Zoloft |
34) 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.
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.
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. One
property of sertraline is that it appears to be also a minor inhibitor of
dopamine reuptake. It is contraindicated in individuals taking MAOIs or
undergoing electroconvulsive therapy.
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.
The recommended limit for alcoholic beverages for people on sertraline is two
per day.
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.
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