pharmachologic effect
Antidepressant, a powerful specific inhibitor of serotonin (5-HT) reuptake in neurons.
It has a very weak effect on the reuptake of norepinephrine and dopamine. In therapeutic doses, it blocks the uptake of serotonin in human platelets. Does not have a stimulating, sedative or anticholinergic effect. Due to the selective inhibition of 5-HT uptake, sertraline does not enhance adrenergic activity. Sertraline has no affinity for muscarinic cholinergic receptors, serotonin, dopamine, histamine, GABA, benzodiazepine and adrenergic receptors. Sertraline does not cause drug dependence and does not cause weight gain with long-term use.
Pfizer antidepressant Zoloft - reviews
Lydia
I have never written reviews about pills, but I will write about these. A psychiatrist prescribed it to me, since my problem was panic attacks. At 14:00 I took half a tablet of Zoloft, after 1.5 hours I was in a cheerful and energetic state, although before that I really wanted to sleep, then I lost sleep, I was in a great mood, I was laughing, I wanted something then I felt like I was on drugs. Then it got worse, I noticed that my pupils were very dilated, it seemed to me that my appearance was changing, I was becoming some kind of freak, and then when I wanted to call the doctor and ask if it was normal that my pupils were dilated, and then a strange feeling flew through me a thought in my head, my heartbeat quickens, it seems to me that my body is going numb, my hands are getting cold, I became very scared, I have never been so scared, and if I had panic attacks, it wasn’t in this form, I started calling an ambulance and running around the apartment, I wanted to run out of the house or just out the window from this state, I wanted to call a taxi and go to the hospital myself, I didn’t know what to do, in this state I usually cry, but I couldn’t even cry, but I really wanted to... We arrived doctors, the man told me that everything was coming from my head, that I needed to change my thoughts, etc., but I didn’t listen to him, it seemed to me that I had heart problems because of the drug, it seemed like a heart attack, stroke.. He talked to me for a long time that I just needed a distraction, then he told me to pour Corvalol, after Corvalol I felt better, and then I went to bed. This hellish state began for me at 12 o’clock at night, the doctor said that it couldn’t be the pills, since they were eliminated after 12 hours, I became scared again and it seemed to me that I was dying from some kind of disease.. The next day. I didn’t take these pills, I felt scared, I woke up and everything was fine, but at 15:00 my arms and legs began to go numb again, it seemed as if everything inside my body was also going numb, and that I was about to fall into a coma. even now, when I write about this, fear arises in me... I also want to say that there is a dry mouth, I want to drink a lot. Sometimes my head goes numb, and it seems to me that I have problems with my head, that I have cancer. It's very scary. I never wanted my previous less severe panic attacks to return and I returned to a normal lifestyle... I understand that you can heal yourself without pills, but it is very, very difficult. Now that I am writing this, I want to say that we can get out of depression on our own, we can also get away from panic attacks without pills, but there would be a desire, and a change in consciousness to something else..
Eugene
During the treatment of cervical osteochondrosis, sleep was disturbed (falling asleep was good but sleep was short, only 4 hours). The neurologist prescribed Zoloft, 1 tab a day. I was prepared for side effects, but not these. 16 days of taking Zoloft minus 7 kg of weight (weighed 77 kg). Sleep disappeared completely, although I covered it up with atarax ( at the beginning 1t was enough, but by the 16th day I stopped sleeping at all, atarax didn’t help even 2t) the sausage specifically. Now I’m in a neurology hospital to improve my sleep. Zoloft is a very dangerous thing.
19Aliona
https://irecommend.ru/content/individualnaya-neperenosimost-7
I started taking the drug as prescribed by the doctor. Depression and panic attacks, Dosage 0.25 in the first 7 days, then increase the dose to 0.50 in the next 30 days. After taking the second pill, terrifying side effects appeared. Tremor of the limbs, eyelids began to twitch, chills, sweating, nausea. Panic attacks reached their climax (such terrible ones had never happened before), obsessive ideas and thoughts appeared in my head. My head felt like I was in a fog, pressure on my temples. It was impossible to sit in one place, I just wanted to run out of the house and run wherever I could. In general, all the declared help turned out to be complete hell. I had to take Xanax at a dosage of 0.50 to somehow come to my senses. I read that often both drugs are prescribed in combination to avoid side effects of the drug. However, is it worth putting such a load on the liver and the entire body as a whole? It's up to everyone to decide. Perhaps for some, the drug turned out to be a real solution to the problem. One thing I can safely say is that the drug has a very individual tolerance. I recommend taking it under the supervision of a doctor and in strict proportions.
Mne_nik_ne_nuzhen
https://irecommend.ru/content/reshaite-sami-prinimat-ili-net
This drug is the latest generation antidepressant.
Antidepressant, SSRI (selective serotonin reuptake inhibitor) Active ingredient: sertraline
Show quote
Used for depression, panic attacks, phobias, obsessive-compulsive, anxiety disorders.
Based on my application experience, I can say the following:
1. After taking the first dose (25 or 50 mg, depending on the doctor’s recommendations), after a few hours euphoria sets in, it becomes fun, and the mind becomes foggy. This continues for several days. Then you don’t feel anything like that anymore when you take it consistently every day. If you stop taking the drug and then resume it again, the same sensations will arise.
2. Coping with anxiety, it’s not possible to cry at all. Aggression also disappears, but not completely. Still, something can piss you off.
3. Libido is almost zero. Getting an orgasm is very difficult, and it is not pronounced.
4. It does not remove suicidal thoughts, if any. They just become, how can I put it, calm. It’s like “I don’t see the meaning of life, but I don’t want to die.”
5. There was no insomnia from him.
6. After withdrawal there is no sudden change in mood, but the nervous system gradually becomes the same as it was before using the drug.
7. Price approximately 1200 for 28 tablets of 50 mg. Usually prescribed 50 mg per day. Sold by prescription. But it seems that a couple of times I bought it without a prescription when I didn’t have it with me. But this is an exception. Usually now even nootropics are sold by prescription.
8. There are cheaper generics, but I didn’t buy them.
What can be concluded? Let everyone decide for themselves. Plus, DON'T FORGET that taking pills every day affects your kidneys and liver!
I would also add about alcohol... one glass of wine will not do anything, but if you drink too much, you will feel sick (vomit). I had such an experience. And of course, a double blow to the liver and kidneys :) So I don’t recommend drinking alcohol at all.
I tried it too
Cipralex has a similar effect, but only it gave me a headache. But I don’t remember about Zoloft.
Olala
https://otzovik.com/review_1129550.html
Advantages:
was not particularly available for sale
Flaws:
by-effect
I don’t know how such a good doctor could prescribe these pills to me. And I didn’t have any depression. But I trusted the doctor and began looking for this Zoloft. It was a long time ago, by the way, five years ago, no less. I found it at the pharmacy only to order, I waited a long time. I took the first pill and after I went to bed, after a while I felt strange, to put it mildly. I began to shake and pound with terrible force. There were even some muscle spasms or something... I don’t know exactly whether they were spasms or not. I’m honest, I’m not lying, I thought I would die right that day. This state lasted for several hours and was not relieved by anything, neither Corvalol, nor a shower, nor anything else I could think of. After everything was over, I felt sorry for the money I spent. I read in the instructions that Zoloft is indicated for treatment of alcoholism. I began to think about giving these pills to an alcoholic friend, but I was stopped by the thought of responsibility and what could happen to this person from these pills. I was never able to give them away. Threw it away.
Glanke
https://otzyv.expert/ne-peyte-etu-dryan-2009267
Advantages:
No
Flaws:
While taking the drug, other organs can be damaged.
Details:
The psychoneurologist prescribed Zoloft 50 mg once a day in the morning. Immediately after taking it, my legs felt weak and I wanted to lie down (This applies to everyone who drives a car - under no circumstances should you drink in the morning!). After another half an hour, my stomach and pancreas ached, belching and nausea appeared, and my intestines became distended. The entire gastrointestinal tract could not be restored within 24 hours! Moreover, I lost my appetite (that’s why the side effects in the instructions say weight loss!). At night, restless sleep, headaches. The doctor answered all this - you need to get used to it, it will pass in 2 weeks. What kind of chemistry is it that you have to get used to for 14 whole days with such symptoms! Don't drink and ruin your health!
Thinted
https://otzyv.expert/ostorozhno-1382804
Advantages:
No
Flaws:
leads to suicide
Details:
My daughter took 2 ZOLOFT 50 mg tablets and became ill overnight. We fell asleep, and in the morning she jumped out of the window and died. I never talked about suicide. CAREFULLY!!!
DieAnotherDay
Insomnia!!!!!, depression, depression, the appearance of a feeling of fear, zombie state, nausea first
It just so happened that after breaking up with my ex, I was attacked by depression, accompanied by tearfulness, irritability, reluctance to enjoy life, etc. The doctor prescribed Zoloft, an antidepressant or tranquilizer that was supposed to help my psyche. So, the dosage is 100 mg. per day, it was necessary to start with 50 mg for the first 10 days. Then it was supposed to increase the dose to 100 mg.
1 day of taking the drug. 16.00. I took the pill and went to work, driving, which I later regretted three times... Although the doctor assured that the “happiness” pill does not affect driving. After 45-60 minutes I suddenly wanted to sleep, so much so that my eyes closed involuntarily. The first thought was that I didn’t get enough sleep... I went to sleep as soon as I entered the house. I woke up a few hours later, wet from head to toe, I was shivering, my teeth were shaking a little, my heart was beating quickly, although I had never suffered from tachycardia.
Day 2. The feeling of fear, even in my usual environment, did not leave me. Dizziness, absolute lack of appetite, when thinking about food, a gag reflex. It was impossible to work, I constantly wanted to sleep.
Day 3. Still no appetite. But realizing that I hadn’t eaten anything for 2 days, I decided to grab yogurt and processed cheese. Three times it (the cheese) ended up somewhere in my throat ((((There is more on this day I didn’t try. Insomnia. Well, just fantastic. I didn’t fall asleep for a minute until 6 am (((The feeling of fear and panic attacks have not gone away.
Day 4. I took a few days at my own expense, because “I have a terrible disease.” I want to sleep, I count sheep and elephants, I drank green tea, a couple of drops of valerian. There is no sleep. Night is falling. Howling at the moon, counting the stars. Sweating appears, and with it for some reason a chill. It’s either insanely hot, or terrible cold, as if it’s January outside.
Day 5. Allergy. Redness of the cheeks, tooth (thank God, not strong), millia on the cheeks and forehead. I tolerate it, bought an acne cream. Night comes, I no longer howl at the moon, but buy Sonex (more on that later) .
Day 6. People around are monsters, everything is annoying, I want to at least kill someone, preferably slowly and painfully. Night. My friend is now “Sonex”)
Day 7 Minus 4 kilos on the scales. Minus 4 cm in the waist and the same in the hips.
Day 8. Thanks to Sonex and the ability to at least help the body sleep, I decide to resume training in the gym after a week-long break. Weakness, slight drowsiness. I constantly yawn, every 5-7 minutes. I crawl into the gym and lo and behold!!! I can do anything! I could lift the weight 10-15 kilos more than a week ago before Zoloft. I don’t get tired! 2 hours flew by in an instant! Several sweats came off me! For the first time in a year of playing sports, I regretted it. that I didn’t take a hairdryer with me, since I literally wrung out my (long) hair after class.
For the remaining 12 days of my torment, I ate Sonex because I couldn’t sleep without it, cottage cheese (which didn’t make me sick), yoghurt and water. The reason for withdrawal was pain in the pancreas (perhaps not due to the drug, but everything went away after withdrawal ), millia on my face and an allergy that made my face look like... Damn, it definitely looked like something).
My life after withdrawal. After 7-10 days, the pimples went away, sleep returned without sleeping pills on the 9th day, the feeling of fear went away on days 4-5, appetite returned on the 2nd day, sweating and terrible heart palpitations stopped on days 3-5 .
I don’t know if the next thing I’ll write can be called the advantages of the drug, but!!!: the antidepressant “Zoloft”, which with a clear conscience can be called a “Depressant”, is an amazing tool for weight loss. It completely kills appetite, increases endurance during physical activity .And secondly, I forgot to think about my ex, “hooked” on this legal “LSD”. It’s not for nothing that they say: if you want to forget about all your problems, buy shoes 2 sizes smaller. My “shoes” in some way did their job.
I don’t recommend Zoloft. Although some people are delighted with it. But who?
I had enough for 3 days of treatment... tatka29
I consulted a psychotherapist about obsessive thoughts. He prescribed me Zoloft. He didn’t say anything about side effects at all. Dosage 50 mg 1 time per day. I took the first pill and after a few hours I felt pressure in the head area, well, this is still nonsense. Then the state of complete “brake”, I was afraid to even be on the street in this state. The next day, terrible anxiety began, insomnia at night, and severe fear. I called the doctor and he said to take half a tablet. And half the dose was no better. A terrible state of fear and hopelessness. The instructions indicate terrible side effects.
In general, it lasted me for 3 days and I didn’t drink this rubbish anymore. With these pills it is 1000 times worse than without them. Some write that you need to be patient for 1-2 weeks and everything will pass, I couldn’t endure such a nightmare, it’s scary to even remember. I didn’t go to this doctor anymore and in general I don’t take any pills.
zhenek22
Diarrhea, increased symptoms of depression
Good afternoon
Zoloft was prescribed to me by an immunologist)) Which is, of course, very strange. The fact is that I had a difficult life situation, and after some time I began to get sick... For a long time and for a long time, the cold symptoms went away, but the low-grade fever did not go away. I went to an immunologist, she ordered a bunch of tests for hidden infections and immune status, and everything was fine everywhere. Therefore, he assumed that my temperature had arisen simply due to stress... And in order for us to eliminate this condition, he prescribed Zoloft (and a bunch of other drugs, but they were just immunomodulators).
In general, I took 1 tablet at work (he didn’t talk about any quarters). For the first 1.5 hours everything was fine..Then I started to slow down little by little..Then I went with my friend for lunch, and in the cafe I started to feel really bad...And I had a panic attack. I never knew WHAT THIS IS! I’m generally a pretty stress-resistant person, but this happened to me!!! I ran to work, I started having diarrhea (when I’m nervous, this happens to me), but this time I just felt sick in the toilet)) I had this panic: my palms were sweating, my heart thought it was going to jump out! In the end, I wanted to go home, but I was wildly scared)) How will I drive! So I got drunk on glycine and sat in the office alone all day... And then, apparently, my brain remembered this state, and I started having terrible panic attacks... And as the psychotherapist later said, this antidepressant is quite mild and not bad, but it is prescribed not like that at all! If I had taken half a tablet of it and half a tablet of Phenazepam, then I would not have felt any effect at all, but so, yes... I, like many others, felt worse from it at first. The funny thing is, okay, it would just make my condition worse, so I never had panic attacks! And then they appeared... After one pill, I decided to stop taking antidepressants before I even started...
In general, I will take such drugs only under the supervision of an experienced psychotherapist. If, God forbid, the need arises. And I got rid of my panic attacks 60% thanks to Atarax, and 40% because I went on vacation to Thailand)) So in any case, pills alone are sometimes not enough... You need a positive
HOPE
https://www.woman.ru/health/woman-health/thread/3876164/11/
my daughter took 2 tablets of Zoloft 50 mg each and jumped out of the window - DIED!!! Be careful!!!
Dmitriy
https://www.best-antidepressanty.ru/zoloft-sertralin.php
I tried three times to get on Zoloft, but it didn’t work. The side effects are simply terrible. The first days of admission are simply hell on earth, panic intensifies, fear, nausea, fear of people. Even with my strong will, I could not wait out the side effects and left him. Along with it, I was prescribed tranquilizers to ease the discomfort, but even with them I felt bad. But among psychotherapists, Zoloft is considered a favorite drug to prescribe. maybe he just wasn't right for me
Irina
https://www.otzyvua.net/zoloft-sertralin/review-209534
After taking half a tablet in the morning, the day went fine, but after lunch, in the evening, severe apathy began, then by night a feeling of fear, I could barely fall asleep, and in the morning I had an attack of tachycardia and almost panic with the feeling that I was about to lose consciousness. This Zoloft is such rubbish! Then the doctor told me that this was a side effect and that I needed to take it for the first two weeks with a tranquilizer. People, save yourself, those who can without this chemistry!!!
Pharmacokinetics
Suction
Absorption is high, but at a slow rate. When taking the drug simultaneously with food, bioavailability increases by 25%, Cmax increases by 25% and Tmax decreases.
In humans, when taking sertraline at a dose of 50 to 200 mg 1 time / day for 14 days, Cmax was achieved 4.5-8.4 hours after administration. Cmax and AUC are proportional to the dose within the range of 50-200 mg of sertraline 1 time / day for 14 days, while the linear nature of the pharmacokinetic dependence is revealed.
Distribution
Plasma protein binding is about 98%.
According to the final T1/2, an approximately twofold cumulation of the drug is observed until the onset of equilibrium concentrations after 1 week of treatment (dose 1 time/day).
Metabolism
Sertraline undergoes active biotransformation during the “first pass” through the liver. The main metabolite found in plasma, N-desmethylsertraline, is significantly inferior (about 20 times) to sertraline in activity in vitro and is virtually inactive in in vivo models of depression.
Sertraline and N-desmethylsertraline are actively biotransformed.
Removal
The average T1/2 of sertraline in young and elderly men and women is 22-36 hours. T1/2 of N-desmethylsertraline varies between 62-104 hours. Metabolites are excreted in feces and urine in equal quantities. Only a small part of the drug (less than 0.2%) is excreted unchanged in the urine.
Pharmacokinetics in special clinical situations
The pharmacokinetic profile in adolescents and elderly patients does not differ significantly from that in patients aged 18 to 65 years.
The pharmacokinetics of sertraline in children with OCD have been shown to be similar to those in adults (although the metabolism of sertraline is somewhat more active in children). However, given the lower body weight in children (especially those aged 6-12 years), it is recommended to use the drug in a lower dose to avoid excessive plasma levels.
In patients with liver cirrhosis, T1/2 of the drug and AUC increase compared to those in healthy people.
How to cancel and stop taking Zoloft?
Zoloft causes withdrawal symptoms if its use is abruptly stopped. This drug affects the processes occurring in the human brain, so you should take the medicine only with a doctor's prescription. How to stop taking the drug and get off Zoloft? To avoid withdrawal syndrome, the dosage of the medication according to the doctor's plan is reduced by 25 mg every 14 days. If stable remission is achieved after a course of treatment, the doctor will stop taking the drug. However, the specialist will stop the drug if the patient experiences side effects, insomnia and headaches from Zoloft are not uncommon.
In what case can the doctor stop taking the medicine:
- the patient has a headache;
- causeless sadness and anxiety arise;
- feeling of devastation;
- nervousness, irritability;
- weakness;
- suicidal tendencies;
- sleep and appetite disorders;
- decreased concentration.
If a person has lost their appetite or has regular headaches, the doctor will begin a gradual process of reducing the dosage. The therapeutic dose is reduced over several weeks and sometimes months.
Dosage
The drug is administered orally, 1 time/day in the morning or evening. The tablets can be taken regardless of meals.
For depression and OCD
treatment begins with a dose of 50 mg/day.
Treatment of panic disorders, PTSD and social phobia
start with a dose of 25 mg/day, which is increased after 1 week to 50 mg/day. The use of the drug according to this regimen can reduce the incidence of early undesirable treatment effects characteristic of panic disorder.
If the effect of using sertraline in patients at a dose of 50 mg/day is insufficient, the daily dose can be increased. The dose should be increased at intervals no more than once per week to a maximum recommended dose of 200 mg/day.
Initial effects may be seen within 7 days of starting treatment, but full effects are usually achieved within 2-4 weeks (or even longer for OCD).
During long-term maintenance therapy
the drug is prescribed in the minimum effective dose, which is subsequently changed depending on the clinical effect.
In children and adolescents aged 13-17 years
with
OCD,
treatment with Zoloft should begin with a dose of 50 mg/day.
In children aged 6-12 years,
treatment for OCD begins with a dose of 25 mg/day, after 1 week it is increased to 50 mg/day. Subsequently, if the effect is insufficient, the dose can be increased in steps of 50 mg/day up to 200 mg/day as needed. In clinical trials in patients with depression and OCD aged 6 to 17 years, it was shown that the pharmacokinetic profile of sertraline was similar to that in adults. To avoid overdose, when increasing the dose above 50 mg, it is necessary to take into account the lower body weight in children compared to adults.
T1/2 of sertraline is approximately 1 day, so dose changes should occur at intervals of at least 1 week.
In elderly patients
the drug is used in the same doses as in younger patients.
The drug should be used with caution in patients with liver disease
.
In patients with liver failure
, use lower doses or increase the interval between doses of the drug.
The drug is largely metabolized in the body. Only a small amount of the drug is excreted unchanged in the urine. As expected given the negligible renal excretion of sertraline, its dose was adjusted depending on the severity of renal failure
not required.
Do not stop taking antidepressants unless directed by a psychiatrist
It's easy to make a decision like, “I don't want to burden the doctor,” and start changing or stopping medications on your own. But please do not change anything without your doctor's instructions, even if it is a small reduction in the dosage of your medication. Antidepressants are useful but are potent substances, so it is important to consult a professional about any minor changes.
When you visit your psychiatrist, ask how best to change your treatment. Your doctor can usually make a plan to reduce your dosage instead of stopping suddenly. If you start a new medicine, it will likely be introduced gradually while reducing the level of your current medicine. This will help alleviate withdrawal symptoms.
Prepare for panic attacks
You may feel panicked while coming off antidepressants, either occasionally or constantly. If you have already experienced panic attacks, use the techniques that already suit you. If you haven't encountered them, place a paper bag next to your bed so you can breathe into it during attacks. Practice deep breathing and counting objects in the room until your heartbeat calms down.
Have a cry
Tears go hand in hand with panic attacks. In some cases you may be very tearful. Our advice is to cry if you want to. It's nothing to be ashamed of, and honestly, tears can make you feel quite refreshed. Do not be afraid.
Side effects
From the digestive system:
dyspeptic symptoms (flatulence, nausea, vomiting, diarrhea, constipation), abdominal pain, pancreatitis, dry mouth, hepatitis, jaundice, liver failure, decreased appetite (rarely increased), even anorexia; rarely, with long-term use - an asymptomatic increase in transaminase activity in the blood serum occurs. Discontinuation of the drug in this case leads to normalization of enzyme activity.
From the cardiovascular system:
palpitations, tachycardia, arterial hypertension.
From the musculoskeletal system:
arthralgia, muscle cramps.
From the central nervous system and peripheral nervous system:
extrapyramidal disorders (dyskinesia, akathisia, teeth grinding, gait disturbance), involuntary muscle contractions, paresthesia, fainting, drowsiness, headache, migraine, dizziness, tremor, insomnia, anxiety, agitation, hypomania, mania, hallucinations, euphoria, nightmares, psychosis, decreased libido, suicide, coma.
From the respiratory system:
bronchospasm, yawning.
From the urinary system:
enuresis, incontinence or urinary retention.
From the reproductive system:
sexual dysfunction (delayed ejaculation, decreased potency), galactorrhea, gynecomastia, menstrual irregularities, priapism.
From the senses:
blurred vision, mydriasis, ringing in the ears.
From the endocrine system:
hyperprolactinemia, hypothyroidism, syndrome of inappropriate ADH secretion.
Dermatological reactions:
redness of the skin or flushing of the face, alopecia, photosensitivity reaction, purpura, increased sweating.
Allergic reactions:
urticaria, pruritus, anaphylactoid reaction, angioedema, periorbital edema, facial edema, rarely Stevens-Johnson syndrome and epidermal necrolysis.
From the hematopoietic system:
possible development of leukopenia and thrombocytopenia.
Other:
weight loss or gain, peripheral edema, increased serum cholesterol levels, weakness, bleeding (including nasal, gastrointestinal or hematuria). Rare cases of withdrawal syndrome have been described when stopping treatment with sertraline. Paresthesia, hypoesthesia, symptoms of depression, hallucinations, aggressive reactions, psychomotor agitation, anxiety, or symptoms of psychosis may appear that cannot be distinguished from the symptoms of the underlying disease.
What to expect after stopping antidepressants
Many symptoms are associated with depression or anxiety, so it's worth keeping an eye on how you feel and how long it lasts. Withdrawal syndrome often manifests itself as:
- Panic attacks
- Poor motor coordination
- Strong emotionality
- Dizziness or inability to concentrate
- Insomnia and/or nightmares
- Fever
- Strange twitching and “bumps”
- Loss of appetite
- Nausea
This doesn't sound very nice. Withdrawal syndrome is not a pleasant thing. But if you're experiencing any of the above, remember: it won't last forever. Everything will be alright. We have a list of tips to help you feel better during this difficult time.
Overdose
Symptoms:
no severe symptoms were detected in case of an overdose of sertraline even when using the drug in high doses. However, when administered simultaneously with other drugs or alcohol, severe poisoning can occur, including coma and death.
In case of overdose, manifestations of serotonin syndrome are possible (nausea, vomiting, drowsiness, tachycardia, agitation, dizziness, psychomotor agitation, diarrhea, increased sweating, myoclonus and hyperreflexia).
Treatment:
There are no specific antidotes. Intensive supportive care and constant monitoring of vital body functions are required. Inducing vomiting is not recommended. The administration of activated carbon may be more effective than gastric lavage. The airway must be maintained. Sertraline has a large Vd, and therefore increased diuresis, dialysis, hemoperfusion or blood transfusion may be ineffective.
Drug interactions
Zoloft with MAO inhibitors provoke the development of severe complications that can be fatal. Most often, with the simultaneous use of drugs, serotonin syndrome occurs, which is characterized by an increase in body temperature, fluctuations in respiratory and cardiovascular activity, and changes in mental state.
The combination of Zoloft with drugs that depress the nervous system (including ethanol) is not recommended. Zoloft reduces the effectiveness of indirect anticoagulants, therefore, during the therapeutic course and some time after its completion, monitoring of prothrombin time is necessary. The simultaneous use of antihistamines and Zoloft significantly reduces the rate of cleansing of sertraline from the body.
Zoloft does not change the pharmacological properties of lithium preparations, drugs affecting serotonergic transmission, or Sumatriptan. However, when combining these medications, caution should be exercised and the patient's condition should be regularly monitored.
