Sertraline (Zoloft) For Depression

Sertraline For Depression

The following article is a summary of current evidence and information about taking Sertraline for depression. Sertraline is most famously known as 'Zoloft', but is currently sold under a variety of generic names. 

Depression, or Major Depressive Disorder, is a common mental health disorder where a person suffers through prolonged periods of lowered mood, decreased energy, and loss of interest in previously engaging activities.

Sertraline is classified as an antidepressant medication and belongs to the group of selective serotonin reuptake inhibitors, or SSRI, for short. As the name of the implies, Sertraline works through the mechanism of blocking reuptake of serotonin in the nerve cell endings, thus increasing serotonin's effect on the brain.

The information in this article is not to be interpreted as individual medical advice. Remember to always consult with your psychiatrist before taking Sertraline for depression.

Evidence

• Sertraline has been studied over multiple decades and there is conclusive evidence that using Sertraline for depression is a well-tolerated and effective way of treating it.

• One extensive systematic review from 2010 compared Sertraline to other antidepressants, and it found evidence favoring treatment with Sertraline for depression in terms of efficiency over Fluoxetine. Compared to the other second generation antidepressants, it was equally effective. Overall, it had less side effects than tricyclic antidepressant, but patients taking Sertraline for depression experienced increased problems with diarrhea and insomnia.

Treatment with Sertraline for Depression

• When taking Sertraline for depression, the dosage is as if the person would take it for anxiety. The dosage in adults starts at 25-50 mg daily and can increase by 50 mg per week up to 200 mg once a day (maximum FDA approved dose) if necessary.

• Studies have shown that the half-life of Sertraline is significantly lower in children than in adults, suggesting that there might be a benefit from children under 12 years taking Sertraline twice a day instead of once.

• It typically takes 14-28 days before Sertraline starts having an effect on the symptoms of depression.

• Treatment with Sertraline for depression usually lasts between 3 to 6 months. In more severe cases, it can be continuous and lifelong.

Side Effects of Sertraline (Zoloft)

• Some common side effects of taking Sertraline for depression include dizziness, nausea, loss of appetite, dry mouth, diarrhea, difficulty sleeping, sweating, as well as sexual dysfunction (difficulties reaching orgasm or ejaculation, decreased sexual desire, and erectile dysfunction).

• Among more rare and severe side effects, Sertraline may cause increased risk of bleeding, weight loss, seizures, and serious allergic reactions.

• In the past years there have been increased research on emotional blunting, which is a side effect frequently leading to the discontinuation of SSRIs, including Sertraline. Currently, research suggests it might be dose related, with higher doses being more likely to induce emotional blunting. It is generally advised to lower the dosage or switch antidepressants if this side effect occurs. 

• Due to increased risk of suicidal thoughts and behaviors in children and adolescents, the FDA issued a black box warning for Sertraline.

Major Contraindications

• If you have moderate-to-severe liver issues.

• If you are allergic to Sertraline or any other selective serotonin reuptake inhibitor.

• In the past 14 days, if you have taken or are currently taking an MAOI medication.

Useful Information

• The most common side effects of Sertraline can be avoided by starting with a low dose and gradually increasing it.

• Keep in mind that mild-to-moderate side effects of Sertraline usually resolve by themselves within the first few weeks of starting medication.

• When stopping treatment with Sertraline for depression, the dose should be gradually lowered to minimize the risk of withdrawal or rebound symptoms.

Author: J. Martin, M.D. 
Last updated: August 10, 2023

Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease seek immediate medical attention.