Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. In 2006 it was the most prescribed antidepressant on the U.S. retail market with 28,060,000 prescriptions.
Side effects
Sertraline can have adverse effects, including: sleep disorder (both insomnia and increased sleep time), asthenia, gastrointestinal complaints, tremors, weight gain, confusion, dizziness, anorgasmia, nausea/vomiting, bruxism, mild depersonalization, and decreased libido. Sertraline, like all of the other SSRI drugs, can increase anxiety and depression symptoms in the first few days/week of use. These side effects generally go away as the body adjusts chemically to the drug. Sertraline can induce mania or hypomania in around 0.5% of patients. It has also been known to cause minor weight loss. It is contraindicated in individuals taking monoamine oxidase inhibitors (MAOIs) or undergoing electroconvulsive therapy. Patients are advised to stop taking MAOIs for at least 14 days before beginning a course of sertraline.
Zoloft has long been seen as the best option for breastfeeding mothers who wish to continue breastfeeding and be able to take their antidepressants. Despite its apparent safety and effectiveness during the breastfeeding period, recent studies and consumer complaints have seen a need to alter Zoloft's labeling regarding use during the third trimester of pregnancy. Though there are no teratogenic effects associated with Zoloft, there is reason to be concerned about its effects on infants who were exposed to sertraline during the third trimester in utero. It seems that Zoloft use in late pregnancy significantly increases the potential need for hospitalization and breathing assistance in the newborn period and has also been shown to cause an increased risk of neonatal death. In light of this increased risk it is still being used due to the greater potential risk of a seriously depressed mother to herself and her fetus. Like all other medications, Zoloft's use must be decided only after carefully weighing out all potential risks and benefits.
Although SSRI anti-depressants may cause problems in newborn babies whose mothers took Zoloft during pregnancy, the ceasing of Zoloft consumption during pregnancy may cause a relapse of depression.
According to the manufacturer's website, "if depression is left untreated, the risk of childhood suicide increases about 12 times, according to federal figures".[22]
Sertraline and other SSRIs have been shown to cause sexual side effects called Post SSRI Sexual Dysfunction in both males and females taking them.[23] Sometimes, these may last months, years, or indefinitely after the drug has been withdrawn.
Suicidality
According to mentalhealth.com, Zoloft is not currently recommended or advised for use in individuals under the age of 18. After these changes, multiple incidences and at least one medical study showed an increased suicide risk in seniors who were taking Zoloft. In response to these findings, the FDA released a public health warning. This warning indicates that anyone currently using Zoloft for any reason has a greater chance of exhibiting suicidal thoughts or behaviors regardless of age. This warning is questionable, however, due to the types of illnesses Zoloft is used to treat, it is impossible to determine if these tendencies are a side effect of the drug or the illness the drug is meant to treat, though some have found links to increased suicide rates especially among individuals with bipolar disorder.
Discontinuation syndrome
Sertraline, along with other SSRIs, has been associated with a "cessation syndrome." This syndrome has both somatic and psychological elements, although SSRIs fall short of being classified as addictive. This non-addictive classification stems from the fact persons given the drug will not seek it out in ever-increasing quantities. Although sertraline is defined as non-habit forming, the existence of SSRI discontinuation syndrome often necessitates a gradual tapering of one's prescribed dose when seeking to stop SSRI therapy. The prescription insert for Zoloft describes the potential side effects SSRI discontinuation as follows:
"During marketing of Zoloft and other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g. paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms."
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