Zoloft sertraline hydrochloride
Zoloft is an antidepressant used to treat psychological disorders. However, the drug carries significant risk, especially to pregnant mothers.
What is Zoloft?
Zoloft (also known by its generic name, sertraline hydrochloride) is an antidepressant approved by the U.S. Food and Drug Administration (FDA) and is used to treat a number of psychiatric conditions, including depression. Its manufacturer is Pfizer, which claims that the drug has fewer side effects than other SSRIs. In recent years, there has been controversy around the drug, linking its use in pregnant women to birth defects, autism, and ADHD. It has been thought to cause suicidal thoughts and withdrawal symptoms in some of its users. As such, it has been issued with an FDA black box warning for suicidal thoughts.
Approved by the FDA in 1990, Zoloft is part of a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. Zoloft is approved by the FDA to treat the following conditions in adults: major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). It is also approved to treat children aged 6 to 17 years old who suffer with OCD.
MDD occurs when a person experiences several of the following symptoms concurrently over a period of two weeks: low or depressed mood, decreased interest in activities, changes in appetite and sleep, low energy, feeling worthless, guilty, or hopeless, difficulty concentrating, and suicidal thoughts.
PTSD occurs when a person experiences a traumatic event, such as a physical assault, while involved in combat. The person later experiences flashbacks and nightmares. They can feel agitated and on edge, avoiding situations that may remind them of the traumatic event.
PMDD occurs when a woman experiences symptoms associated with her menstrual cycle. These differ from premenstrual syndrome; PMDD features are more extreme in both mood swings and its impact on day-to-day life. PMDD can also include irritability, mood changes, bloating, and breast tenderness.
OCD occurs when a person experiences unwanted, recurrent, obsessive, and compulsive thoughts that lead to repetitive and ritualistic behaviors.
Zoloft is taken orally in both tablet and oral solution form. The dosage varies from 25mg to 200mg and is determined by a physician.
How does Zoloft work?
Zoloft is categorized as an SSRI. These drugs work to inhibit depression by controlling the production and restoring the balance of the neurotransmitter serotonin, a chemical responsible for mood, sleep, appetite, anxiety, fear, and general sense of well-being.
SIDE EFFECTS of Zoloft
Like any other medication, patients may experience side effects when initially starting a new drug. Most are thought to subside over a few weeks of treatment. However, some are very serious. The biggest concerns with Zoloft are an increase in suicidal thoughts and a risk of birth defects.
It is advised that weight and height should be monitored in children while they are taking this medication because it may cause weight change and a slowed growth rate.
As with other SSRIs, when patients stop taking the medication, they may experience discontinuation syndrome. This causes a number of unpleasant symptoms, including dizziness, lightheadedness, vertigo, electric shock-like sensations, visual disturbances, headache, nausea, vomiting, diarrhea, insomnia, flu-like symptoms, agitation, irritability, low mood, tearfulness, and lethargy. To limit withdrawal-type symptoms, doctors are advised to slowly reduce the dosage of SSRIs before the patient stops the medication completely.
Common Side Effects
- Nausea and indigestion
- Dry mouth
- Loss of appetite
- Change in sleeping habits
- Sexual dysfunction
- Aggressive reaction
- Nose bleeds
- Urinary incontinence
Serious Side Effects
- Possible slowed growth rate in children
- Weight change
- Suicidal thoughts
- Discontinuation syndrome/withdrawal
- Pregnancy complications
- Birth defects
Who is at Risk?
Anyone taking Zoloft may experience side effects. However, certain groups are especially at risk, including children and pregnant women.
There have been linked complications in pregnant women, resulting in birth defects. It is therefore highly advisable that any woman who is, or potentially could become pregnant, exercise extreme caution when taking Zoloft.
There is also evidence that shows Zoloft can slow down the growth process in children, as well as causing a number of other mental and physical effects. The growth rates of children on this medication should be closely monitored for this reason.
Evidence of Zoloft Complications
A number of studies have associated SSRIs with increased risks in pregnant women taking the medication. These studies have linked the medication to babies being born with autism, attention deficit hyperactivity disorder (ADHD), heart defects, increased rates of hospitalization, premature birth, low birth weight, birth defects, lung problems, and withdrawal symptoms. The New York Times reported on a study conducted at John Hopkins University that said boys with autism were three times more likely to have been exposed to SSRIs before birth. Harvard reported that there was a link between prenatal exposure to SSRIs and a nearly doubled risk of ADHD.
Zoloft can also cause a life-threatening condition serotonin syndrome when used with other medications. Its symptoms include hallucinations, agitation, nausea or vomiting, diarrhea, rapid heartbeat, and loss of coordination.
Drug Reactions with Zoloft
There are a number of medications that should not be taken with Zoloft. People taking monoamine oxidase inhibitors (MAOIs), nonsteroidal anti-inflammatory drugs (NSAIDs), blood thinners (such as warfarin), the mood stabilizer lithium, the antibiotic linezolid, any other sertraline-containing medication, antabuse (if taking the liquid form of Zoloft) or the antipsychotic medicine pimozide (Orap) are advised against taking this medication.
Last Edited: February 23, 2018
- Pfizer. Zoloft (Sertraline HCI) About Zoloft. https://www.zoloft.com/about-zoloft
- WebMD. Zoloft. https://www.webmd.com/drugs/2/drug-35-8095/zoloft-oral/sertraline-oral/details
- Mayo Clinic. (2016). Selective serotonin reuptake inhibitors (SSRIs). June 2016. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
- Guzman, F. (2017). Psychopharmacology Institute. September 2017. https://psychopharmacologyinstitute.com/antidepressants/antidepressant-discontinuation-syndrome-diagnosis-prevention-management/
- Rabin, R. (2014). New York Times Well Blog. September 2014. https://well.blogs.nytimes.com/2014/09/01/possible-risks-of-s-s-r-i-antidepressants-to-newborns/?_r=0
- Zoloft Fact Sheet. National Alliance of Mental Illness. http://www.namihelps.org/assets/PDFs/fact-sheets/Medications/Zoloft.pdf
- Alwan, S. (2009). CDC Safety of selective serotonin reuptake inhibitors in pregnancy. https://www.ncbi.nlm.nih.gov/pubmed/19480468