These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Zoloft- Interaction with Feldene
Question: Is there an interaction between Zoloft and Feldene? Both
can cause diarrhea. When taken together, is this side effect increased or enhanced?
Answer: Zoloft (sertraline hydrochloride) is a drug normally used in depression. It apparently works on the inhibition of serotonin in the brain. About 10 to 15% of patients will experience diarrhea. Feldene (piroxicam) is usually classed as a non-steroidal anti-inflammatory. About 3 to 5% of my patients experience loose stools or diarrhea on this drug. Usually, the diarrhea will start as one starts, consequently, I am not sure that the drugs have anything to do with diarrhea. Clearly, stopping the drugs-with your physician’s permission-would clear the diarrhea within 3 to 4 days if the diarrhea is drug related. If diarrhea does not stop with cessation of drugs, a gastrointestinal workup needs to be done to find the cause of the diarrhea. both weight loss and diarrhea could be due to the drugs; however, serious mistakes could be made if this is ignored.
Zoloft- Other Medications
Question: I was diagnosed and treated for depression about six years ago when I was a police officer. I have since left that profession after 13 years and started my own business. I have been taking Paxil, but was switched to Zoloft in an effort to eliminate the loss of libido and impotence which I have experienced while on these medications. I haven’t had any feelings of depression for quite some time, but have had feelings of anxiety…constricted throat, heart palpitations, dizziness, nausea, feeling of impending doom…for no apparent reason. I only experience these anxious feelings when I forget to take my Zanex or Paxil. Should I switch to another medication that would just treat my anxiety? I would like to get off of all medications (I’m just taking this one), but don’t think I’ll be able to. My father, grandfather, and great-grandfather all suffered from depression. Will switching to Elavil be beneficial as far as decreased side-effects?
Answer: Depression and anxiety are different disorders; but, are commonly seen together. There is even a subgrouping of depression which commonly includes a lot of feelings of anxiety. If the anti-depressant is effectively treating the depression I would stay with it . This is because the anti-anxiety drugs in general are fairly sedating and have addiction potential. There are some treatments for anxiety like Buspar which are not; but, their effectiveness is limited. Elavil is an anti-depressant from a class of drugs called tricyclics. These are older anti-depressants and in general, produce a fair number of side-effects. This is one of the major reasons Paxil, Zoloft and similar drugs are used in place of drugs like Elavil. While you should discuss this with your physician, I suspect you will encounter more side-effects with Elavil. There has recently been released a few new entries in the serotonin class of drugs which are advertised as having less effect on sexual libido.
Zoloft- Sexual Drive
Question: What are the side effects? Does it reduce sexual drive? I have been showing less interest toward sex since taking the drug about 5 weeks ago. Please adsvise.
Answer: Zoloft is one of a newer class of anti-depressives. These include Prozac and Paxil. One of the usual side-effects is a decrease in sexual drive and libido. This will return to normal once the medicine is discontinued. Sometimes, a decrease in sexual drive can also be due to the underlying depression. However, if the decrease occurs with taking the anti-depressant the drug is the usual culprit. Serzone, which is an anti-depressant, is currently thought to have similar effects, but without sexual suppression.
Zoloft- Memory loss
Question: My 77 year-old wife is suddenly having a problem with immediate and recent memory loss. Can you tell me if 100 mg of Zoloft or a similar dosage of Wellbutrin can cause memory loss.
Answer: Zoloft (sertraline hydrochloride) and Wellbutrin (bupropion hydrochloride) are relatively new anti-depressant drug. Zoloft’s action is thought to be directed through the drug serotonin and inhibition of its reuptake by neurons. Wellbutrin and its mode of action are less well understood. Zoloft is not thought to have a major effect on memory. Wellbutrin has more central nervous system effects in general. These include delusions, hallucinations, confusion and paranoia. Patients are commonly warned that Wellbutrin may impair their judgment, motor, and cognitive skills. This may be seen by the patient or the family as a loss of memory.
Zoloft- Long term use of
Question: I have been on 100 mg of Zoloft for 2 years. The effects on my depression seem to be diminishing. In other words, the
long-term use benefit seems to be decreasing. In long-term
use of Zoloft, should an increased dosage be considered?
Answer: Clinical use of most of the anti-depressants of all classes is usually based on empiric effect. That is, one starts the drug and watches the effect on depression. The drug is increased until side-effects appear, or the depression is treated. There are a few of the anti-depressants which do have blood levels available, but there are only a few. Consequently, if the depression appears to be increasing it certainly would make sense to increase the dose and watch the effect(vs. side-effects). There doesn’t appear to be major tolerance with long-term use.
Zoloft
Question: Is this drug excreted with the semen?
Answer: Zoloft is metabolized by the liver. Also, about 40-50% of the drug is excreted in the urine. I could find no data about semen.
Zoloft- Breastfeeding
Question: Is it safe to breastfeed an 11-month-old while on Zoloft (50 mg/day)?
Answer: Unfortunately, there is currently no data on the amount of Zoloft (or its metabolites) secreted in human milk. Also, safety and effectiveness in children have currently not been established. Studies of the carcinogenesis of Zoloft have generally been favorable with an increase in liver adenomas and some indication of uterine cancers.
Zoloft and Fen-phen
Question: I have recently begun the fen-phen program for weight loss. I have taken Zoloft for approximately one year and have been advised that I can continue taking 50mg of Zoloft in combination with these other drugs but not my previous dose of 100mg per day. Is there a potential problem with taking these drugs together or will I get the same anti-depressant effect from the fenfluramine and be able to discontinue the zoloft?
Answer: I know of no studies which look at this particular combination of drugs. Generally, given a lack of information, a physician will attempt to decrease the risks. I suspect that is the underlying reason for decreasing your dosage. I would discuss this with my physician.
