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ZOLOFT

ZOLOFT
Zoloft

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.

WARNING: Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of Zoloft or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Zoloft is not approved for use in pediatric patients.

(See WARNINGS: Clinical Worsening and Suicide Risk, PRECAUTIONS: Information for Patients, and PRECAUTIONS: Pediatric Use.)

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 with a protocol that includes hydration, vitamins and supplements for biological balancing. Call us to talk to a Detox Advisor.
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