ZOLOFT (sertraline)
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Zoloft is prescribed for major depression a persistently low mood that interferes with everyday living. Symptoms may include loss of interest in your usual activities, disturbed sleep, change in appetite, constant fidgeting or lethargic movement, fatigue, feelings of worthlessness or guilt, difficulty thinking or concentrating, and recurrent thoughts of suicide.

Some doctors also prescribe Zoloft for obsessive - compulsive disorders.

Zoloft is thought to work by boosting the amount of serotonin in the brain. Serotonin is one of the brain's natural chemical messengers.

Take Zoloft exactly as prescribed: once a day, in either the morning or the evening.

Improvement with Zoloft may not be seen for several days to a few weeks.

Zoloft may make your mouth dry. For temporary relief suck a hard candy, chew gum, or melt bits of ice in your mouth.

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Zoloft.

More common side effects may include: Agitation, confusion, constipation, diarrhea or loose stools, difficulty with ejaculation, dizziness, dry mouth, fatigue, fluttery or throbbing heartbeat, gas, headache, increased sweating, indigestion, insomnia, nausea, nervousness, sleepiness, tremor.

Less common or rare side effects may include:Abdominal pain, abnormal hair growth, abnormal skin odor, acne, altered taste, anxiety, back pain, bad breath, breast development in males, breast pain or enlargement, bruise-like marks on the skin,changeable emotions, chest pain, cold, clammy skin, conjunctivitis (pinkeye), coughing, difficulty breathing, difficulty concentrating, difficulty swallowing, double vision, dry eyes, enlarged abdomen, excessive menstrual bleeding, eye pain, fainting Zoloft may also cause mental or emotional symptoms such as: Abnormal dreams or thoughts, aggressiveness, exaggerated feeling of well-being, depersonalization ("unreal" feeling), hallucinations, memory loss, paranoia, rapid mood shifts, suicidal thoughts, tooth-grinding
Many people lose a pound or two of body weight while taking Zoloft. This usually poses no problem but may be a concern if your depression has already caused you to lose a great deal of weight.

In a few people, Zoloft may trigger the grandiose, inappropriate, out-of-control behavior called mania or the similar, but less dramatic, "hyper" state called hypomania.

Do not use this drug while taking an MAO inhibitor.

The effects of Zoloft during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Zoloft should be taken during pregnancy only if it is clearly needed. It is not known whether Zoloft appears in breast milk. Caution is advised when using Zoloft during breastfeeding.

The usual starting dose is 50 milligrams once a day, taken either in the morning or in the evening.

Your doctor may increase your dose depending upon your response. You should not take more than 200
milligrams in a day.

If you have a kidney or liver disorder, take Zoloft cautiously and under close medical supervision.

Bibliography
Freud KM., Moskowitz MA., Lin TH., McKinlay JB. Early antidepressant therapy for elderly patients. Am J Med 2003;114:15-19.
Kupfer Dj. The interaction of drug and psycotheraphy in the long-term treatment of depression. Journal of affective disorders 2001;62:131-137.
Jarret RB., Doyle J. et Al. Preventing recurrent depression using cognitive therapy with and without a continuation phase: a randomized clinical trial. Arch Gen Psychiatry 2001;58:381-388.
Mayberg HS., Mahurin RK. et Al. Regional metabolic effects of fluxetine in major depression: serial changes and relationship to clinical response. Biol Psychiatry 2000;48:830-843.
Brody A., Saxena S. et Al Regional metabolic effects in patients with major depression treated with either paroxetine or interpersonal therapy. Arch Gen Psychiatry 2001; 58:631-640.
Mayberg HS., Brannan M. et Al. Reciprocal limbic-cortical function and negative mood: converging PET findings in depression and normal sadness. Am J Psychiatry 1999;156:675-682.
Robinson RG. An 82-year-old woman with mood changes following a stroke. JAMA 2000;283:1607-1613.

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