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©2006-2012
Deborah Wiig
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Many people living with depression or certain anxiety disorders find Zoloft® ® (Sertraline) and its generic to be an effective treatment with relatively few side effects. Sertraline is an SSRI antidepressants with most of the pros and cons of other medications in that class.

Sertraline tablets are used as a treatment for major depressive disorder (MDD) in adults and the liquid concentrate is used to treat MDD and some anxiety related disorders, including panic attacks, posttraumatic stress disorder, social anxiety disorder and obsessive-compulsive disorder. It is also used to relieve the symptoms of premenstrual dysphoric disorder.

First approved in 1991, Zoloft® has been the top-selling antidepressant in the U.S. Its patent expired in 2006 and in June, the FDA approved the first generic versions. Generic sertraline tablets are made by Ivax Pharmaceuticals and sertraline hydrochloride oral concentrate is made by Roxane Laboratories.

How does it work?
Sertraline works by increasing the amounts of serotonin, a natural substance in the brain that helps maintain mental balance.

How is it taken?
Sertraline comes as a tablet and a liquid concentrate to take by mouth. It is usually taken once daily in the morning or evening, but follow your doctor's instructions. Sertraline may be taken with or without food on a full or empty stomach. The concentrate should be mixed with 4 ounces of water, ginger ale, lemon-lime soda, lemonade or orange juice. Take it right away after mixing. Your doctor may start you on a low dose of sertraline and gradually increase your dose, not more than once a week.

Do not stop taking this medicine without first checking with your doctor. Your doctor will gradually reduce the amount you are taking to decrease the chance of having discontinuation symptoms.

How fast does it work?
You may have to take sertraline for 4 weeks or longer before you begin to feel better. Your doctor should regularly check your progress during this time. If you are taking this medicine for depression, you may need to keep taking it for 6 months or longer to help prevent the return of the depression.

What are its side effects?
Like most psychiatric medications, sertraline may cause side effects.

Side effects that may be temporary:
These side effects may go away as your body adjusts to the medicine and usually do not need medical attention. But, tell your doctor if any of these continue or become a problem:
More common:
Acid or sour stomach; belching; decreased appetite or weight loss; diarrhea or loose stools; dizziness; drowsiness; dryness of mouth; headache; heartburn; increased sweating; nausea; sleepiness or unusual drowsiness; stomach or abdominal cramps, gas, or pain; trembling or shaking; trouble in sleeping
Less common:
Agitation, anxiety, or nervousness; bladder pain; burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings; changes in vision, including blurred vision; cloudy urine; constipation; difficult, burning, or painful urination; flushing or redness of skin, with feeling of warmth or heat; frequent urge to urinate; increased appetite; pain or tenderness around eyes and cheekbones; sore throat; stuffy or runny nose; vomiting

Side effects that may need medical attention
More common
Decreased sexual desire or ability; abnormal ejaculation or difficulty reaching orgasm.
Less common or rare
Tell your doctor immediately if you experience any of these effects.
Abnormal bleeding; aggressive reaction; breast tenderness or enlargement; fast, pounding, irregular, or slow heartbeat; fast talking and excited feelings or actions that are out of control; fever; hallucinations; inability to sit still; loss of bladder control; symptoms of low blood sodium (confusion, convulsions [seizures], drowsiness, dryness of mouth, increased thirst, lack of energy); muscle spasm or jerking of all extremities; nose bleeds; restlessness; symptoms of serotonin syndrome (diarrhea, fever, increased sweating, mood or behavior changes, overactive reflexes, racing heartbeat, restlessness, shivering or shaking); skin rash, hives, spots or itching; sudden loss of consciousness; unusual or sudden body or facial movements or postures.

Like all antidepressants, Zoloft® could trigger a manic episode. Let the doctor know if you've ever had this problem.

Always tell your doctor immediately if you are having suicidal thoughts or your depression is getting worse.

Where can I find more information?
Complete FDA Patient Information
Complete Zoloft® label information
Pfizer, Inc., maker of Zoloft®

Sources
FDA
Drugs.com
MedlinePlus

Page updated March 1, 2010