- Generic name: Sertraline
- Trade names: Zoloft, Lustral (UK)
- Pharmacologic category: Selective serotonin reuptake inhibitor
- FDA Approved: December 30, 1991
- Manufacturer: Pfizer Inc.
- Habit forming? No
- Pregnancy risk factor: C
What is Zoloft?
Zoloft is a potent representative of selective serotonin reuptake inhibitors (SSRIs). Sertraline strongly affects serotonin and weakly affects noradrenaline and dopamine. Imbalance of these chemical in the brain may cause several mental and mood disorders such as depression, panic or anxiety.
Zoloft is approved to treat depression, social anxiety disorder, posttraumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD) in adults over age 18. It is also approved for OCD in children and adolescents age 6-17 years.
The most common side effects are nausea, dry mouth, fatigue, and decreased libido.
Withdrawal and discontinuation
You should not suddenly stop taking Sertraline because abrupt discontinuation can cause withdrawal symptoms. The most common withdrawal symptoms are dizziness, nausea, anxiety, headache, agitation, insomnia, increased sweating. These symptoms can be alleviated by gradual tapering off, usually over a period of weeks or months.
- Elimination half-life: 25-26 hr.
- Metabolism: extensively metabolized by the liver; undergoes metabolism via N-demethylation to form the principal metabolite N-desmethylsertraline. In laboratory tubes, the conversion of sertraline to N-desmethylsertraline correlates more with CYP3A3/4 isoenzyme activity than with CYP2D6.
- Excretion: renal (40–45%) and fecal (40–45%).
- Relatively low risk of weight gain 
- The only medication approved for the long-term treatment of PTSD
- Low potential for drug interactions, involving hepatic metabolism.
- Minimal anticholinergic side effects
- Well tolerated and effective for chronic depression 
- Sertraline is a good choice for elderly people because its elimination is not affected substantially by aging.
- general anxiety disorder 
- bulimia nervosa 
- premature ejaculation 
- autistic disorders 
- fibromyalgia 
- bipolar depression 
- binge eating disorder (BED) 
Mechanism of action
Sertraline inhibits central nervous system neuronal re-uptake of serotonin, thus increasing the concentration of the serotonin and enhancing the neuronal transmission. The increased levels of serotonin are thought to improve the symptoms of depression.
Sertraline also appears to be a minor dopamine reuptake inhibitor.
Food appears to increase the bioavailability by about 40%.
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- Zoloft seems to be effective in the treatment of refractory vasovagal syncope (fainting) in children and adolescents.
- A study has shown that Zoloft can diminish irritability, aggression, and self-destructive behaviors in persons with personality disorders.