also extremely tired, having worked well beyond my normal limitations that day. A reply would be greatly appreciated. Thank you very much.

Answer: Zoloft or any of the SRI antidepressant class is the first drug of choice for an explosive personality or so called rage attacks. Usually very effective, but, I would also check your sugar at home with a home monitor to see if a low sugar could be responsive for your spell, wouldn't be the first time that personality changes occur with low sugar. Generally, not with high sugars by the way.

Zoloft Alternatives [posted 10/8/98]
Question:I am a 45 yr. old woman who has taken Zoloft 50mg-100mg for the past 4 years. The medication helped me tremendously. However my new health insurance will not cover the cost of Zoloft and my health care provider has switched me to Serzone. I am unhappy about this as I am experiencing severe dizziness,sleepiness and have been suffering with a Migrain headache for the last 2 days of treament on this new drug. Will I be able to tolerate the Serzone? Will the dizziness go away? What can I expect? I am currently feeling lousy. Also experiencing lack of focus, short memory loss and no interest in anything I just want to sleep. Feeling like I lost my best friend. (Zoloft)

Answer: Serzone is a lot different drug than Zoloft. Check with the company and see if they will allow Prozac, Paxil etc. these are very similar to Zoloft. If not, have your doctor document the difference and contact their medical director.

Zoloft Side Effects [posted 10/8/98]
Question:I have tried both Paxil and Zoloft. I am worried about wieght gain. Which drug is more likely to cause weight gain, IS have only been on Zoloft for 2 mos, however, I have gained 5 lbs. I did not gain weight with the Paxil. Should I switch back to the paxil? I have also experience memory loss and headaches. Are these common side effects?

Answer: They seem to be about the same in my experience. Possible but, uncommon side effects.

Zoloft Side Effects [posted 10/6/98]
Question:I have been taking 50 mg. of Zoloft for about 2months with no side effects other than tiredness and decreased sexual desire. About one week ago I stopped taking it and about four days later I started to feel dizzy and as if I would lose my balance. Is this a side affect from stopping? How much longer should I allow these symptoms to go on? It has been 3 days of dizziness and one week of no Zoloft.

Answer: Probably due to discontinuing the drug. The side effects usually last about 7-10 days for most patients.

Zoloft & Irritated Bowel [posted 10/6/98]
Question:My doctor has me on Zoloft 25mg a day and Prevacid for irritable bowel. My question is sometimes I can't sleep at night. When that happens I usually take a valium or Melatonin that you can purchase at the drug store. Is either valium or the melatonin a dangerous combination with the zoloft?? How does Zoloft help irritible bowel?? Also I drink occassionally. Is the combination of Zoloft and alcohol dangerous?

Answer: Zoloft and alcohol are not recommended;but, not a serious problem. Valium and alcohol is potentially lethal. As to the effect of Zoloft on irritable bowel, no one is completely clear as to why it helps. Obviously,it has something to do with the nerve endings responsible fro what we call irritable bowel-exact mechanism is not known. Zoloft and valium/melatonin are usually of no problem.

Zoloft Alternatives [posted 10/1/98]
Question: I have a 18 year old daughter that has been on 50mg of Zoloft QD for the past 9 months. While it has managed her chronic pelvic pain for which is was prescribed for, she has now developed extremely high intra-ocular pressures which could suggest glaucoma. Would you be familar with any anti-depressant that could be used for chronic pain and that would not raise intr-ocular pressures. Thank you in advance for your assistance.

Answer: Most have some anticholinergic effect and would potentially raise occular pressures. Bupropion might be an alternative.

Zoloft and Alcohol [posted 8/14/98]
Question: I have only been taking zoloft for 3 days for ADD and I noticed that there was an alcohol warning on the bottle. Is it harmful to drink alcohol with this medication?

Answer: They have this listed, but I don't know why. Many of my patients will have occasional drinks without any appreciable problem. I do not limit alcohol with this medication. You should be aware that alcohol is a depressant however.

Zoloft and Illicit Drugs [posted 7/31/98]
Question: What would the effects be if a 19 year old girl is taking prescribed Zoloft (50 mg/day) and doing drugs such as MDMA, LSD, Cocaine, Crystal Meth, and any other drug of that sort.

Answer: Zoloft and the like are exceptionally well tolerated with few drug interactions. However, there is no data for interaction with illicit drugs.

Zoloft and Urinary Incontinence [posted 7/23/98]
Question: Is there any evidence to indicate that urinary incontinence may be a side effect of this drug?

Answer: Zoloft does have a very mild anticholingeric activity. This gives constipation, dry mouth and occasionally urinary hesitation (especially in men with large prostates).

Zoloft and Alcohol [posted 7/17/98]
Question: What side effects can happen if I take zoloft while I drink?

Answer: Zoloft is incredibly well tolerated and has little drug interaction with anything, including alcohol. It does have some effect in changing sleep and orientation with alcohol - dose dependent, but it is not a major problem. I would not recommend it since alcohol is a major depressant and zoloft is given for treatment of depression. So, the depression would not be expected to respond with continued alcohol use.

Problems with Zoloft
Question: I had been taking 25mg of Zoloft every morning for a week and then 50mg per day for the last week. I had some expected side effects, such as nausea and insomnia, but those are now gone. I have also noticed a major decline in sex drive and ability to achieve an orgasm. Will this side effect go away like the nausea? I am not depressed, but my doctor chose to put me on the Zoloft to help treat my Irritable Bowel Syndrome. I have not been able to find much information on Zoloft for IBS. Is there some other similar medication (perhaps another antidepressant) that will not have the same sexual side effects? Would Serzone work for the IBS as the Zoloft would?

Answer: Whether any of the antidepressants help in IBS is not clear. It is certainly worth a try(and many of us have) due to the theoretical effect of the drugs as well as their ability to slow the bowel slightly. All the SRI antidepressants will cause sexual dysfunction. This ranges from low drive to lack of arousal to lack of orgasm. This will not go away as long as you take the drug. Serzone is better with sexual aspects. Whether it will help your IBS will be trial and error. There are small reports of improvement of sexual drive and function by taking small amounts of amphetamines when you desire sex. I have not tried this in my practice, but it is an option depending on how well the Zoloft is working on your IBS.

Zoloft
Question: I have been on Zoloft for over 1 1/2 years to treat depression. I began with 50 mg. Earlier this spring I had a severe episode of depression and was raised to 75 mg by my psychiatrist. I now (at 75 mg) am experiencing hot flashes, extreme weakness, tiredness, irritability, insomnia and an overall "spaced out" feeling. My psychiatrist today lowered my Zoloft back to 50 mg. How long will it take for the symptoms of the 75 mg to disappear? I am not taking any other meds that would cause any of the above side effects.

Answer: Hard to tell if this is Zoloft or not. The only sure way is to decrease the dose. This will take 3- 7 days to clear your system.

Zoloft
Question: I have been treated for 1+1/2 years with Zoloft to control PMS. It has worked very well and made a tremendous difference in my life. The only remaining disturbing side effect is diminished sexuality. In the postings concerning Zoloft, I saw mentioned that Serzone is a newer drug which does not have this undesirable side effect. Is it the same type of drug as Zoloft? Would it also be used to treat PMS or just actual depression?

Answer: In general, Serzone will not have the effect on your sex drive and your ability to reach orgasm. Whether it will help you with PMS will not be clear until you try it. In general, Serzone has a somewhat different effect than the SRI class. Try it and see.

Zoloft and Pregnancy
Question: My wife is pregnant (approx. 10 weeks). She has been taking 25 mg of Zoloft daily for approx. 2 years. She is currently coming off the medication based on her doctors advice. I have two concerns. First, are there any alternatives to Zoloft during pregnancy, or is zoloft safe? Second, are there any potential side effects to the baby if Zoloft is continued or during the first eight weeks the medication was taken.

Answer: There are no studies done on pregnant women. However, the drug is used extensively and many women have become pregnant on this drug. To date, there appear to be no evidence of problems. Studies in rats and mice don't show major problems. However, long term studies of babies born on this drug have not been done.

Reactions to Zoloft
Question: I have been taking zoloft for 3 days (50 mg) and am experiencing a tightness in my throat like I have something stuck in it. Could the drug be affecting my thyroid? Will this symptom go away with continued use? Is this a normal symptom?

Answer: This is probably not your thyroid, but it probably does have something to do with the anticholinergic activity of the drug. This produces a dry mouth, and I suspect that is contributing to the sensation. The only way you will know is to stop the drug(after conferring with your MD) and see if it goes away.

Zoloft and Orgasm
Question: My girlfriend has been taking zoloft for about 2 years. She seems not to be able to achieve an orgasm. She was able with her last boyfriend and thinks that it might be from the medications. Will she be on Zoloft forever? She says that it is a genetic thing and her sister is also on it. Can you give some insight?

Answer: Many people experience difficulties with orgasm or arousal on SRI antidepressants. Some patients actually prefer the experience. Use of other antidepressants like Serzone may help. Also, there is some published data on use of small doses of amphetamines with SRI to achieve better sexual arousal and orgasm.

Zoloft - long-term effects
Question: I have been taking Zoloft (100 mg) for about 4 years. Initially, I thought it was helping me a lot. I had much more energy than before the zoloft, but I lost a lot of weight. Over the years, The effect of zoloft has diminished. I often feel wiped out, with the inability to focus, and I have gained a lot of weight. Is this abnormal? What are your suggestions?

Answer: Your symptoms are possibly represent what you yourself have determined them to be due to. That is, you report that the effect of the Zoloft has "diminished", and with your symptoms of feeling fatigued, and "wiped out", as well as weight change and inability to focus, it may very well be that the depression symptoms are starting to return. A less likely possibility is that these symptoms are actually due to the medication itself, and not a diminishing effect of the drug. Other factors that may or may not be related are how well you are sleeping, any stressors in your life, as well as any other possible physical conditions you may have. A visit to your health care provider should be your first step. He or she can take a thorough history and examination, and hopefully make a determination as to why you are experiencing your symptoms. Also, be sure to speak to your health care provider with any other concerns you may have. The best way to manage a Zoloft regimen is with close follow up, and adjustments as needed. If indeed your provider feels that your symptoms are in fact due to a return of your depression, a dosage adjustment or medication change may provide you with a great deal of benefit.

Zoloft
Question: I am 35 years old and have been on 300 mg/day of Zoloft for almost 2 years. My doctor started me on 50 mg/day and gradually increased the dosage to 300 mg/day. I did not show any improvement until my dosage reached 300 mg/day. At 300 mg/day the depression was completely gone and I have been feeling fine ever since. However, my doctor insists that because of the severity of my depression that I should not try to taper down the dosage and should stay on this dosage as long as I am not experiencing any problems. Has there been any studies on long term effects of Zoloft, specially at a very high dosage?

Answer: Zoloft is a commonly used and effective antidepressant medication. It works by affecting the brain's metabolism of seratonin, a brain chemical, or neurotransmitter. Typically, Zoloft requires about 3-4 weeks of consistent and regular dosing before any antidepressant effect can be expected. Once stopped the half-life of the medication (or, time it takes for 50% of the medication to be cleared from the body) is about 26 hours. One of the drug's metabolites, or chemicals that the body converts Zoloft into, has a half life of 62 to 104 hours, thus some of the medications effects will last for several days after the medication has been stopped. Among the reported effects and uncommon side effects of Zoloft in the Physician's Desk Reference are: agitation, nausea and/or vomiting, diarrhea, heartburn due to acid reflux, tremor, dizziness, insomnia, increased sweating, dry mouth, and sexual dysfunction. Stopping or sometime, lowering the dose of the medication can improve some of the side effects if they occur. The maximum recommended daily dose for Zoloft is 50-200 mg. However, as is often the case with many medications, physicians often feel higher doses are beneficial to obtain a benefit for their patients, and without a change in the number, or severity of side effects. Speak to your health care provider with any concerns you may have. The best way to manage your Zoloft regimen is with close follow up, and adjustments as needed. Long term studies are not yet available for the newer anti-depressant classes, which include Zoloft, since they have not been in use long enough. Your physician keeps up to date on the latest medication research, and can keep you up to date about Zoloft as future information becomes available.

Zoloft
Question: I am an otherwise healthy, 28-year old woman, diagnosed with depression after suffering through a year and a half of an abusive relationship, aggravated stalking, physical and emotional abuse, rape, and the sudden loss of a close sibling. I have been taking 50-75 mg of Zoloft for 6 weeks now for the first three weeks and 100 mg/day since. I am immensely less depressed, even happy much of the time. My doctor would like me to begin weaning myself off in about a month, and I look forward to it. Since I began taking it, I have lost 12 pounds in 6 weeks at a steady rate. I am eating, but the weight still goes. This has me concerned, because I am now down to 100 lbs (at 5’ tall) and would prefer not to lose any more weight.. In addition, I find that my interest in sex is diminished, despite being in a new and wonderful relationship. I also find it impossible to reach orgasm. What can I do? Will this resolve itself when I quit Zoloft? Finally, what can I look forward to when I do begin to cut down? I've seen posts from people who say they've been taking it for years. Is 3-4 months too short a time?

Answer: Zoloft (generic name sertraline) is an effective antidepressant medication, and it sounds like it has made you fell a great deal happier. I am sure this has pleased your health care provider as well. First, there is no preset or recommended duration of therapy for these medications. The best way to gauge the effectiveness and need for antidepressant medications is by frequent discussions between patient and health care provider. Monitoring during the weaning down period is particularly important, so as to assure that depressive symptoms are not returning. The happy relationship you are now in, will hopefully only serve to make weaning off of the medication easier for you. Also, it is not uncommon for patients to go on a short course of antidepressant, or on an extremely long course. The key is what benefits the medication provides. With respect to the symptoms you mention-weight loss and loss of sexual interest- these are noted side effects of the medication. Often the weight loss is not so much a direct side effect of the drug, but rather the result of less overeating as the depression improves. This may be the result of the Zoloft itself, and should taper off as the dosage is reduced. Likewise, sexual dysfunction can occur in both men and women on antidepressant medications, and can range from loss of desire, to problems with orgasm, ejaculation, and erectile dysfunction. With lowering dosages, this too should improve. Of course, you should let your health care provider know about these concerns, that way you can both keep track of them and monitor them over time, while you come off of the medication.

Zoloft and Sex Drive
Question: Does any research indicate that 100mg of Zoloft daily can result in sexual dysfunction and short term memory loss in men?

Answer: Zoloft, generic name sertraline, is a commonly used and effective antidepressant medication. It works by affecting the brain's metabolism of serotonin, a brain chemical, or neurotransmitter. Typically, Zoloft requires about 3-4 weeks of consistent and regular dosing before any antidepressant effect can be expected. Once stopped the half-life of the medication (or, time it takes for 50% of the medication to be cleared from the body) is about 26 hours. One of the drug's metabolites, or chemicals that the body converts Zoloft into, has a half life of 62 to 104 hours; thus, some of the medications effects will last for several days after the medication has been stopped. Among the reported effects and uncommon side effects of Zoloft in the Physician's Desk Reference are agitation, nausea and/or vomiting, diarrhea, heartburn due to acid reflux, tremor, dizziness, insomnia, increased sweating, dry mouth, and sexual dysfunction. Although confusion is listed amongst the possible rare side effects, memory loss per se is not. The sexual dysfunction ranges from loss or lack of libido (desire) to delayed ejaculation to erectile dysfunction. Memory loss may very well be a component of the depression for which the Zoloft is being taken, as this problem is a very common symptom in individuals with depression. Stopping or sometimes lowering the dose of the medication can improve the sexual dysfunction. Speak to your health care provider with any concerns you may have. Dosage adjustments or switching to a different agent may prove beneficial if the side effects are excessively troublesome.

Zoloft and Fertility
Question: I recently stopped taking Zoloft after 3 years on 150 mg. I'm trying to conceive. Does Zoloft effect fertility? How long should I be off of it before trying to conceive?

Answer: Zoloft is an antidepressant, and its mode of action is to affect the brain's use of a chemical known as serotonin. With respect to its use during or immediately preceding pregnancy, the Physician's Desk Reference reports that at doses many times higher than those normally used to treat depression, there was no evidence of effects on the developing fetus. However, no clinical studies have been done to assess the effects of this medication on fertility, be it in patients trying to conceive while on the medication, or shortly after stopping the medication. The half life (or time it takes the body to clear 50% of the medication) of the medication is about 26 hours, but the half life of its metabolites (or chemicals that the medication is converted into by the body) of this medication are up to 104 hours. As there is no data available to answer your specific question, close follow up with your doctor while you are trying to conceive, as well as during your pregnancy is still, as always, the best way to make sure you and your baby both do well.

Zoloft
Question: Will Zoloft appear in a routine employment drug screening? Is Zoloft something that would be noticed in the results?

Answer: For most office screens , no. However, it depends on the specificity of the test. You will need to stop for at least 2 weeks to ensure it is completely gone. I doubt that these are the types of drugs they are looking for. Prescription drugs are usually not an issue. Illegal use of prescription drugs or illegal drugs is behind most drug screens.

Zoloft
Question: My doctor recently stopped my Elavil after 8 months and started me on Zoloft. I have multiple sclerosis and was having "emotional incontinence" like crying at the drop of a hat. The Elavil helped, but I gained twenty pounds. Will the Elavil help with the weight loss and the crying? Also, my Thyroid quit working, and I'm on Synthroid. Does the Elavil have any thing to do with this. I'm forty one and dx. two years ago with Multiple Sclerosis.

Answer: The only way you will know if Zoloft will be as effective is to try it. Most patients don't lose weight, even though the package insert mentions this prominently. I can't think of any connection between Elavil and hypothyroidism.

Zoloft
Question: About a month ago I began tapering off my dosages of Zoloft. I normally took my dosage (50 mg for the past few years) at night because it caused me to feel quite dizzy for the first few hours after taking it. For the past 2 days I have not taken any and I have been quite dizzy all day. Is this normal? How long does Zoloft stay in one's system? When will I feel normal again?

Answer: Zoloft is usually cleared from the body in 3 to 5 days. Consequently, I doubt that your dizzy spells have anything to do with Zoloft. I would consult your physician if they persist.

Zoloft for depression in children
Question: My 12 year old son has been diagnosed with severe depression. His pediatrician in conjunction with his clinical psychologist has prescribed Zoloft. Although they both say that the 50 mg dose prescribed is not harmful and has no side effects except sleeplessness, it bothers me that I cannot find any information on studies done on children taking this drug. What is your opinion, as a pharmacist, on prescribing this drug for depression in children? Are there any precautions when taking this drug with asthma medication?

Answer: There is no data on treating children because it has not been done. In view of the difficulty of informed consent it probably will never be done. There have been no major toxicities discovered on the children treated with this drug, although the number is relatively small. Severe depression in children does not appear to be as common as in adults, maybe because it is not recognized. There should be no major interaction with asthma or with the drugs to treat asthma.

Zoloft and weight gain
Question: I have be on Zoloft for over 1 year now. Since taking the drug (50-100 mg daily) I have experienced gradual weight gain. I have gone from 125-130 or less to about 155. My appetite has not increased that much. Does Zoloft slow down your metabolism or something? And if I diet or cut out calories and fat more (I don’t mean to imply that I eat unhealthy stuff) will that help or am I destine to be happy for the trade off of a few extra lbs.? Before I was on Desyril and it wasn't helping much. Please, all I need is a little piece of mind!

Answer: The Serotonin Reuptake Inhibitors(SRI) as a class was initially thought to be an adjunct to losing weight. Indeed, on the Prozac information is a specific warning about weight loss. In my experience, most patients gain weight. I’m not quite sure why-- the drug should cause weight loss if anything. I am not aware of studies as to the mechanism.


Zoloft and Trazadone
Question: How long does it take for these 2 drugs to leave the body? Do they leave the body completely, or is there any residue left anywhere (stored in fat?)? If so, where? If some residue exists, how long is it there, or is it always there? If someone took 150 mg of Zoloft and 175 mg of Trazodone over an 8 day time period, is there any health risk to any other part of the body? Should that person not have children after taking these drugs? If it's okay to have children, how long should they wait? Will having ever taken these drugs affect the fetus in any way? Does having taken these drugs alter the brain or body in any way? Is there anything else one should know about them?

Answer: Zoloft is cleared from the body after about three days. Trazadone varies more from individual to individual, but will usually be gone after three days. Trazadone is more likely to be stored in fat, but in negligible quantities. Neither of these drugs has a particular contraindication concerning pregnancy. However, no drug will say that it is completely safe. I would not be concerned about conception with either of these drugs. Each of these drugs affects the brain while one is taking the drug. That is their purpose. However, once the drug is cleared, there is no residual effects.

Zoloft
Question: Is there a drug to take with Zoloft to counteract the side affect of the inability to achieve orgasm? If so, what are the side affects of that drug?

Answer: There are none that I am aware of. However, a similar anti-depressant called Serzone can often avoid the problems with orgasm and sexual drive. Some of my patients have had luck switching to this drug.

Zoloft vs. Prozac
Question: Recently I was switched from Prozac to Zoloft. I was taking 10 mg per day Prozac, then a three day rest before starting 25 mg per day Zoloft for one week, then increased to 50 mg per day. My current symptoms are extreme tiredness as I can barely stay awake. Another problem I have been having since switching drugs is a "buzzing" when I bend my head down towards my chest. This is causing a mild tingling down my legs and arms. What is going on? Also, how long does it take your system to clear of either of these drugs?

Answer: These drugs take about a week to completely clear your system. You fail to mention why Prozac was stopped? If for side effects, the side effects of Prozac and Zoloft are very similar. If the problem you are experiencing is the drug, I'd discuss it with your physician and allow the drug to clear your system. Possibly a smaller dose might work. Also, Wellbutrin and Serzone are newer anti-depressants which have different side effects than Prozac and Zoloft.

Zoloft
Question: I have been taking 50 mg of zoloft per day for about 3 months. I feel that I have more anxiety than depression and have always felt that I was unnecessarily prescribed zoloft. How can I wean myself off of zoloft? I do not want to take it. I feel that it contributes to restlessness, anxiety, and sleeplessness.

Answer: Zoloft and SRI drugs are often used in the treatment of depression and agitated depression. This is a mixture of anxiety with depression. Sometimes in addition to the SRI, an anti-anxiety drug like valium is necessary. I would not stop this drug without discussing it with your physician.

Zoloft
Question: I am an 18 year old female and I have been on Zoloft (100 mg) for 2 and a half months. I have found great feelings of confidence. I am a college student, and enjoy going to parties. I was wondering what the effects of mixing Zoloft and alcohol were? Is it safe?

Answer: Alcohol and SRIs are not a recommended mix. This is for several reasons. There is some interaction causing drowsiness, etc. With alcohol, most of my patients will have 1 to 2 drinks maximum, but this is still not recommended.

Zoloft and Memory Loss
Question: After reading through the previous comments, I only saw one that mentioned memory loss associated with Zoloft. I have been taking Zoloft on and off for the past 3 years. Each time I start up, I notice that I experience memory loss (mainly short term) while on Zoloft. I have a hard time concentrating. To help combat this problem, I also take Dexedrine during the day. It helps somewhat. I explained this to my doctor and he said he hasn't heard of many incidents of this. Are there more people that are experiencing memory loss while on Zoloft or am I an isolated case? The PDR does not list memory loss as one of the side effects. I am curious to find out more. Is there a possibility that this is going to be permanent memory damage?

Answer: This is not uncommon, although not listed in the PDR. It also appears to completely abolish with cessation of the drug. You have stumbled into one of the recent research avenues in SRI treatment (use of amphetamines with the drug). If you want more information, have your doctor contact the company Roerig Division if Pfizer, 800-438-1985.

Zoloft drug interaction
Question: Recently, a friend of mine has started treatment for depression using Zoloft. I am concerned because she plans on smoking marijuana while taking this prescription drug. She refuses to ask her doctor about any possible effects of this drug interaction, and I can do nothing to prevent her from doing this, other than advising her not to. What are the possible effects of mixing Zoloft with marijuana and other illegal drugs?

Answer: There is no specific research on this that I am aware of. You might try contacting the company and see if they have any drug interaction reports on file (filed set a tely and not generally released except to the FDA). The company is Roerig Division of Pfizer and their number is 800-438-1985.

Zoloft
Question: Today is my second day on 50 mg of Zoloft. I have been slightly dizzy, moderately nauseated, and have indigestion and gas all day. Do you know if these side effects are common with Zoloft, and how long I can expect them to last?

Answer: These symptoms you are experiencing are fairly common. About 1/2 of patients will have these symptoms abate with continued use. About 1/4 will have these symptoms forever and about 1/4 will have them on and off, especially as the drug doses are increased.

Zoloft and Children
Question: My 10 year old son has just been prescribed Zoloft for depression. He takes 1/2 a 50 mg tablet each morning. Is this the anti-depressant that is recommended for children? If so, is 25 mg enough or too much? Also, is long term use damaging to the liver?

Answer: Well, we really don't know since medical drug trials in children are not allowed. We have to extrapolate data from adults concerning toxicity, etc., to children and judge from experience. Side effects in children seem to be similar to adults. The dosing would depend on the effect of the drug and your child's weight, but this would probably be about right for a 12 year old.

Zoloft- Interaction with Feldene
Question: Is there an interaction between Zoloft and Feldene? Both can cause diarrhea. When taken together, is this side effect increased or enhanced?

Answer: Zoloft (sertraline hydrochloride) is a drug normally used in depression. It apparently works on the inhibition of serotonin in the brain. About 10 to 15% of patients will experience diarrhea. Feldene (piroxicam) is usually classed as a non-steroidal anti-inflammatory. About 3 to 5% of my patients experience loose stools or diarrhea on this drug. Usually, the diarrhea will start as one starts, consequently, I am not sure that the drugs have anything to do with diarrhea. Clearly, stopping the drugs-with your physician's permission-would clear the diarrhea within 3 to 4 days if the diarrhea is drug related. If diarrhea does not stop with cessation of drugs, a gastrointestinal workup needs to be done to find the cause of the diarrhea. both weight loss and diarrhea could be due to the drugs; however, serious mistakes could be made if this is ignored.

Zoloft- Other Medications
Question: I was diagnosed and treated for depression about six years ago when I was a police officer. I have since left that profession after 13 years and started my own business. I have been taking Paxil, but was switched to Zoloft in an effort to eliminate the loss of libido and impotence which I have experienced while on these medications. I haven't had any feelings of depression for quite some time, but have had feelings of anxiety...constricted throat, heart palpitations, dizziness, nausea, feeling of impending doom...for no apparent reason. I only experience these anxious feelings when I forget to take my Zanex or Paxil. Should I switch to another medication that would just treat my anxiety? I would like to get off of all medications (I'm just taking this one), but don't think I'll be able to. My father, grandfather, and great-grandfather all suffered from depression. Will switching to Elavil be beneficial as far as decreased side-effects?

Answer: Depression and anxiety are different disorders; but, are commonly seen together. There is even a subgrouping of depression which commonly includes a lot of feelings of anxiety. If the anti-depressant is effectively treating the depression I would stay with it . This is because the anti-anxiety drugs in general are fairly sedating and have addiction potential. There are some treatments for anxiety like Buspar which are not; but, their effectiveness is limited. Elavil is an anti-depressant from a class of drugs called tricyclics. These are older anti-depressants and in general, produce a fair number of side-effects. This is one of the major reasons Paxil, Zoloft and similar drugs are used in place of drugs like Elavil. While you should discuss this with your physician, I suspect you will encounter more side-effects with Elavil. There has recently been released a few new entries in the serotonin class of drugs which are advertised as having less effect on sexual libido.

Zoloft- Sexual Drive
Question: What are the side effects? Does it reduce sexual drive? I have been showing less interest toward sex since taking the drug about 5 weeks ago. Please adsvise.

Answer: Zoloft is one of a newer class of anti-depressives. These include Prozac and Paxil. One of the usual side-effects is a decrease in sexual drive and libido. This will return to normal once the medicine is discontinued. Sometimes, a decrease in sexual drive can also be due to the underlying depression. However, if the decrease occurs with taking the anti-depressant the drug is the usual culprit. Serzone, which is an anti-depressant, is currently thought to have similar effects, but without sexual suppression.

Zoloft- Memory loss
Question: My 77 year-old wife is suddenly having a problem with immediate and recent memory loss. Can you tell me if 100 mg of Zoloft or a similar dosage of Wellbutrin can cause memory loss.

Answer: Zoloft (sertraline hydrochloride) and Wellbutrin (bupropion hydrochloride) are relatively new anti-depressant drug. Zoloft’s action is thought to be directed through the drug serotonin and inhibition of its reuptake by neurons. Wellbutrin and its mode of action are less well understood. Zoloft is not thought to have a major effect on memory. Wellbutrin has more central nervous system effects in general. These include delusions, hallucinations, confusion and paranoia. Patients are commonly warned that Wellbutrin may impair their judgment, motor, and cognitive skills. This may be seen by the patient or the family as a loss of memory.

Zoloft- Long term use of
Question: I have been on 100 mg of Zoloft for 2 years. The effects on my depression seem to be diminishing. In other words, the long-term use benefit seems to be decreasing. In long-term use of Zoloft, should an increased dosage be considered?

Answer: Clinical use of most of the anti-depressants of all classes is usually based on empiric effect. That is, one starts the drug and watches the effect on depression. The drug is increased until side-effects appear, or the depression is treated. There are a few of the anti-depressants which do have blood levels available, but there are only a few. Consequently, if the depression appears to be increasing it certainly would make sense to increase the dose and watch the effect(vs. side-effects). There doesn't appear to be major tolerance with long-term use.

Zoloft
Question: Is this drug excreted with the semen?

Answer: Zoloft is metabolized by the liver. Also, about 40-50% of the drug is excreted in the urine. I could find no data about semen.

Zoloft- Breastfeeding
Question: Is it safe to breastfeed an 11-month-old while on Zoloft (50 mg/day)?

Answer: Unfortunately, there is currently no data on the amount of Zoloft (or its metabolites) secreted in human milk. Also, safety and effectiveness in children have currently not been established. Studies of the carcinogenesis of Zoloft have generally been favorable with an increase in liver adenomas and some indication of uterine cancers.

Zoloft and Fen-phen
Question: I have recently begun the fen-phen program for weight loss. I have taken Zoloft for approximately one year and have been advised that I can continue taking 50mg of Zoloft in combination with these other drugs but not my previous dose of 100mg per day. Is there a potential problem with taking these drugs together or will I get the same anti-depressant effect from the fenfluramine and be able to discontinue the zoloft?

Answer: I know of no studies which look at this particular combination of drugs. Generally, given a lack of information, a physician will attempt to decrease the risks. I suspect that is the underlying reason for decreasing your dosage. I would discuss this with my physician.

Zoloft and Bipolar
Question:I am a 26 year old female who has been suffering from Major Depression for the past 3 weeks. I started taking Zoloft (25 mg) a few days ago. On the 3rd day of treatment, after two doses of the medication, I experienced severe nausea, so I skipped my dose for that day. The following day (with only 2 doses of the medication taken so far) I was over at a friend's house and found myself in an elated mood. I was talking very very fast and did not want to stop talking for quite a few hours. My thinking which had been sluggish during the previous weeks was very fast and clear. I felt on top of the world, and extremely optimistic about the future. I went back on the medication that night and now, the following day my mood seems normal (not depressed, but not particularly talkative). I am concerned about the reaction I had yesterday because I have read that if a person is even the slightest bit bipolar, there is a chance that a manic or mixed manic-depressive episode can be induced by antidepressants if that person is not also taking a mood stabilizer such as lithium. I had never considered that I was bipolar, but rather that I have been experiencing chronic atypical depression that has turned to Major depression 3 times in my life, once at age 16, again at 21, and now at 26. What I am wondering is whether or not it is possible that mania can be induced in atypical depressives who take antidepressants, and if not, whether or not I could be slightly bipolar, even though I have rarely seen in myself the typical symptoms of mania? (My definition of atypical depression is a depression where I am "cheered up" by people or events in my life, perhaps synonymous with dysthymic disorder) Should I continue with the Zoloft and see what happens or should I take a mood stabilizer, then add the antidepressant? From talking with me, my general practitioner, who is prescribing the medication, does not think that I need to see a Psychiatrist, because my depression for the most part is endogenous. He said that even if he did make a referal, I would be on a 3 month waiting list to see someone. Is it imperative that I get a diagnosis from a mental health professional before treatment? I don't think I could handle 3 months without any kind of medication.

Answer:Bipolar disease is often difficult to diagnose. Many people have depression and a certain number of these also have mania. Occasionally, people have hypo-mania which is a minor or "light" form of mania. This is possibly what happened to you. If indeed you are having hyopmania reflection will find other spells of similar symptoms. Since these spells feel positive and get social reward they tend to be forgotten or assumed to be normal. Lithium is usually used in manic-depression to fend off the manic spells. However, in many people it has been found that lithium will also have some effect on the depression. In this circumstance, lithium must be paired with a anti-depressant to achieve maximum effectiveness. I would recommend that you see a psychiatrist-preferably one with an interest in manic-depressive disorders. Most primary care physicians are not comfortable starting lithium-although they are comfortable regulating the dosage and the subsequent necessary blood tests on thyroid function and serum electrolytes.

Zoloft Dosing Levels
Question:I have been prescribed 50 mg. Zoloft per day for the past month. I find it has been very beneficial for my depression which we suspect is due to the 200 mg. per day of the drug Danazol -- which is to hopefully put my endometriosis in remission after a 2nd major surgery. In my early 30's, I was diagnosed with benign essential tremor and put on mild dosages of Propranolol (to calm the shakes), and later, Clonazepam to curb anxiety. I have gone off these medications periodically, only to find they are necessary in my life. I find that the Zoloft has been easily tolerated and has lifted my spirits. Quite a blessing for me (since I would like to continue with the Danazol treatment), and for my supportive husband! The only drawback is that I find myself very nervous and shake so much that I have once again, found myself unable to steady my hand enough to even sign my name! My doctor has put the Propranolol up from 20mg per day to 40mg. But, I still seem to be having the problem. I wonder if cutting the dosage of Zoloft to 25mg will lessen the shakes, but still be enough to keep the depression at bay.

Answer:Tremor isn't a big problem with Zoloft. However, I've never used it in a person with familial tremor. Stopping the Zoloft for a few days would allow you to see if the tremor improves. Then restarting at small doses would allow you to experiment with the smallest dose that would treat your depression and allow you not to shake constantly. In general, 25 mg will not treat very many young people.

Zoloft and Depakote
Question:Since my husband has been on Zoloft and Depakote(together), he has gained about 15 pounds that he does not need! Do you know if he will eventually lose these extra pounds, since weight gain is a side effect of zoloft in some cases. Also, I have an eight year old son with t.s., o.c.d., and a.d.h.d. The psychiatrist is thinking about taking him off luvox and putting him on zoloft. Has zoloft been proven safe for use in children and what are the side effects in children? Any information you can provide is appreciated.

Answer:Although the drug insert with Zoloft cautions against weight loss, in clinical practice, I see many more people who gain weight than lose weight with this and similar SRI drugs. Generally, this will decrease after the zoloft is discontinued-like most weight loss slower than one thinks rational. Data in children concerning using serotonin reuptake inhibitor drugs is minimal.

Zoloft & Alcohol
Question:I am currently taking 100mg of zoloft in the mornings im wonder if it would hurt to have a few beers in the evenings once in a while?

Answer: Zoloft and alcohol are not recommended to be taken together. This is due to their additive ability to impair cognition and the depressant effect of alcohol which tends to negate the effectiveness of an anti-depressant.

Extended Use
Question:I would like to know side effects of extended use of Zoloft.

Answer: Currently, nothing different that the short term use. However, this drug has only been available in the US about 5 years and in Europe about 10 or so. So , long term side effects are just beginning to appear -if there are any.

Withdrawl Symptoms
Question:Two days after I weaned off of 100 mg. Zoloft, I got very nauseated and dizzy day and night. Now, a week and 4 days later, the nausea is infrequent, but the dizziness is still present. I feel dazed and close to fainting most of the time. Is any of this normal, especially after so long? Is it possible that it will subside any time soon?

Answer: Zoloft isn't supposed to do this; but, I keep hearing from patients with similar stories. I have no patients with withdrawal symptoms-I'd guess that it should be over in ten days or so if it is only the Zoloft.

High Dosage
Question:Hello. A relative of mine is currently taking 350 mg. of Zoloft per day. I have read the maximum dosage is 200mg. Her psychiatrist feels that this dosage amount (350 mg.) is O.K. It seems terribly high to me! I am worried about the negative effects of too much Zoloft.

Answer: The upper limit on any drug is only the manufacturer's recommendation. Physicians have the legal right to use a drug in any dosage and for any purpose that they medically see fit. So, although this is a high dosage, the physicians is in their legal boundaries.

Low Serotonin
Question: This email is in regards to the drug Zoloft which I have been taking for the past two years. I have an extremely low serotonin level and have been taking the above mentioned drug (not depression) to help me think more clearly. My dosage started at 25 mg per day and is now prescribed at 200 mg per day. For the past six months, I have been feeling very fatigued and suffering from headaches four or five times a week. I religiously get 8 hours a sleep a night. I'd much rather sleep than study and rarely am able to keep an interest while in the classroom setting. As a college sophomore (20), it doesn't help much at all. In the more technical classes such as Statistics and Accounting, I never feel prepared no matter how much effort I put in. Occasionally, I will have those days when I am feeling good, but only about 1 or 2 days a week. I have spoken with my physician, but he considers them as "normal" effects to the drug. Your input would be greatly appreciated.

Answer: Some patients really have a sleep disorder with the SRI antidepressants. Sometimes, Serzone will be better. Also, some patients find that hypericum(St. John's Wort) will treat the depression without the fatigue.



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