What is Zoloft? What does it do?

Zoloft is approved by the FDA for treatment of Major Depressive Disorder, Post Traumatic Stress Disorder, Premenstrual Dysphoric Disorder, Social Anxiety Disorder, Panic Disorder and Obsessive-Compulsive Disorder in children and adolescents from 6 to 17 years of age. ¹

Zoloft is a selective serotonin reuptake inhibitor or SSRI. SSRI’s prevent serotonin (a chemical produced in the nervous system, the vascular system and the gastrointestinal tract that is thought to affect mood) from being transferred between cells. ²

Does Zoloft work?

SSRIs have become very popular in recent years, and if you are not taking one, someone in your family probably is. However, you should know that researchers reviewing the drug studies that garnered FDA approval for anti-depressants such as Zoloft found that the drug companies did not publish their results accurately. This called into question whether or not these drugs are actually effective.

The researchers used the Freedom of Information Act, and looked exhaustively at the studies that were done for the drug companies. They reviewed 74 studies involving 12 drugs, including Zoloft, and over 12,000 people. Their review disclosed that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”³

As the researchers pointed out:

“Medical decisions are based on an understanding of publicly reported clinical trials. If the evidence base is biased, then decisions based on this evidence may not be the optimal decisions. For example, selective publication of clinical trials, and the outcomes within those trials, can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.” ⁴

You should make sure that both you and your doctor are aware of the actual risk-benefit ratio for any drug that you decide to take.

What should I go over with my doctor?

The U.S. Food and Drug Administration (FDA) has required Zoloft to include a “black box” warning that Zoloft may cause suicidal thoughts and behavior in children and adolescents. There are concerns that this may also affect adults.⁵

While the potential of suicidal thoughts and behavior are the most alarming side-effects of Zoloft, the list of additional unpleasant side-effects is long. The most common side-effects, for example, include loss of sexual drive or desire, nausea, insomnia, and trembling. Many patients may find a more effective and less expensive treatment for depression in a generic anti-depressant, diet change, exercise or therapy.

Patients should also be careful about taking Zoloft concurrent to other medications. Anti-depressants combined with medications for migraine headaches, for example, can cause a life-threatening condition called “Serotonin syndrome.” This condition can cause seizures and even death. Serotonin syndrome can also be caused by taking SSRI anti-depressants with older, monoamine oxidase inhibitor depressants (drugs that interfere with the transfer of other chemicals between cells). Antipsychotics taken with an anti-depressant have been found to more than double patients’ risks of fatal heart attack and stroke. ⁶

Zoloft, like other anti-depressants, is not recommended for pregnant women. It can sometimes affect the development of a baby’s heart and lungs in the womb, a rare birth defect in which a newborn can’t adapt to breathing outside the womb and which can also cause multiple organ damage, brain damage and death. ⁷

What if I’m already taking Zoloft?

Always talk to your doctor before discontinuing any prescription medication. When withdrawing from Zoloft, people have experienced symptoms, just a few of which are dizziness, nausea, insomnia, vomiting, diarrhea, confusion, fatigue, agitation, anger, nervousness, crying and many more. ⁸

Learn everything you can about Zoloft before you start taking it.

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¹ FDA, “FDA Approved Labeling for Zoloft for the Treatment of Social Anxiety Disorder, Attachment to FDA Approval Letter for NDA 19-839/S-045″ (December 2002) http://www.fda.gov/ohrms/dockets/ac/04/briefing/4006B1_06_Zoloft-Label.pdf ;Pfizer, Inc. http://www.zoloft.com, retrieved 24 July 2012
² http://www.whatisserotonin.com/“Discover what is serotonin, themedicalbiochemistrypage.org, LLC, Michael W King, PhD, “Table of Neurotransmitters,” (last modified 25 June 2012) http://themedicalbiochemistrypage.org/nerves.php#5ht
³ Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260. http://www.ncbi.nlm.nih.gov/pubmed/18199864
⁴ Ibid.
⁵ FDA, “Antidepressant Use in Children, Adolescents, and Adults” (2 May 2007) http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm096273.htm
⁶ News Medical, “Combination of antipsychotic and antidepressant drugs may increase risk of CV mortality” (16 November 2011), http://www.news-medical.net/news/20111116/Combination-of-antipsychotic-and-antidepressant-drugs-may-increase-risk-of-CV-mortality.aspx
⁷ FDA, “FDA Drug Safety Communication: Selective serotonin reuptake inhibitor (SSRI) antidepressant use during pregnancy and reports of a rare heart and lung condition in newborn babies” (13 December 2011) http://www.fda.gov/Drugs/DrugSafety/ucm283375.htm
⁸ Professional Psychology: Research and Practice, Rafael A. Rivas-Vasquez, et al, “Selective Serotonin Reuptake Inhibitor Discontinuation Syndrome,” (March 1999) http://psychrights.org/research/Digest/CriticalThinkRxCites/rivas-vazquez.pdf