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Zoloft

Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®, Xydep®, Serlain®) is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. more...

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Uses

Sertraline is used medically mainly to treat the symptoms of depression and anxiety. It has also been prescribed for the treatment of obsessive-compulsive disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, panic disorder, and bipolar disorder. It was first approved by the FDA in 1991. The patent for this brand-name drug expired in December 2005.

Side effects

Sertraline can have a number of adverse effects, including insomnia, asthenia, gastrointestinal complaints, tremors, confusion, dizziness, anorgasmia, and decreased libido; it can induce mania or hypomania in around 0.5% of patients. It has also been known to cause minor weight loss. Sertraline also has dopamine reuptake properties at high doses. It is contraindicated in individuals taking MAOIs or undergoing electroconvulsive therapy.

Forms and dosages

Sertraline is manufactured by Pfizer and sold as Zoloft in the United States as small green 25 mg tablets, blue 50 mg tablets, and orange 100 mg tablets (Generic 100mg sertraline tablets are yellow), each of which is scored to allow easy halving. In Australia, only the 50 mg and 100 mg strengths are available, both as white tablets. Sertraline is an odorless, white, sparingly soluble crystalline solid. The minimum effective dose is 50 mg per day, but lower doses may be used in the initial weeks of treatment to acclimate the patient's body, especially the liver, to the drug and to minimize the severity of any side effects. Patients who do not experience relief of symptoms at 50 mg a day may have their dose increased, up to 200 mg a day.

Precautions

Because of its metabolism, liver impairment can affect the elimination of this drug from the body. If someone with liver impairment is treated with sertraline, lower or less frequent dosage should be used. Similarly, patients should limit their alcohol intake while on sertraline (or any antidepressant). Because the liver is doubly taxed with processing both substances (in addition to any other drugs the patient may be taking), alcohol remains in the bloodstream longer, so the effects of alcohol may be more strongly and quickly felt by people taking sertraline or other antidepressants.

Controversy

In June 2003, Britain banned the use of sertraline for children under 18 after studies showed a link to increasing suicidal rates. Similar concern has prevailed in the United States, where only the anti-depressant fluoxetine (another SSRI) is officially endorsed by the FDA for the treatment of depression in minors. However, because the antidepressant-suicide link is correlational, scientists do not know whether the increased suicide risk for people taking antidepressants occurs because the drugs make people suicidal, whether suicide occurs because the drugs un-depress the people enough to motivate the energy required to commit suicide (a popular theory), or because of a third, unknown factor.

Read more at Wikipedia.org

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Fat pharms: weight gain is the dreaded side effect of some psychotropics
From Psychology Today, 5/1/05 by Brenda Goodman

THE STRESS OF working at a turbulent office finally dragged 37-year-old Maggie Little * under. For the second time in her life, she recognized the smothering symptoms of depression--slowness, a bleak outlook and lack of interest in fun. Her doctor prescribed Lexapro, a selective serotonin reuptake inhibitor, or SSRI.

The pill quickly kicked in. It was "a miracle," she says. Six months later, Little still loves Lexapro, but she's desperate to switch to another drug. Like many people using SSRIs, she gained a significant amount of weight--40 pounds.

Weight gain has long been a bane of psychotropic drug treatment. Mood stabilizers such as lithium and clozapine are among the worst offenders, causing up to 50 percent of all long-term users to become obese. Patients on older tricyclic antidepressants can expect a steady gain of one to three pounds per month. But the medical community was caught off guard when patients on newer antidepressants complained the pounds were piling on.

If anything, says Charles Raison, a psychiatrist with Emory University in Atlanta, drugs such as Prozac and Zoloft were believed to cause weight loss. indeed, many antidepressants seem to be associated with an initial small loss, but new studies show that over months, patients not only regain what they lose, but add to it--sometimes dramatically. "It's not always the fault of the drug," says Raison. "Depression can be, all by itself, an incredible diet. When [patients] start to feel better again, their appetite increases."

The metabolic pathway at work is a mystery, although current theories include resistance to the hormones insulin and leptin. One study found that those most vulnerable to antidepressant-induced weight gain are women and patients who were already overweight. On the bright side, gaining some extra padding is usually linked to the drug's efficacy. "A few extra pounds usually means the drug is doing something," says Raison. But he says many of his patients would rather be sad than fat.

Exercise and diet can help, of course. The drug orlistat, or Xenical, which blocks the body's ability to absorb dietary fat, also shows promise. Switching drugs may also provide some relief.

* name has been changed

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