Antidepressant Zoloft - use, reviews, narcotic effect

Pharmacodynamics and pharmacokinetics

The substance sertraline is a powerful antidepressant, with a powerful specific inhibitor of serotonin reuptake in neurons. At the same time, there is a slight effect on the reuptake of dopamine and norepinephrine . Therapeutic dosages of sertraline block the uptake of serotonin within platelets. This drug does not have a stimulating, sedative or anticholinergic effect, and does not increase adrenergic activity. In addition, sertraline does not contribute to drug dependence, weight gain and other undesirable effects.

The drug has a fairly high, but slow absorption. An increase in bioavailability occurs when taken simultaneously with food. Thus, food may increase the maximum concentration but reduce the therapeutic effect. Almost 98% of the active substance is protein bound. Undergoing biotransformation in the liver, sertraline forms the main metabolite - N-desmethylsertraline , which is less active. Excretion from the body occurs in urine and feces.

Properties

The action of an antidepressant is based on its ability to reuptake the hormone serotonin (responsible for a person’s positive emotional mood) at the level of nerve cells; as a result of such accumulation of the mediator, its positive effect becomes longer lasting.

Zoloft is absorbed slowly, but almost completely. Accelerates its adsorption (by about 15%) by eating.

The highest concentration of the drug is found in patients 4-8 hours after taking the tablet. The antidepressant is half eliminated from the body through urine and feces within a few days, and completely after 4-5 days.

Zoloft does not cause habituation (dependence) and weight gain when taken for a long time, and does not have a stimulating or calming effect.

Contraindications for use

The medicine is not prescribed for:

• children under 6 years of age;
• high sensitivity to sertraline;
• simultaneous treatment with MAO inhibitors and pimozide;
• lactation, pregnancy.

Caution is recommended if patients have organic brain diseases, epilepsy , liver or kidney failure, or severe loss of body weight.

Indications and contraindications

It is believed that Zoloft is a good drug, the action of which is aimed at combating bad mood, sadness, phobias, fears and anxiety. Excessive appetite caused by such factors is treated with tablets. The medicine has analgesic and sedative properties to a much lesser extent. Pharmacokinetics in mature and elderly people is practically the same. At the same time, Zoloft does not cause a dopaminergic or adrenergic effect, and therefore is quite freely prescribed to people over sixty.

Zoloft is used to treat symptoms of depression, which is accompanied by feelings of anxiety with or without a history of mania.

Zoloft is usually taken for depression, but there are other indications for use, such as:

• Social phobia;
• Panic disorders;
• Obsessive-compulsive disorders;
• Post-traumatic stress disorders.

Tablets are prescribed for both treatment and prevention of depressive conditions of any nature. However, the product has contraindications. Although the pharmacokinetics of sertraline in adults and children are essentially the same, due to lower body weight it is necessary to change dosages or abandon treatment altogether. For this reason, Zoloft is not prescribed to children under six years of age.

Side effects of Zoloft

During therapy with this drug, side effects may occur that affect the functioning of the digestive system, which are manifested by dyspeptic disorders. For example: flatulence, nausea, vomiting, diarrhea, constipation, abdominal pain, pancreatitis and so on.

Disturbances in the functioning of the cardiovascular, nervous, motor, respiratory, urinary and other systems are also possible.

In addition, deviations in the functioning of the visual organs, the development of various forms of allergic reactions and general undesirable symptoms are possible.

Sometimes, cessation of treatment with sertraline may be accompanied by the development of a withdrawal syndrome, with manifestations of paresthesia, hypoesthesia, depressive symptoms, hallucinations , aggressive reactions, psychomotor agitation, anxiety or psychosis, complicating the ability to make an accurate diagnosis.

History of creation

The drug was developed by the pharmaceutical company Pfizer. Initially, work was carried out on the drug tametralin, which was a catecholamine reuptake inhibitor. Tametraline has not proven to be an effective antidepressant because it has demonstrated the undesirable effects of illicit psychostimulants.

Many years later, research on tametraline resumed, resulting in the creation of sertraline. Sertraline differs from tametraline by the presence of two chlorine atoms in the molecule. However, studies have shown that this substance is a highly selective serotonin reuptake inhibitor. At the time of the research, Pfizer was considering other drugs as an antidepressant for the wider market. However, the scientists working on sertraline, without any motivation, persistently proposed their invention. As a result of these actions, sertraline was sold under the trade names Zoloft and Lustral and for some time was the most prescribed drug for depression in the United States.

Zoloft tablets, instructions for use (Method and dosage)

According to the instructions for use of Zoloft, the tablets should be taken daily, one piece, in the morning or evening.

In this case, the initial dosage depends on the type of disorder, for example, for depression, a daily dose of 50 mg is immediately prescribed. Panic disorders and social phobia suggest initial therapy of 25 mg per day. This approach helps prevent the development of early side effects characteristic of panic disorders.

In the future, it is possible to increase the therapeutic dose, but not more than once a week. In this case, the maximum daily dosage should not exceed 200 mg. The manifestation of the therapeutic effect can be expected after 7 days, but usually the full therapeutic effect is achieved after 2-4 weeks.

When carrying out long-term treatment, a minimally effective maintenance dose is prescribed, which is adjusted depending on the therapeutic effect.

Compound

The active ingredient of this medicine is sertraline hydrochloride, in an amount of 50-100 mg.
(depending on the release form). Additional components for long-term storage, formation of the desired tablet shape and enhancing the effect of the drug are calcium (phosphate), cellulose (microcrystalline and hydroxypropyl), polyethylene glycol, starch, magnesium stearate, polysorbates, titanium dioxide.

The active ingredient in Zoloft is sertraline hydrochloride. Each tablet of the drug may contain 50 mg or 100 mg of the active ingredient.

Auxiliary elements:

• titanium dioxide;
• microcrystalline cellulose;
• polyethylene glycol;
• calcium phosphate;
• polysorbates;
• sodium starch glycolate;
• hydroxypropyl methylcellulose;
• hydroxypropylcellulose;
• magnesium stearate.

Use in pediatrics

This drug is often used to treat children aged 6-17 years who suffer from obsessive-compulsive disorder.

In this case, adolescents 13–17 years old are prescribed a daily dosage of 50 mg at the beginning of treatment. Children 6–12 years old are recommended to take 25 mg daily during the first week, then it is increased to 50 mg. After this, taking into account the therapeutic effectiveness and characteristics of the patients, the dose is adjusted upward or downward. To prevent an overdose, increasing the dose from 50 mg, it should be remembered that children have less weight than adult patients.

Content

• 1 History of creation
• 2 Pharmacological action
• 3 Pharmacokinetic properties
• 4 Indications for use
• 5 Method of administration and dosage
• 6 Contraindications
• 7 Treatment of obsessive-compulsive disorder with sertraline
• 8 Side effects
• 9 Overdose
• 10 Special instructions
• 11 Interaction with other drugs
• 12 Generics and original sertraline preparations
• 13 Research
• 14 Notes

Overdose

While taking Zoloft in high doses, the development of severe symptoms was not noted. But if treatment with other drugs is carried out simultaneously, the following may develop: nausea, vomiting, tachycardia, agitation, drowsiness, dizziness, psychomotor agitation, increased sweating, diarrhea, myoclonus and hyperreflexia .

In such cases, symptomatic therapy is required, with careful monitoring of important body functions, especially respiratory.

special instructions

Zoloft should not be taken together with monoamine oxidase inhibitors, or 2 weeks after their discontinuation. The same applies to the use of monoamine oxidase inhibitors after Zoloft withdrawal.

During the use of the drug, serotonin syndrome may develop.

Particular care must be taken when transferring patients from other anti-obsessive and antidepressant drugs to Zoloft due to the lack of clinical studies.

Patients with epilepsy taking this drug should be closely monitored. If seizures occur, the drug should be discontinued immediately.

Patients suffering from depression should also be kept under control, as this category of patients is prone to frequent suicide attempts. The risk persists until remission of the pathology.

The simultaneous use of Zoloft in combination with other drugs may cause impairment of psychomotor functions. Therefore, during the course of treatment it is not recommended to engage in potentially hazardous activities and drive vehicles.

Interaction

The simultaneous use of this drug with pimozide can significantly increase its concentration in the body, and since pimozide has a narrow therapeutic index, their combined use is not recommended.

Combination with MAO inhibitors can lead to the development of serotonin syndrome with hyperthermia, rigidity, myoclonus , lability of the autonomic nervous system, and so on. Such symptoms can occur with serious complications and be a threat to the health and life of patients.

Combinations with cimetidine significantly reduce the clearance of sertraline.

Tricyclic antidepressants or antiarrhythmic drugs , for example, Propafenone and flecainide , can lead to a mutual increase in the concentration of these substances in the body.

Taking medications containing lithium may increase the occurrence of tremors and other nervous system disorders, so extreme caution must be exercised.

Tryptophan, fenfluramine and antipyrine should not be taken sertraline , as this can cause liver problems and nervous system disorders.

With long-term use of phenytoin and sertraline in dosages up to 200 mg, clinically significant adverse symptoms usually do not occur. However, it is necessary to carefully monitor the dosage and level of phenytoin in the blood plasma with each dose adjustment of these drugs.

Combined treatment with sumatriptan and sertraline can lead to the development of weakness, increased tendon reflexes, impaired consciousness, anxiety and agitation. Therefore, it is necessary to carefully monitor the condition of patients who have clinical grounds for taking these substances together.

Dosage form

These are oval (oblong) tablets, on which there are inscriptions about the company that patented this antidepressant and about the dosage of sertraline in the pill.

Thus, Zoloft has “Pfizer” engraved on one side and “ZLT-50” or “ZLT-100” on the other.

The tablets are white in color and have a dividing line; they are packaged in one or two blisters (containing 14 or 28 pieces) in a cardboard package.

The drug Zoloft is available in the form of oblong white oval-shaped tablets, film-coated. Each tablet is embossed with the "PFIZER" logo on one side and the dosage indications "ZLT|50" and "ZLT|100" on the other. The tablets are packaged in blisters made of opaque polypropylene and aluminum foil, 14 units each. Each cardboard box contains 1 or 2 blisters.

When Zoloft is combined with monoamine oxidase inhibitors, severe complications may occur (for example, confusion, pyrexia, irritability, mental status changes, rigidity, agitation, coma).

The simultaneous use of Zoloft with pimozide stimulates an increase in the concentration of the latter when used once in a dosage of 2 mg, which is extremely undesirable.

It is not recommended to use sertraline with medications and drinks containing ethyl alcohol.

Parallel use of Zoloft with warfarin increases prothrombin time.

Zoloft analogs

Level 4 ATC code matches:
Actaparoxetine

Plizil

Fluxen

Paroxin

Surlift

Asentra

Elycea

Fluoxetine

Lenuksin

Escitalopram

Adepress

Selectra

Stimuloton

Citalopram

Cipramil

Paroxetine

Prozac

Paxil

Rexetine

Fevarin

The main analogues of this drug: Serenata, Solotik, Asentra, Aleval, Sertralux, Sertraloft, Stimuloton, Deprefault, Depraline, Seralin, Sertraline hydrochloride, Zalox, Torin, A-depresin, Adyuvin, Sertraline, Serlift and so on.

Adequacy of Zoloft prescription by doctors

Rough, but quite accurate about the adequacy of the drug prescription

Sometimes it happens that a person does not need an antidepressant, but it helps.

I took sertraline under the trade name Torin. 14 days and no visible effect. I know that antidepressants do not work immediately, but apparently nothing helps me except fluoxetine (the results of which I feel on the first day of taking it).

I tried many ADs. Yes, by the way, my libido was absent from sertraline as such compared to fluoxetine. It even appeared from the latter (apparently as a consequence of weakening symptoms of depression).

Antidepressants do not help a person! And what helps is a “side effect” of one of them, Fluoxetine! I won’t go into detail, but this is a fact.

In total, a completely different drug or combination of drugs will help him much better, faster and more reliably!

A few life examples

Firstly, I want to write about decreased libido. I don’t know how this happens in men, but I have hyperexcitability. I think that soon my husband will ask me to go somewhere, for a while, or he will leave himself)))) I’m joking, of course, but I haven’t noticed any decrease in libido, quite the contrary.

But I’ll write about Sertraline. For a long, long time I could not return to a normal state, and this is not 4-6 weeks as they say in the instructions. For me this period was almost 3 months.

They increased the dose to 200 mg and my psychotherapist said if it didn’t help, then further increase was pointless, but in the third month a miracle happened and I began to slowly return to normal and I even began to shake from the overabundance of the drug. Gradually they began to reduce the dose and now it is 100 mg.

I feel very good. I would also like to say that I was taking Phenazepam at the same time, but my doctor said that this is not a cure and we need to get rid of it. This scared me very much, because... Phenazepam was my lifesaver, but I managed (of course, thanks to the psychotherapist).

In fact (probably) the person was “addicted” to Phenazepam, and some of the symptoms were explained by this. That is, it’s not that Phenazepam is not suitable for her or that it is “not a medicine”! But simply combinations of drugs are also necessary, with one replacing another. In accordance with the dynamics and changes in state.

I also had a terrible headache from taking Zoloft, and the doctor prescribed Mexidol, I took it for 1.5 months and forgot about the headache. I hope for a long time.

She also completed a course of electrophoresis (15 procedures). I want to say right away that this is quite expensive, but compared to my current state it is nothing at all. If you haven’t read my previous messages, then I repeat that my depression, in addition to the standard symptoms of malaise, was accompanied by wild pain, I would even compare it to the withdrawal symptoms of a drug addict who was not given a dose.

I don’t know what kept me in this world, in such a state you don’t think about your children, or your husband, or anyone at all, you only feel pain. I thought that giving birth would be painful, but it turns out there are worse things.

And here I will draw the attention of interested parties to the series about “the influence of the neck on the head.” Knowing the cause makes it easier to fight and more realistically defeat this disease.

Okay, who am I telling all this to, you probably know about these sensations as well as I do. And I also want to advise you to find your doctor. Before that, I was treated by a psychiatrist with Ludiomil, the result was short-term, and I was in a state of depression almost the entire time I took it for 6 months, and in the end she admitted that I needed to look for another doctor, because... She didn’t deal with my symptoms.

So keep at it and everything will be fine. And further. Be sure to do sports, I think it also helped me (jogging in the morning, swimming pool, gym (in my case yoga) at first you won’t get a buzz, but believe me, time will pass (in my case it’s 7 months) and you will dissolve in sports and at the same time do not feel tired, but only a surge of strength.

Now I visit a psychotherapist once every 2 weeks, he began to, in his words, “Let me go into the world.” Previously it was 3 times a week, but gradually we reached this result.

Get comprehensive treatment, and when you feel better, try to be around people more. I used to have panic attacks in stores and on public transport, but now I enjoy it.

And also, when you feel better and you don’t suffer from depression for months, keep yourself busy with something. In my case, it’s my studies, I passed the last session with flying colors (on my own), and the teachers praised me, although they say that when taking antidepressants, memory deteriorates, you just need to train it.

If you have children, try to teach them the rhymes that are given in kindergartens. I wrote a lot, I apologize, but I wanted to convey to you some of what helped me personally in treating depression.

And this is also true. Without hypochondria, without getting lost in illness - get lost in life and find yourself!

I would like to draw your attention to the gradual “letting go into the world” - I also recommend this, including to former gays, transsexuals, former pedophiles and other people who seem to have gotten rid of their peculiarity, but still need “guidance” until they fully adapt to the world , in real life.

The fact is that I usually do not “forbid” the original paraphilic feature; it is supplanted by heteroattraction and love. However, in case of stress, depression, and finally, there may be setbacks in dreams, in the emergence of previous images. They can be “suppressed”, but I usually strive for maximum environmental friendliness in my work.

Therefore, the faster we remove stress or depression, which can be in the life of any person, the faster and more reliably we will prevent this “rollback”.

Reviews about Zoloft

As a rule, reviews of Zoloft on forums and websites report that this drug is prescribed to patients suffering from various forms of depression, phobias and other disorders of the nervous system.

In most cases, people note the fairly high effectiveness of this drug, but the improvement comes somewhat slowly. However, as a result of taking Zoloft, sleep and psychological state are normalized.

In addition, side effects such as severe drowsiness or insomnia may occur during treatment with this drug. There are also stories about the development of diseases affecting the functioning of the kidneys and liver.

According to experts, Zoloft is one of the highly effective drugs that improve the condition of the nervous system. However, during the treatment period it is necessary to strictly control the dosage, make timely adjustments and remember the risk of developing unwanted drug interactions with other drugs. Therefore, only a specialist can prescribe and observe treatment.

Zoloft during pregnancy and breastfeeding

There are no controlled results of using sertraline in pregnant women, so Zoloft can be prescribed during pregnancy only if the expected benefit to the mother outweighs the potential risk to the fetus. Women of reproductive age should use effective contraception during treatment with sertraline. Sertraline is found in breast milk, and therefore the use of Zoloft during lactation is not recommended. There is no reliable data on the safety of its use in this case. If the drug is necessary, breastfeeding should be stopped. When sertraline is used during pregnancy and breastfeeding, some infants whose mothers took antidepressants from the group of selective serotonin reuptake inhibitors, including serotonin, may experience symptoms similar to a reaction to drug withdrawal.

Zoloft price, where to buy

Prices for Zoloft 100 mg, film-coated tablets, for 28 pieces in a pack vary between 1100-1350 rubles.

You can buy Zoloft 50 mg, film-coated tablets, for 14 pieces in a pack for 520-550 rubles.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine

ZdravCity

• Zoloft tab.
  p.p.o. 50 mg n28Haupt Pharma Latina RUB 854 order
• Zoloft tab. p.p.o. 100 mg n28Haupt Pharma Latina

  RUB 1,119 order

• Zoloft tab. p.p.o. 50mg n14Haupt Pharma Latina

  465 rub. order

Pharmacy Dialogue

• Zoloft tablets 100 mg No. 28)Haupt Pharma Latina SrL

  RUB 1,228 order

• Zoloft tablets 50mg No. 14Pfizer

  460 rub. order

• Zoloft tablets 50 mg No. 28)Haupt Pharma Latina SrL

  903 rub. order

show more

Pharmacy24

• Zoloft 50 mg N28 tablets Haupt Pharma Latina S.r.l., Italy
  459 UAH.order

Compatibility with other drugs and overdose

You cannot buy Zoloft without a prescription; taking the medication requires compliance with dosages. If you consume the standard 50 mg per day, you should not be too afraid of negative reactions. However, if Zoloft is taken in large quantities, an overdose may occur. This usually happens when taking several similar drugs at the same time. Patients have encountered:

• Diarrhea,
• agitation,
• Tachycardia,
• Dizziness,
• Drowsiness,
• Increased sweating
• Myoclonus,
• Psychomotor agitation,
• Hyperreflexia,
• Nausea and vomiting.

In case of overdose, symptomatic treatment is carried out, during which doctors must carefully monitor respiratory function. In order not to interfere with the process of purifying the blood from the drug, it cannot be combined with cimetidine. An increased concentration of components can be observed when Zoloft is consumed simultaneously with antiarrhythmic drugs.

Zoloft® is a prescription drug and requires taking the medication in the dosage prescribed by your doctor.

Combination with lithium-containing drugs leads to tremor and various disorders of the nervous system. Zoloft is incompatible with tryptophan, antipyrine and fenfluramine. It is important to use caution when consuming sertraline and phenytoin concomitantly. You should avoid combining the drug with sumatriptan. Zoloft and alcohol are also incompatible. Drinking alcohol can lead to poisoning, coma and even death.