Zoloft....?

[GoinStag]

I just got back from seeing my psychiatrist and explained to her that the Wellbutrin (anti-depressants) I had been taking wasn't working like it used to, so we decided to switch me over to Zoloft. Have any of you guys taken Zoloft, or know anyone who has? Any side-effects you know of?

[stilllovelyafte]

Standard caveats (not a doctor etc). Zoloft is one I have heard recommended. Another one that's popular is lexapro. Most SSRIs have the potential for the same side effects - which often can be of a sexual variety. Supposedly Lexapro and possibly Zoloft are a little lighter on these, but from everything I've read it TOTALLY depends on the person. Some people have life changing results on drugs that make other's batty.

[Tracker57]

I'm talking Welbutrin and Lexapro. I've had family members taking Zoloft with no ill effects. Check the side effects: Lexapro has a side effect of "delayed ejaculation." In my case it can mean NO ejaculation. So if you have trouble functioning, it might be the drugs.

[GoinStag]

Originally Posted by Tracker57

I'm talking Welbutrin and Lexapro. I've had family members taking Zoloft with no ill effects. Check the side effects: Lexapro has a side effect of "delayed ejaculation." In my case it can mean NO ejaculation. So if you have trouble functioning, it might be the drugs.

oh fuck dude Zoloft better not do that or I'm getting off (no pun) of that shit...well maybe not, but still...please God don't let it do that. Wellbutrin never did that.

[J Snow]

My father and Grandmother have both taken it, but my family keeps stuff like that hidden and doesn't talk about it. My mother told me that he was on zoloft for his blood pressure but that's a bunch of crap. He has, or at least had, serious anxiety issues.

I have no idea if he still takes it, but I don't think he does to the best of my knowledge.

[Austin]

I took it for a bit and I had trouble ejaculating and my sex drive was lower while on it. None other than that.

[stilllovelyafte]

I don't think a single one of these SSRIs can claim to have no sexual side effects. Each has the potential, I think, for the same issues to arise. However, for some reason, which few can really explain, you might take wellbutrin and have no side effects, while I might take it and be shut down. We could then be the reverse on lexapro. There are some, I think that have a reputation of being a little better with these issues than others, but from what I've read, the evidence sort of points in each and every direction. Hope this helps.

[Mogget]

Echoing others, all SSRIs have the potential for similar side effects, and it's very individual-specific as to what side effects will occur. I take Sertraline, the generic for Zoloft, with no side effects at all, but I'm on a fairly low dosage. The worst side effects I've had from SSRIs were sunlight-induced headaches and a massive increase in my libido coupled with an inability to climax.

[seeksanctuary]

Took it when I was younger... made me sicker than a dog and MORE suicidal. It helped a tiny bit with anxiety but made the depression worse.

[Chip]

zoloft is one of the older SSRIs. I know several people who used it and found it beneficial. But... being one of the older SSRIs, it's also a bit less specific than the newer ones and, I believe, has some tendency to amplify depression in some people (which, of course, is the complete opposite of what it's supposed to do.)

KB or Blair will know better than I, but my impression is that it's pretty good as far as minimal side effects, other than, as others have said, inhibiting ejaculation.

If the Welbutrin isn't working like it used to, are you sure it's that the effect itself is diminished, or is it possible that other things are going on in your life and so you're feeling the feelings a little more strongly than normal? One of the issues with all of these antidepressants is that people get used to the idea they should never feel down, and that simply isn't true. Particularly for young people, the idea of being on *any* drug long term used to be considered completely ridiculous, but now doctors seem quite content to do long-term prescriptions.

I'm not trying to second guess your doctor here, just giving you some things to think about next time you talk to him.

[Mogget]

It's also common for people to be put on cocktails. I've been on multiple SSRIs for most of my psychiatric history.

[Chip]

Actually, while a lot of psychiatrists might do that, there's very little in the literature that I just read to indicate that cocktails of SSRIs are more effective. In fact, except in a very few cases of really intractable depression or anxiety that's failed multiple single-drug treatment regimens, I found pretty much no data to support multi-drug regimens, and even in those cases, there is very little in the way of actual data supporting that those protocols work, and certainly not in the case of someone who has had previous success with a single-drug regimen.

I try to call out these situations because it seems that most every therapy professional I talk to, and most physicians, feel that psych medications are grossly overprescribed, and that the majority of psychiatrists seem ready to prescribe more medication rather than spending the time to find the perfect single medication, in the right dose, to do the trick.

There's no question that some people need more help from medication than others. And I have no doubt that in your case, Liam, the protocol your doctor prescribed works for you. But cocktails aren't the right solution for most people, and the more people know and understand, the more they can guard against being overmedicated by an overworked or downright incompetent psychiatrist.

[Zach]

Zoloft gave me the typical sexual side effects, but the main reason I hated Zoloft was because of the horrible nightmares I would get every night. The "wake up screaming" and can't get back to sleep kind. After my doctor lowered the dosage, and eventually took me off of the Zoloft, the nightmares stopped.

[MommaFrog]

Here is what the Davis says about Zoloft ((Davis is a drug guide used by nurses))


Zoloft
Classification
Therapeutic: antidepressants
Pharmacologic: selective serotonin reuptake inhibitors (SSRIs)
Pregnancy Category C
Copyright © 2011 by F.A. Davis Company

Indications
Major depressive disorder. Panic disorder. Obsessive-compulsive disorder (OCD). Post-traumatic stress disorder (PTSD). Social anxiety disorder (social phobia). Premenstrual dysphoric disorder (PMDD). Unlabelled Use: Generalized anxiety disorder (GAD).

Action
Inhibits neuronal uptake of serotonin in the CNS, thus potentiating the activity of serotonin. Has little effect on norepinephrine or dopamine. Therapeutic Effects: Antidepressant action. Decreased incidence of panic attacks. Decreased obsessive and compulsive behavior. Decreased feelings of intense fear, helplessness, or horror. Decreased social anxiety. Decrease in premenstrual dysphoria.

Pharmacokinetics
Absorption: Appears to be well absorbed after oral administration.
Distribution: Extensively distributed throughout body tissues.
Protein Binding: 98%.
Metabolism and Excretion: Extensively metabolized by the liver; one metabolite has some antidepressant activity; 14% excreted unchanged in feces.
Half-life: 24 hr.

Contraindications/Precautions
Contraindicated in: Hypersensitivity; Concurrent MAO inhibitor therapy (may result in serious, potentially fatal reactions); Concurrent pimozide; Oral concentrate contains alcohol; avoid in patients with known intolerance.
Use Cautiously in: Severe hepatic or renal impairment; Patients with a history of mania; History of suicide attempt; OB/Lactation: Pregnancy or lactation; Pedi: May ↑ risk of suicide attempt/ideation especially during early treatment or dose adjustment; risk may be greater in children or adolescents.

Adverse Reactions/Side Effects (CAPITALS indicate life-threatening; bold indicate most frequent.)
CNS: NEUROLEPTIC MALIGNANT SYNDROME, SUICIDAL THOUGHTS, dizziness, drowsiness, fatigue, headache, insomnia, agitation, anxiety, confusion, emotional lability, impaired concentration, manic reaction, nervousness, weakness, yawning. EENT: pharyngitis, rhinitis, tinnitus, visual abnormalities. CV: chest pain, palpitations. GI: diarrhea, dry mouth, nausea, abdominal pain, altered taste, anorexia, constipation, dyspepsia, flatulence, ↑ appetite, vomiting. GU: sexual dysfunction, menstrual disorders, urinary disorders, urinary frequency. Derm: ↑ sweating, hot flashes, rash. F and E hyponatremia. MS: back pain, myalgia. Neuro: tremor, hypertonia, hypoesthesia, paresthesia, twitching. Misc: SEROTONIN SYNDROME, fever, thirst.

Interactions
Drug-Drug: Serious, potentially fatal reactions (hyperthermia, rigidity, myoclonus, autonomic instability, with fluctuating vital signs and extreme agitation, which may proceed to delirium and coma) may occur with concurrent MAO inhibitors. MAO inhibitors should be stopped at least 14 days before sertraline therapy. Sertraline should be stopped at least 14 days before MAO inhibitor therapy. May ↑ pimozide levels and the risk of potentially life-threatening cardiovascular reactions. Drugs that affect serotonergic neurotransmitter systems, including linezolid, tramadol, and triptans, ↑ risk of serotonin syndrome. May ↑ sensitivity to adrenergics and ↑ the risk of serotonin syndrome. Concurrent use with alcohol is not recommended. May ↑ levels/effects of warfarin, phenytoin, tricyclic antidepressants some benzodiazepines (alprazolam), cloazapine or tolbutamide. ↑ risk of bleeding with NSAIDS, aspirin, clopidogrel, or warfarin. Cimetidine ↑ blood levels and effects.


Drug-Natural: ↑ risk of serotinergic side effects including serotonin syndrome with St. John’s wort and SAMe.
Route/Dosage
Depression/OCD
PO (Adults): 50 mg/day as a single dose in the morning or evening initially; after several weeks may be ↑ at weekly intervals up to 200 mg/day, depending on response.
PO (Children 13–17 yr): OCD—50 mg once daily.
PO (Children 6–12 yr): OCD—25 mg once daily.
Panic Disorder
PO (Adults): 25 mg/day initially, may ↑ after 1 wk to 50 mg/day.
PTSD
PO (Adults): 25 mg once daily for 7 days, then ↑ to 50 mg once daily; may then be ↑ if needed at intervals of at least 7 days (range 50–200 mg once daily).
Social Anxiety Disorder
PO (Adults): 25 mg once daily initially, then 50 mg once daily; may be ↑ at weekly intervals up to 200 mg/day.
PMDD
PO (Adults): 50 mg/day initially either daily or daily during luteal phase of cycle. Daily dosing may be titrated upward in 50–mg increments at the beginning of a cycle. In luteal phase–only dosing a 50 mg/day titration step for 3 days at the beginning of each luteal phase dosing period should be used (range 50–150 mg/day).
Availability (generic available)
Tablets: 25 mg, 50 mg, 100 mg Cost: Generic-- 25 mg $87.98/90, 50 mg $89.98/90, 100 mg $99.96/90. Capsules: 50 mg, 100 mg. Oral concentrate (12% alcohol): 20 mg/mL in 60–mL bottles Cost: $65.28/60 mL.

---------- Post added 28th Dec 2011 at 10:26 AM ----------

Feel free to ask more about what I posted

Also, I am on Lexapro and have NO side effects, I refuse to take zoloft or prozac because of the pregnancy ratings (C means it can harm the baby) and usually zoloft and prozac have worse side effects on women

[KaraBulut]

Originally Posted by Chip

KB or Blair will know better than I, but my impression is that it's pretty good as far as minimal side effects, other than, as others have said, inhibiting ejaculation.

Zoloft has been around since the early 90s and was one of the first of the drugs introduced to try to knock Prozac from the #1 slot in drugs prescribed in the US.

It's considered safe and because the patent has run out, it's available as a generic which makes it very affordable compared to the brand name drugs on the market.

These simple SSRI meds are considered safe and their long history on the market has created a fairly thorough clinical history to support that safety record.

The usual problems with these drugs have to do with individual tolerances- some people are more sensitive to some SSRIs while others may have no response to the same SSRIs. And the most common complaint is a feeling of detachment- both emotional and sexual. The problems with delayed orgasm/ejaculation in men is well-documented, or as one of my patients once described it, "I'm horny, it takes forever for me to come but I'm not sure I care".

[GoinStag]

Originally Posted by KaraBulut

Zoloft has been around since the early 90s and was one of the first of the drugs introduced to try to knock Prozac from the #1 slot in drugs prescribed in the US.

It's considered safe and because the patent has run out, it's available as a generic which makes it very affordable compared to the brand name drugs on the market.

These simple SSRI meds are considered safe and their long history on the market has created a fairly thorough clinical history to support that safety record.

The usual problems with these drugs have to do with individual tolerances- some people are more sensitive to some SSRIs while others may have no response to the same SSRIs. And the most common complaint is a feeling of detachment- both emotional and sexual. The problems with delayed orgasm/ejaculation in men is well-documented, or as one of my patients once described it, "I'm horny, it takes forever for me to come but I'm not sure I care".

Wait....so I'm not gonna be able to cum? Everything worked just fine on Wellbutrin. I don't wanna lose my sex-drive. Seriously!

[Chip]

Your mileage may vary, but that's the single complaint that I've heard more often about Zoloft than any other. It's worth trying, because you might not have the problem... and if you do, you can always try going back to Welbutrin or <gasp> working with your psychiatrist to try to wean off entirely.

[seeksanctuary]

Originally Posted by Zach

...the main reason I hated Zoloft was because of the horrible nightmares I would get every night. The "wake up screaming" and can't get back to sleep kind.

... I didn't know that. At least now I have some explanation for the horrible dreams I had while on that stuff. x_x

[KaraBulut]

Originally Posted by GoinStag

Wait....so I'm not gonna be able to cum? Everything worked just fine on Wellbutrin. I don't wanna lose my sex-drive. Seriously!

The incidence of this particular side effect varies from person to person. The studies will tell you it's about 10% but most of us who have prescribed SSRIs will tell you that it's probably closer to 30-40% of men.

And just to be clear, it's not that you can't come. It's that there is an odd feeling of detachment. The meds usually improve erections and increase libido however it's difficult to get to climax even though the sex is fine. The primary complaint is that it takes longer to come but for many guys with partners who want to last longer, this may also be a positive side effect.

[Cymbrii]

I havent read the whole thread since it's long but I wanted to throw in my two cents. I've been on Zoloft for.. not sure, half a year maybe? The only side effect I've noticed is decreased sex drive and trouble climaxing like other people have already posted. It hasn't been a permanent thing though honestly, it's more been kinda on and off (most of the time I'm not experiencing said side effect).