Drug Uses
Zoloft is a prescription medicine used to treat depression, panic disorder, obsessive-compulsive disorder (also called OCD) and posttraumatic stress disorder (also called PTSD) in adults. Zoloft is also used to treat OCD in children (ages 6-12) and adolescents (ages 12-17).
How Taken
Zoloft comes as a tablet to take it orally. It is usually taken once daily and may be taken with or without food. Take Zoloft exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Continue to take Zoloft even if you feel well. Do not stop taking Zoloft without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will want to decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.
Warnings/Precautions
Before taking Zoloft, tell your doctor if you have liver disease; kidney disease; suffer from seizures; or suffer from mania or have suicidal thoughts.
You may not be able to take Zoloft, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Zoloft is in the FDA pregnancy category C. This means that it is unknown whether it will be harmful to an unborn baby. Do not take Zoloft without first talking to your doctor if you are pregnant or could become pregnant during treatment.
It is not known whether Zoloft passes into breast milk. Do not take Zoloft without first talking to your doctor if you are breast-feeding a baby.
Missed Dose
If you take Zoloft once a day in the morning, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. If you take Zoloft once a day at bedtime and do not remember to take it until the next morning, skip the missed dose. Do not take a double dose to make up for a missed one.
Possible Side Effects
If you experience any of the following serious side effects, stop taking Zoloft and contact your doctor immediately or seek emergency medical treatment: an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives); an irregular heartbeat or pulse; low blood pressure (dizziness, weakness); high blood pressure (severe headache, blurred vision); or chills or fever.
If you experience any of the following less serious side effects, continue taking Zoloft and talk to your doctor: headache; tremor, nervousness, or anxiety; nausea, diarrhea, dry mouth, or changes in appetite or weight; sleepiness or insomnia; or decreased sex drive, impotence, or difficulty having an orgasm.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Storage
Store at 25°C (77°F); excursions permitted to 15° - 30°C (59° - 86°F).
Overdose
Seek emergency medical attention. Symptoms of a Zoloft overdose include nausea, vomiting, tremor, seizures, agitation, drowsiness, hyperactivity, and enlarged pupils.
More Information
Use caution when driving, operating machinery, or performing other hazardous activities. Zoloft may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities.
Use alcohol cautiously. Alcohol may increase drowsiness or dizziness while taking Zoloft.
Disclaimer
This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.
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More women become depressed while their children are babies than at any other time in life (Clin Pharmacokinet 1994 Oct;27(4):270-89). With the surging tide of postpartum hormones, mounting sleep deprivation, persistent noise, shifting body image, the change of life structure, and the loss of control of one's own time, this depression is not surprising -- even with a brand-new bundle of joy in the home.
For a nursing mother, making the decision to take medicine to treat this depression is tricky. We know some medicines are not safe to take when nursing; others are okay. For most medicines, there is not enough known to do better than make an educated guess. Most of the antidepressants fall into this last category.
Since most medications of any kind taken by the mother do show up in the breast milk, my rule of thumb is that, all other things being equal, it is better for a nursing mom not to take a medicine that is not clearly okay to prescribe for the baby.
In the case of depression, all other things are not equal.
Solid evidence is mounting that maternal depression is not good for babies' development. A study released just last month looked at 225 four-month-old infants, and their responses to the voices of depressed and non-depressed women. Babies do not learn as well when they are listening to the flatter, less melodic voices of depressed women. Adults' perky, high-pitched baby talk sets the stage for intellectual development (Child Development 1999;70:560-570).
Depressed mothers deserve treatment, both for their babies' sakes, and so that the mothers do not miss out on enjoying one of life's unrepeatable joys -- the all-too-brief babyhood of each child.
It’s best to treat the depression with sleep, exercise, bright light, upbeat music, and healthy food. Exercise is particularly difficult in the postpartum period -- both time and energy are often lacking. But exercise has been proven to help specifically with postpartum depression (J Sports Med Phys Fitness 1997 Dec;37(4):287-91). Cooperation and commitment will be needed from family and friends to guard Mom's sleep and to free her up for daily aerobic exercise -- outside if possible (Prev Med 1999 Jan;28(1):75-85). An hour of aerobic exercise daily can be as powerful as even the strongest antidepressant medications. Even 10 minutes a day can make a noticeable difference.
Anaerobic exercise, while effective at treating depression, creates lactic acid that causes sore muscles. This lactic acid gets into the breast milk. It doesn't taste good and leads to fussier babies -- which in turn increases the risk of depressed moms (Pediatrics 1992 Jun;89(6 Pt 2):1245-7). I also wonder whether depression itself may alter breast milk, giving another good reason to treat.
Even an hour of quiet rest with no responsibilities can significantly improve the depressed symptoms (J Sports Med Phys Fitness 1997 Dec;37(4):287-91). Seeking out support and therapy is also very important. If treating the depression without medicines isn't satisfactory, I am in favor of using antidepressant medicines.
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