ZOLOFT

	ZOLOFT Description / Definitions Abuse Addiction / Dependence Side Effects Withdrawal Symptoms Treatment

DESCRIPTION / DEFINITIONS: Zoloft® (sertraline hydrochloride) is a selective serotonin reuptake inhibitor.

ABUSE: Zoloft is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE: Half life and metabolism, Black Box Warning.

SIDE EFFECTS: High blood pressure, suicide, dizziness (see list below).

WITHDRAWAL SYMPTOMS: Nausea, insomnia, electric shock like sensations (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Zoloft® (sertraline hydrochloride) is a selective serotonin reuptake inhibitor (“SSRI”). Although there are no medical tests to determine if a person has insufficient serotonin, SSRI drugs like Zoloft increase the amount of serotonin in the brain. According to its label, "The mechanism of action of sertraline is presumed to be linked to its inhibition of CNS neuronal uptake of serotonin (5HT)."

ABUSE

Zoloft is a drug prescribed for the treatment of depression.

ADDICTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Zoloft is 26 hours.

Zoloft is mainly metabolized through the P450 pathway in the liver, and the enzymes primarily handling the metabolism are CYP2D6, CYP2C9, CYP2B6, CYP2C19 and CYP3A4.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

BLACK BOX WARNING

The Food and Drug Administration (FDA) has decided that some drugs pose very serious risks and have required that these drugs have what is called a black box warning. Zoloft has a black box warning. Here is the warning.

SIDE EFFECTS

The following information is taken from the Zoloft label:

abdominal pain abnormal accommodation abnormal coordination abnormal dreams abnormal gait abnormal hepatic function abnormal lacrimation acne acute female mastitis aggravated depression aggravated hypertension aggressive reaction agitation allergic reaction allergy alopecia amenorrhea amnesia anemia anorexia anterior chamber eye hemorrhage anxiety apathy aphthous stomatitis apnea appetite increased arthralgia arthrosis asthenia ataxia atrophic vaginitis back pain balanoposthitis bradypnea breast enlargement bronchitis bronchospasm bullous eruption cerebrovascular disorder chest pain choreoathetosis cold clammy skin colitis coma confusion conjunctivitis constipation contact dermatitis coughing cystitis delusions dependent edema depression dermatitis diarrhea/loose stools diplopia diverticulitis dizziness dry skin dyskinesia dysmenorrhea dyspepsia dysphagia dysphonia dyspnea dystonia dysuria earache eczema edema

ejaculation failure emotional lability epistaxis eructation erythematous rash esophagitis euphoria exophthalmos eye pain face edema fatigue fecal incontinence female breast pain fever flushing follicular rash gastritis gastroenteritis generalized edema glaucoma glossitis gum hyperplasia gynecomastia hallucination hematuria hemoptysis hemorrhagic peptic ulcer hiccup hot flushes hyperacusis hyperesthesia hyperkinesia hypertension hypertonia hypertrichosis hyperventilation hypoesthesia hypoglycemia hypoglycemia reaction hypokinesia hypomania hyporeflexia hypotension hypotonia hypoventilation illusion impotence increase the risk of bleeding events increased saliva insomnia intermenstrual bleeding labyrinthine disorder laryngismus laryngitis leg cramps leukorrhea libido decreased libido increased maculopapular rash malaise mania melena menorrhagia menstrual disorder micturition frequency migraine mouth dry muscle cramps muscle weakness myalgia

mydriasis myocardial infarction nausea nocturia nystagmus oliguria other female sexual dysfunction other male sexual dysfunction pain pallor palpitations paranoid reaction paresthesia paroniria periorbital edema peripheral edema peripheral ischemia photophobia photosensitivity reaction polyuria postural dizziness postural hypotension priapism proctitis pruritus ptosis pustular rash pyelonephritis rash rectum hemorrhage renal pain rhinitis rigors scotoma sinusitis skin discoloration somnambulism somnolence stomatitis strangury stridor suicide ideation sweating increased syncope tachycardia teeth-grinding tenesmus thirst tinnitus tongue edema tongue ulceration tooth caries aggravated tremor twitching ulcerative stomatitis upper respiratory tract infection urinary incontinence urinary retention urticaria vaginal hemorrhage vasodilation vertigo vision abnormal visual field defect vomiting weight increase weight loss withdrawal syndrome xerophthalmia yawning

WITHDRAWAL SYMPTOMS

Zoloft can be a very difficult drug to stop taking:

agitation confusion depression diarrhea dizziness dreams, including vivid dreams drowsiness electric shock-like sensations

fatigue/malaise feelings of being hot or cold feelings of unreality flatulence flu-like feelings headache insomnia irritability

mood swings muscle spasms nausea other strange tingling or painful sensations sweating tremor

TREATMENT

Withdrawal from Zoloft should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility. At an inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements, most patients can safely stop taking Zoloft in about seven days. Patients can withdraw from Zoloft on an outpatient basis but it will normally take at least four weeks.