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Zoloft withdrawal. How to reduce Zoloft 150mg, Zoloft, 100mg and Zoloft 50mg dosages. Avoid Zoloft withdrawal by a correct Zoloft withdrawal.

Zoloft Withdrawal

Step by step Zoloft withdrawal procedures

How to withdrawal from Zoloft; 150mg, 100mg and 50mg dosages.

Zoloft 50mg withdrawal instructions  Click here

Zoloft 100mg withdrawal instructions Click here

Zoloft 150mg withdrawal instructions Click here

On this page:

How to stop Zoloft withdrawal side effects

A list of 186 Zoloft withdrawal side effects with the medical terms defined.

The Road Back founder, Jim Harper, has been assisting individuals off psychotropic medication for the past 20 years. Click here to read his bio.

First, why there is Zoloft withdrawal side effects:

During 2014, a clinical study was published showing Zoloft caused the activation of a substance called MAP4K4. The activation of the MAP4K4 would then cause the over activation of the JNK gene and these two events directly leads to liver cell death. Source: Sertraline, an Antidepressant, Induces Apoptosis in Hepatic Cells Through the Mitogen-Activated Protein Kinase Pathway.  Researchers: Division of Biochemical Toxicology Center for Toxicological Research, United States F.D.A. and the Division of Genetic and Molecular Toxicological Research, United States F.D.A.

The study shows the JNK activation of Zoloft is the direct cause of cell death. The study also demonstrated if you were to silence the MAP4K4 that action would stop the cell death being induced by Zoloft. I will be writing a complete Zoloft withdrawal book in the near future and at that time I will go into depth detailing what specifically is happening within the cells of the liver and how this further aggravates Zoloft withdrawal and Zoloft withdrawal.

When trying to address any problem in life, the problem is usually much easier to address when all or most of the true facts are known. In the case of Zoloft, just knowing the source of the Zoloft side effect problem is the activation of the MAP4K4, which in turn activates the JNK gene to an unhealthy level gives a major advantage to locate a solution. Knowing, if the MAP4K4 can be silenced, this action will stop the continual activation of the JNK gene is the icing on the cake.

Finding a way to silence the MAP4K4 was difficult enough but that has now been accomplished.  I actually got more than I ever expected while researching and looking for natural methods to silence the MAP4K4. 

There is a way to silence the MAP4K4, reduce the over activation of the JNK gene and bring relief for many of the Zoloft withdrawal side effects as well as making Zoloft more livable for those people that are staying of the drug.

Zoloft withdrawal

Body

Zoloft withdrawal
Dry Mouth -
The usual amount to moisture in the mouth is noticeably less.

Zoloft withdrawal
Sweating Increased -
A large quantity of perspiration that is medically caused.

Cardiovascular
(Involving the heart and the blood vessels)

Zoloft withdrawal
Palpitation -
Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering.  It can be brought on by shock, excitement, exertion, or medical stimulants.  A person is normally unaware of his/her heartbeat.

Zoloft withdrawal
Hypertension -
Is high blood pressure, which is a symptom of disease in the blood vessels leading away from the heart.  Hypertension is known as the “silent killer”.  The symptoms are usually not obvious, however it can lead to damage to the heart, brain, kidneys and eyes, and even to stroke and kidney failure. Treatment includes dietary and lifestyle changes.

Zoloft withdrawal
Bradycardia -
The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult.

Zoloft withdrawal
Tachycardia -
The heart rate is speeded up to above 100 beats per minute in an adult.  Normal adult heart rate is 72 beats per minute.

Zoloft withdrawal
ECG Abnormal -
A test called an electrocardiogram (ECG) that records the activity of the heart.  It measures heartbeats as well as the position and size of the heart’s four chambers.  It also measures if there is damage to the heart and the effects of drugs or mechanical devices like a pacemaker on the heart.  When the test is abnormal this means that one or more of the following are present: heart disease, defects, beating too fast or too slow, disease of the blood vessels leading from the heart or of the heart valves, and/or a past or about to occur heart attack. 

Zoloft withdrawal
Flushing
- The skin all over the body turns red.

Zoloft withdrawal
Varicose Vein
- Unusually swollen veins near the surface of the skin that sometimes appear twisted and knotted, but always enlarged.  They are called hemorrhoids when they appear around the rectum.  The cause is attributed to hereditary weakness in the veins aggravated by obesity, pregnancy, pressure from standing, aging, etc.  Severe cases may develop swelling in the legs, ankles and feet, eczema and/or ulcers in the affected areas.

Gastrointestinal (Involving the stomach and the intestines)

Zoloft withdrawal
Abdominal Cramp/Pain
- Sudden, severe, uncontrollable and painful shortening and thickening of the muscles in the belly.  The belly includes the stomach as well as the intestines, liver, kidneys, pancreas, spleen, gall bladder, and urinary bladder.

Zoloft withdrawal
Belching
- Noisy release of gas from the stomach through the mouth; a burp.

Zoloft withdrawal
Bloating
- Swelling of the belly caused by excessive intestinal gas.

Zoloft withdrawal
Constipation
- Difficulty in having a bowel movement where the material in the bowels is hard due to a lack of exercise, fluid intake, and roughage in the diet, or due to certain drugs.

Zoloft withdrawal
Diarrhea
- Unusually frequent and excessive, runny bowel movements that may result in severe dehydration and shock. 

Zoloft withdrawal
Dyspepsia
- Indigestion.  This is the discomfort you experience after eating.  It can be heartburn, gas, nausea, a bellyache or bloating.

Zoloft withdrawal
Flatulence
- More gas than normal in the digestive organs.

Zoloft withdrawal
Gagging
- Involuntary choking and/or involuntary throwing up.

Zoloft withdrawal
Gastritis
- A severe irritation of the mucus lining of the stomach either short in duration or lasting for a long period of time.

Zoloft withdrawal
Gastroenteritis
- A condition where the membranes of the stomach and intestines are irritated.

Zoloft withdrawal
Gastroesophageal Reflux
- A continuous state where stomach juices flow back into the throat causing acid indigestion and heartburn and possibly injury to the throat.

Zoloft withdrawal
Heartburn
- A burning pain in the area of the breastbone caused by stomach juices flowing back up into the throat.

Zoloft withdrawal
Hemorrhoids
- Small rounded purplish swollen veins that either bleed, itch or are painful and appear around the anus.

Zoloft withdrawal
Increased Stool frequency -
Diarrhea.
 

Zoloft withdrawal
Indigestion
- Unable to properly consume and absorb food in the digestive tract causing constipation, nausea, stomach ache, gas, swollen belly, pain and general discomfort or sickness.

Zoloft withdrawal
Nausea
- Stomach irritation with a queasy sensation similar to motion sickness and a feeling that one is going to vomit.

Zoloft withdrawal
Polyposis Gastric
- Tumors that grow on stems in the lining of the stomach, which usually become cancerous.

Zoloft withdrawal
Swallowing Difficulty
- A feeling that food is stuck in the throat or upper chest area and won’t go down, making it difficult to swallow.

Zoloft withdrawal
Toothache
- Pain in a tooth above and below the gum line.

Zoloft withdrawal
Vomiting
- Involuntarily throwing up the contents of the stomach and usually getting a nauseated, sick feeling just prior to doing so.

General

Zoloft withdrawal
Allergy -
The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Zoloft withdrawal
Anaphylaxis -
A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Zoloft withdrawal
Asthenia -
A physically weak condition.

Zoloft withdrawal
Chest Pains -
Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Zoloft withdrawal
Chills -
Appearing pale while cold and shivering; sometimes with a fever.

Zoloft withdrawal
Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid.

Zoloft withdrawal
Fall - To suddenly lose your normal standing upright position.

Zoloft withdrawal
Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities. 

Zoloft withdrawal
Fever -
Abnormally high body temperature, the normal being 98 degrees Fahrenheit or 37 degrees Centigrade in humans, which is a symptom of disease or disorder in the body.  The body is affected by feeling hot, chilled, sweaty, weak and exhausted.  If the fever goes too high, death can result.

Zoloft withdrawal
Hot Flashes -
Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body.  Women in menopause will sometimes experience this.

Zoloft withdrawal
Influenza-like Symptoms -
Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu.

Zoloft withdrawal
Leg Pain -
A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Zoloft withdrawal
Malaise -
The somewhat unclear feeling of discomfort you get when you start to feel sick.

Zoloft withdrawal
Pain in Limb -
Sudden, sharp and uncontrolled leg discomfort.

Zoloft withdrawal
Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain.

Zoloft withdrawal
Tightness of Chest -
Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly).  The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles.

Hemic and Lymphatic Disorders
(Involving the blood and the clear fluids in the tissues that contain white blood cells)

Zoloft withdrawal
Bruise -
Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin.

Zoloft withdrawal
Anemia -
A condition where the blood is no longer carrying enough oxygen, so the person looks pale and easily gets dizzy, weak and tired.  More severely, a person can end up with an abnormal heart, as well as breathing and digestive difficulties.  The causes of anemia are not enough protein in the red blood cells, or missing and chemically destroyed red blood cells, as well as diseased or destroyed bone marrow.

Zoloft withdrawal
Nosebleed -
Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen.

Zoloft withdrawal
Hematoma -
Broken blood vessels that cause a swelling in an area on the body.

Zoloft withdrawal
Lymphadenopathy Cervical -
The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug.  The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

Metabolic and Nutritional Disorders
(Energy and health)

Zoloft withdrawal
Arthralgia
- Sudden sharp nerve pain in one or more joints.

Zoloft withdrawal
Arthropathy - Having joint disease or abnormal joints.

Zoloft withdrawal
Arthritis - Painfully inflamed and swollen joints.  The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Zoloft withdrawal
Back Discomfort
- Severe physical distress in the area from the neck to the pelvis along the backbone.

Zoloft withdrawal
Bilirubin Increased
- Bilirubin is a waste product of the breakdown of old blood cells.  Bilirubin is sent to the liver to be made water-soluble so it can be eliminated from the body through emptying the bladder.  A drug can interfere with or damage this normal liver function creating liver disease.

Zoloft withdrawal

Decreased Weight
- Uncontrolled and measured loss of heaviness or weight.

Zoloft withdrawal
Gout
- A severe arthritis condition that is caused by the dumping of a waste product called uric acid in the tissues and joints.  It can become worse and cause the body to develop a deformity after going through stages of pain, inflammation, severe tenderness, and stiffness.

Zoloft withdrawal
Hepatic Enzymes Increased
- An increase in the amount of paired liver proteins that regulate liver processes causing a condition where the liver functions abnormally.

Zoloft withdrawal
Hypercholesterolemia
- Too much cholesterol in the blood cells.

Zoloft withdrawal
Hyperglycemia
- An unhealthy amount of sugar in the blood.

Zoloft withdrawal
Increased Weight
- A concentration and storage of fat in the body accumulating over a period of time caused by unhealthy eating patterns, that can predispose the body to many disorders and diseases.

Zoloft withdrawal
Jaw Pain
- The pain due to irritation and swelling of the nerves associated with the mouth area where it opens and closes just in front of the ear.  Some of the symptoms are pain when chewing, head aches, losing your balance, stuffy ears or ringing in the ears, and teeth grinding.

Zoloft withdrawal
Jaw Stiffness
- The result of squeezing and grinding the teeth while asleep that can cause your teeth to deteriorate as well as the muscles and joints of the jaw.

Zoloft withdrawal
Joint Stiffness
- A loss of free motion and easy flexibility where any two bones come together.

Zoloft withdrawal
Muscle Cramp
- When muscles contract uncontrollably without warning and do not relax.  The muscles of any of the body’s organs can cramp.

Zoloft withdrawal
Muscle Stiffness
- Tightening of muscles making it difficult to bend.

Zoloft withdrawal
Muscle Weakness
- Loss of physical strength.

Zoloft withdrawal
Myalgia
- A general widespread pain and tenderness of the muscles.

Zoloft withdrawal
Thirst
- A strong, unnatural craving for moisture/water in the mouth and throat. 

Nervous System
(Sensory channels)

Zoloft withdrawal
Carpal Tunnel Syndrome
- A pinched nerve in the wrist that causes pain, tingling, and numbing.

Zoloft withdrawal
Coordination Abnormal
- A lack of normal, harmonious interaction of the parts of the body when it is in motion.

Zoloft withdrawal
Dizziness
- Losing one’s balance while feeling unsteady and lightheaded which may lead to fainting.

Zoloft withdrawal
Disequilibrium
- Lack of mental and emotional balance.

Zoloft withdrawal
Faintness
- A temporary condition where one is likely to go unconscious and fall.

Zoloft withdrawal
Headache
- A sharp or dull persistent pain in the head

Zoloft withdrawal
Hyperreflexia
- A not normal and involuntary increased response in the tissues connecting the bones to the muscles.

Zoloft withdrawal
Light-headed Feeling
– Uncontrolled and usually brief loss of consciousness caused by lack of oxygen to the brain.

Zoloft withdrawal
Migraine
- Reoccurring severe head pain usually with nausea, vomiting, dizziness, flashes or spots before the eyes, and ringing in the ears

Zoloft withdrawal
Muscle Contractions Involuntary
- Spontaneous and uncontrollable tightening reaction of the muscles caused by electrical impulses from the nervous system.

Zoloft withdrawal
Muscular Tone Increased - Uncontrolled and exaggeration muscle tension.  Muscles are normally partially tensed and this is what gives us muscle tone. 

Zoloft withdrawal
Paresthesia
- Burning, prickly, itchy, or tingling skin with no obvious or understood physical cause.

Zoloft withdrawal
Restless Legs
- A need to move the legs without any apparent reason.  Sometimes there is pain, twitching, jerking, cramping, burning, or a creepy-crawly sensation associated with the movements.  It worsens when a person is inactive and can interrupt one’s sleep so one feels the need to move to gain some relief.

Zoloft withdrawal
Shaking
- Uncontrolled quivering and trembling as if one is cold and chilled.

Zoloft withdrawal
Sluggishness
- Lack of alertness and energy, as well as being slow to respond or perform in life.

Zoloft withdrawal
Tics
- A contraction of a muscle causing a repeated movement not under the control of the person usually on the face or limbs.

Zoloft withdrawal
Tremor
- A nervous and involuntary vibrating or quivering of the body.

Zoloft withdrawal
Twitching
- Sharp, jerky and spastic motion sometimes with a sharp sudden pain.

Zoloft withdrawal
Vertigo
- A sensation of dizziness with disorientation and confusion.

Psychiatric Disorders (Mental and emotional)

Zoloft withdrawal
Aggravated Nervousness
- A progressively worsening, irritated and troubled state of mind.

Zoloft withdrawal
Agitation
- Suddenly violent and forceful, emotionally disturbed state of mind.

Zoloft withdrawal
Amnesia
- Long term or short term, partial or full memory loss created by emotional or physical shock, severe illness, or a blow to the head where the person was caused pain and became unconsciousness.

Zoloft withdrawal
Anxiety Attack
- Sudden and intense feelings of fear, terror, and dread physically creating shortness of breath, sweating, trembling and heart palpitations.

Zoloft withdrawal
Apathy
- Complete lack of concern or interest for things that ordinarily would be regarded as important or would normally cause concern.

Zoloft withdrawal
Appetite Decreased
- Having a lack of appetite despite the ordinary caloric demands of living with a resulting unintentional loss of weight.

Zoloft withdrawal
Appetite Increased
- An unusual hunger causing one to overeat.

Zoloft withdrawal
Auditory Hallucination
- Hearing things without the voices or noises being present.

Zoloft withdrawal
Bruxism
- Grinding and clenching of teeth while sleeping.

Zoloft withdrawal
Carbohydrate Craving
- A drive and craving to eat foods rich in sugar and starches (sweets, snacks and junk foods) that intensifies as the diet becomes more and more unbalanced due to the unbalancing of the proper nutritional requirements of the body.

Zoloft withdrawal
Concentration Impaired
- Unable to easily focus your attention for long periods of time.

Zoloft withdrawal
Confusion
- Not able to think clearly and understand in order to make a logical decision.

Zoloft withdrawal
Crying Abnormal
- Unusual and not normal fits of weeping for short or long periods of time for no apparent reason.

Zoloft withdrawal
Depersonalization
- A condition where one has lost a normal sense of personal identity.

Zoloft withdrawal
Depression
- A hopeless feeling of failure, loss and sadness that can deteriorate into thoughts of death.

Zoloft withdrawal
Disorientation
- A loss of sense of direction, place, time or surroundings as well as mental confusion on personal identity.

Zoloft withdrawal
Dreaming Abnormal
- Dreaming that leaves a very clear, detailed picture and impression when awake that can last for a long period of time and sometimes be unpleasant.

Zoloft withdrawal
Emotional Lability
- Suddenly breaking out in laughter or crying or doing both without being able to control the outburst of emotion.  These episodes are unstable as they are caused by things that normally would not have this effect on an individual.

Zoloft withdrawal
Excitability
- Uncontrollably responding to stimuli.

Zoloft withdrawal
Feeling Unreal
- The awareness that one has an undesirable emotion like fear but can’t seem to shake off the irrational feeling.  For example, feeling like one is going crazy but rationally knowing that it is not true.  The quality of this side effect resembles being in a bad dream and not being able to wake up.

Zoloft withdrawal
Forgetfulness
- Unable to remember what one ordinarily would remember.

Zoloft withdrawal
Insomnia
- Sleeplessness caused by physical stress, mental stress or stimulants such as coffee or medications; it is a condition of being abnormally awake when one would ordinarily be able to fall and remain asleep.

Zoloft withdrawal
Irritability
- Abnormally annoyed in response to a stimulus.

Zoloft withdrawal
Jitteriness
- Nervous fidgeting without an apparent cause.

Zoloft withdrawal
Lethargy
- Mental and physical sluggishness and apathy that can deteriorate into an unconscious state resembling deep sleep.  A numbed state of mind.

Zoloft withdrawal
Libido Decreased
- An abnormal loss of sexual energy or desire.

Zoloft withdrawal
Panic Reaction
- A sudden, overpowering, chaotic and confused mental state of terror resulting in being doubt ridden often accompanied with hyperventilation, and extreme anxiety.

Zoloft withdrawal
Restlessness Aggravated
- A constantly worsening troubled state of mind characterized by the person being increasingly nervous, unable to relax, and easily angered.

Zoloft withdrawal
Somnolence
- Feeling sleepy all the time or having a condition of semi-consciousness.

Zoloft withdrawal
Suicide Attempt
- An unsuccessful deliberate attack on one’s own life with the intention of ending it.

Zoloft withdrawal
Suicidal Tendency
- Most likely will attempt to kill oneself.

Zoloft withdrawal
Tremulousness Nervous
- Very jumpy, shaky, and uneasy while feeling fearful and timid.  The condition is characterized by thoughts of dreading the future, involuntary quivering, trembling, and feeling distressed and suddenly upset.

Zoloft withdrawal
Yawning
- involuntary opening of the mouth with deep inhalation of air.

Reproductive Disorder Female

Zoloft withdrawal
Breast Neoplasm
- A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman. 

Zoloft withdrawal
Menorrhagia
- Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Zoloft withdrawal
Menstrual Cramps
- Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Zoloft withdrawal
Menstrual Disorder
- A disturbance or derangement in the normal function of a woman’s menstrual period.

Zoloft withdrawal
Pelvic Inflammation
- The reaction of the body to infectious, allergic, or chemical irritation, which in turn causes tissue irritation, injury, or bacterial infection characterized by pain, redness, swelling, and sometimes loss of function. The reaction usually begins in the uterus and spreads to the fallopian tubes, ovaries, and other areas in the hipbone region of the body.

Zoloft withdrawal
Premenstrual Syndrome
- Various physical and mental symptoms commonly experienced by women of childbearing age usually 2 to 7 days before the start of their monthly period.  There are over 150 symptoms including eating binges, behavioral changes, moodiness, irritability, fatigue, fluid retention, breast tenderness, headaches, bloating, anxiety, and depression.  The symptoms cease shortly after the period begins, and disappear with menopause.

Zoloft withdrawal
Spotting Between Menses
- Abnormal bleeding between periods.  Unusual spotting between menstrual cycles.

RESPIRATORY SYSTEM
(Organs involved in breathing)

Zoloft withdrawal
Asthma
- A disease of the breathing system initiated by an allergic reaction or a chemical, with repeated attacks of coughing, sticky mucus, wheezing, shortness of breath, and a tight feeling in the chest.  The disease can reach a state where it stops a person from exhaling, leading to unconsciousness and death.

Zoloft withdrawal
Breath Shortness -
Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.

Zoloft withdrawal
Bronchitis -
Inflammation of the two main breathing tubes leading from the windpipe to the lungs.  The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction.

Zoloft withdrawal
Coughing -
A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material.

Zoloft withdrawal
Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing.  It can be caused by straining the voice or exposure to infectious, allergic or chemical irritation.

Zoloft withdrawal
Nasal Congestion -
The presence of an abnormal amount of fluid in the nose.

Zoloft withdrawal
Pneumonia Tracheitis
- Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe.  Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge.

Zoloft withdrawal
Rhinitis -
Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Zoloft withdrawal
Sinus Congestion -
The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose.  These areas become clogged with excess fluid or infected.

Zoloft withdrawal
Sinus Headache -
The abnormal amount of fluid in the hollows of the face bone area especially around the nose.  This excess fluid creates pressure, causing pain in the head.

Zoloft withdrawal
Sinusitis -
The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

SKELETAL

Zoloft withdrawal
Neck/Shoulder Pain -
Hurtful sensations of the nerve endings caused by damage to the tissues in the neck and shoulder signaling danger of disease.

SKIN and APPENDAGES DISORDERS (Skin, legs and arms)

Zoloft withdrawal
Acne -
Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Zoloft withdrawal
Alopecia -
The loss of hair or baldness.

Zoloft withdrawal
Eczema -
A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching.  It is often difficult to treat and will sometimes go away only to reappear again.

Zoloft withdrawal
Dermatitis -
Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction.  It is a general inflammation of the skin.

Zoloft withdrawal
Dry Lips -
The lack of normal moisture in the fleshy folds that surround the mouth.

Zoloft withdrawal
Dry Skin
- The lack of normal moisture/oils in the surface layer of the body.  The skin is the body’s largest organ. 

Zoloft withdrawal
Folliculitis
-
Inflammation of a follicle (small body sac) especially a hair follicle.  A hair follicle contains the root of a hair.

Zoloft withdrawal
Furunculosis
- Skin boils that show up repeatedly.

Zoloft withdrawal
Lipoma
- A tumor of mostly fat cells that is not health endangering.

Zoloft withdrawal
Pruritus
- Extreme itching of often-undamaged skin.

Zoloft withdrawal
Rash
- A skin eruption or discoloration that may or may not be itching, tingling, burning, or painful.  It may be caused by an allergy, a skin irritation, a skin disease.

Zoloft withdrawal
Skin Nodule
- A bulge, knob, swelling or outgrowth in the skin that is a mass of tissue or cells.


SPECIAL SENSES

Zoloft withdrawal
Conjunctivitis
- Infection of the membrane that covers the eyeball and lines the eyelid, caused by a virus, allergic reaction, or an irritating chemical.  It is characterized by redness, a discharge of fluid and itching.

Zoloft withdrawal
Dry Eyes
- Not enough moisture in the eyes.

Zoloft withdrawal
Earache
- Pain in the ear.        

Zoloft withdrawal
Eye Infection
- The invasion of the eye tissue by a bacteria, virus, fungus, etc, causing damage to the tissue, with toxicity.  Infection spreading in the body progresses into disease.

Zoloft withdrawal
Eye Irritation
- An inflammation of the eye.

Zoloft withdrawal
Metallic Taste
- A range of taste impairment from distorted taste to a complete loss of taste.

Zoloft withdrawal
Pupils Dilated
- Abnormal expansion of the circular opening in the center of the eye. 

Zoloft withdrawal
Taste alteration
- Abnormal flavor detection in food.

Zoloft withdrawal
Tinnitus
- A buzzing, ringing, or whistling sound in one or both ears occurring from the internal use of certain drugs.

Zoloft withdrawal
Vision Abnormal
- Normal images are seen differently by the viewer.

Zoloft withdrawal
Vision Blurred
- Eyesight is dim or indistinct and hazy in outline or appearance. 

Zoloft withdrawal
Visual Disturbance
- Eyesight is interfered with or interrupted.  Some disturbances are light sensitivity and the inability to easily distinguish colors.

URINARY SYSTEM DISORDER

Zoloft withdrawal
Blood in Urine
- Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red.  Or you could see spots of blood in the water after urinating. 

Zoloft withdrawal
Dysuria
- Difficult or painful urination.

Zoloft withdrawal
Kidney Stone
- Small hard masses of salt deposits that the kidney forms.

Zoloft withdrawal
Urinary Frequency
- Having to urinate more often than usual or between unusually short time periods.

Zoloft withdrawal
Urinary Tract Infection
- An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body.  If the invasion goes unchecked it can injure tissue and progress into disease.

Zoloft withdrawal
Urinary Urgency
- A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

UROGENITAL
(Urinary tract and genital structures or functions)

Zoloft withdrawal
Anorgasmia
- Failure to experience an orgasm.

Zoloft withdrawal
Ejaculation Disorder
- Dysfunction of the discharge of semen during orgasm.

Zoloft withdrawal
Menstrual Disorder
- Dysfunction of the discharge during the monthly menstrual cycle.

Zoloft withdrawal
Acute Renal Failure
- The kidneys stop functioning properly to excrete wastes. 

Zoloft withdrawal
Angioedema
- Intense itching and swelling, welts on the skin called hives caused by an allergic reaction to internal or external agents.  The reaction is common to a food or a drug. Chronic cases can last for a long period of time. 

Zoloft withdrawal
Toxic Epidermal Necrolysis
- An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn.  Often the symptoms include blistering.

Zoloft withdrawal
Gastrointestinal Hemorrhage
- Stomach and intestinal excessive internal bleeding.

Zoloft withdrawal
Grand Mal Seizures (or Convulsions)
- A recurring sudden violent and involuntary attack of muscle spasms with a loss of consciousness.

Zoloft withdrawal
Neuroleptic Malignant Syndrome
- A life threatening, rare reaction to an anti-psychotic drug marked by fever, muscular rigidity, changed mental status, and dysfunction of the autonomic nervous system. 

Zoloft withdrawal
Pancreatitis
- Chemical irritation with redness, swelling, and pain in the pancreas where digestive enzymes and hormones are secreted.

Zoloft withdrawal
QT Prolongation
- A very fast heart rhythm disturbance that is too fast for the heart to beat effectively so the blood to the brain falls causing a sudden loss of consciousness and may cause sudden cardiac death.

Zoloft withdrawal
Rhabdomyolysis
- The breakdown of muscle fibers that releases the fibers into the circulatory system.  Some of the fibers are poisonous to the kidney and frequently result in kidney damage.

Zoloft withdrawal
Serotonin Syndrome
- A disorder brought on by excessive levels of serotonin caused by drugs and can be fatal, as death from this side effect can come very rapidly.

Zoloft withdrawal
Thrombocytopenia
- An abnormal decrease in the number of blood platelets in the circulatory system. A decrease in platelets would cause a decrease in the ability of the blood to clot when necessary.

Zoloft withdrawal
Torsades de Pointes
- Unusual rapid heart rhythm starting in the lower heart chambers.  If the short bursts of rapid heart rhythm continue for a prolonged period it can degenerate into a more rapid rhythm and can be fatal.

  1. Zoloft withdrawal - Anorexia – No longer having a desire to eat.
  1. Zoloft withdrawal - Apothous Stomatitis – Painful red and swollen open sores on a mucus membrane of the mouth commonly called a canker sore.
  1. Zoloft withdrawal - Ataxia – Loss of the ability to move the body with coordination.
  1. Zoloft withdrawal - Arterial Fibrillation – A condition of abnormal twitching of the muscles in the blood vessels that moves the oxygenated blood from the heart to the rest of the body.  The unusual twitching is rapid and irregular and replaces the normal rhythm of contraction of the muscle, which sometimes causes a lack of circulation and pulse. 
  1. Zoloft withdrawal - Blood Cholesterol Increased – An abnormal condition where there is a greater amount in the blood of the oily/fatty substances known as cholesterol.   Cholesterol is a necessary part of living cells (along with proteins and carbohydrates).  Because cholesterol only slightly dissolves in water, it can build up on the walls of the blood vessels, therefore blocking/decreasing the amount of blood flow, which causes blood pressure to go up.  If not corrected, this condition is associated with coronary artery disease.
  1. Zoloft withdrawal - Blood Creatinine Increased – A greater than normal number of creatinine or muscular chemical waste molecules in the blood.  Creatinine plays a major role in energy production in muscles.  Since creatinine levels are normally maintained by the kidneys, Blood Creatinine Increased is an indicator of kidney malfunction or failure. 
  1. Zoloft withdrawal - Blood in Stool – The blood that is in your bowel movement usually comes from any place along your digestive tract (from your mouth to your anus).  The stool can appear black and foul-smelling (usually from the upper part of your digestive tract) or red or maroon-colored (usually from the large intestine area).  Hemorrhoids are the usual cause for blood in the bowels.

   8. Zoloft withdrawal - Bundle Branch Block Right – These are specialized cells in the   upper right heart chamber and are the heart’s pacemaker.  They send electrical signals to the heart that keeps it beating or contracting regularly.  Normally the signal goes to the lower heart chambers at the same time through the bundle of His (hiss) on both the left and right sides of the heart, so the lower chambers contract at the same time.  When the bundle is damaged on the right side, the signal does not fire at the same time as the left, which changes the pace of blood flow.  This can lead to a person fainting.

  1. Zoloft withdrawal - Cardiac Failure – A heart disorder where the heart does not function as usual and may completely stop working. 
  1. Zoloft withdrawal - Cardiac Failure Congestive – The body is asking for the heart to supply more blood than it is capable of producing and maintaining.  Normally, a body can tolerate an increased amount of work for quite some time.  The condition is characterized by weakness, shortness of breath, and a fluid build-up in the body tissues causing swelling. 
  1. Zoloft withdrawal - Cold Sweat – The skin is clammy and moist and you feel chilled.  This is a reaction to a shock or pain as well as to fear and nervousness.
     
  1. Zoloft withdrawal - Colitis – A condition where the large intestine becomes irritated from the use of the drug.
  1. Zoloft withdrawal - Coronary Artery Disease – A condition where the blood vessels that mainly carry the blood away from the heart become clogged up or narrowed usually by fatty deposits.  The first symptom is pain spreading from the upper left body caused by not enough oxygen reaching the heart. 
  1. Zoloft withdrawal - Dehydration – An extreme loss of water from the body or the organs of the body as in sickness or not drinking enough fluids.
     
  1. Zoloft withdrawal - Diplopia – The condition where a person is looking at one object and instead of normally seeing just the one object he sees two.  This is also called double vision.
  1. Zoloft withdrawal - Diverticulitis – There are pouches or sacs on the inside of the intestines that look like fingers.  This increases the area for the body to absorb nutrients as they pass through the intestines.  These sacs become irritated and swollen and end up trapping waste that would normally be eliminated, causing pain and constipation. 
  1. Zoloft withdrawal - Dysarthria – The inability to control the mouth muscles when forming words so the words are not clearly spoken and heard. 
  1. Zoloft withdrawal - Dyslipidemia – The normal fat metabolism in the blood is interfered with.
  1. Zoloft withdrawal - Dysphagia – Trouble swallowing or the inability to swallow.
  1. Zoloft withdrawal - Ecchymosis – When a blood vessel breaks and creates a purple discoloration of the skin.
  1. Zoloft withdrawal - Edema – An abnormal build up of excess fluids in the cells, tissues, and the spaces between the tissues creating swelling.
  1. Zoloft withdrawal - Edema Peripheral – The abnormal build up of fluids in the tissues of the ankles and legs causing painless swelling in the legs, ankles, and feet.  If you squeeze the swollen area it leaves an indentation on the skin for a few minutes.
  1. Zoloft withdrawal - Ejaculation Delayed – The man is not able to release sperm either during sexual intercourse or with manual stimulation in the presence of his sexual partner in spite of his wish to do so.
  1. Zoloft withdrawal - Ejaculation Dysfunction – A condition where the man has one or more of the following symptoms:  He is not able to have an erection, not able to have an orgasm, has a decreased interest in sex, is sexually inhibited, or it is painful to ejaculate sperm.
  1. Zoloft withdrawal - Erectile Dysfunction – Incapable of having sexual intercourse.  Even though a man desires sex he is inhibited in his sexual activity and is unable to have or maintain an erection of the penis. 
  1. Zoloft withdrawal - Erythema – a skin redness caused by the swelling with blood of the tiny blood vessels of the skin as in burns. 
  1. Zoloft withdrawal - Erythematous Rash – Redness of the skin from the swelling of the tiny blood vessels with skin irritation (itching, burning, tingling, pain) and breakouts (eruptions).
  1. Zoloft withdrawal - Esophageal Stenosis Acquired – The tube that moves food from the mouth to the stomach narrows.
  1. Zoloft withdrawal - Exfoliative Dermatitis – The unusual and not normal condition of scaling and shedding of the skin cells.  The skin is usually red colored.
  1. Zoloft withdrawal - Face Edema – The tissues of the face become swollen.
  1. Zoloft withdrawal - Feeling Jittery – A physical sensation of nervous unease. 
  1. Zoloft withdrawal - Gastric Irritation – An inflamed and sore stomach.
  1. Zoloft withdrawal - Gastric Ulcer – An open, irritated, and infected sore in the wall of the stomach.
  1. Zoloft withdrawal - Gingivitis – Sore, swollen and red gums in the mouth that bleed easily.
  1. Zoloft withdrawal - Glaucoma – The delicate nerve to the eye, the optic nerve, becomes easily damaged with the build-up of excess fluid pressure within the eyeball.  The first sign of glaucoma is loss of peripheral (side) vision.  It can progress to total blindness.
  1. Zoloft withdrawal - Hepatic Steatosis – Excessive amounts of fat in the liver.
  1. Zoloft withdrawal - Hyperhidrosis – The triggering of an excess of sweat being produced on the soles of the feet, the palms, or the underarms which can cause embarrassment or losing grip on a pen or other items.
  1. Zoloft withdrawal - Hyperkeratosis – An abnormal enlargement of the skin tissues causing the skin cells to increase in size.
  1. Zoloft withdrawal - Hyperlipidemia – An abnormally high number of fat cells in the blood.
  1. Zoloft withdrawal - Hypertriglyceridemia – Too many triglycerides in the blood. 

Triglycerides are three fatty acids bound together in one molecule stored by the body and available to create high levels of energy when used. 

  1. Zoloft withdrawal - Hypoesthesia – A partial loss of sensation or general loss of awareness.
  1. Zoloft withdrawal - Impaired Gastric Emptying – The contents of the stomach are not passed into the intestines as normal due to the stomach losing the muscular strength to do so.
  1. Zoloft withdrawal - Increased White Blood cell Count – This is an increase in the number of cells in the blood that are responsible for the removal of bacteria and other unwanted particles.  They fight disease and infection by enclosing foreign particles and removing them.  An example of a disease that would increase white blood cell count would be Leukemia.
  1. Zoloft withdrawal - Insomnia – Not able to fall asleep or sleeping for a shorter time than desired, thus not being able to properly rest and feeling un-refreshed.  As a result, a person can become irritable, have difficulty concentrating and feel a lack of energy.  This can be caused by stimulants such as by caffeine or drugs or by mental anxiety and stress.  Mental stress can be communicated and relieved.
  1. Zoloft withdrawal - Irritable Bowel Syndrome – A painful condition where either the muscles or the nerves of the lower intestines, are not responding normally.  This results in an alternating condition of diarrhea followed by constipation, back and forth.
  1. Zoloft withdrawal - Keratoconjunctivitis Sicca – A condition where the outer coating of the eyeball is dry because of a decrease in the normal amount of tears in the eye.  As a result, the eyeball and inside of the eyelid thickens and hardens sometimes causing the vision to be less sharp.
  1. Zoloft withdrawal - Leukopenia – An unnaturally low number of white blood cells circulating in the blood.
  1. Zoloft withdrawal - Loose Stools – The bowel movement is runny instead of formed.
  1. Zoloft withdrawal - Lower Abdominal Pain – A hurtful irritation of the nerve endings in the area of the hipbones housing the lower digestive tract.  Pain usually means tissue damage.
  1. Zoloft withdrawal - Lymphadenopathy – The lymph nodes, where the immune cells are located, become larger than is normal because of a high concentration of white blood cells.
  1. Zoloft withdrawal - Macular Degeneration – The gradual loss of central vision, which is the sharpest vision while peripheral eyesight, is unaffected.
  1. Zoloft withdrawal - Maculopathy – An abnormal condition of the yellow spot of the eye, which is located in the center of the inner lining of the eyeball and connected to the main nerve to the eye and is responsible for sharp vision.
  1. Zoloft withdrawal - Mania – Unusually irrational, excessive and/or exaggerated behavior or moods ranging from enthusiasm, sexuality, gaiety, impulsiveness and irritability to violence.
  1. Zoloft withdrawal - Melena – Abnormally darkly colored stools as a result of hemorrhaging in the digestive tract where the blood has interacted with the digestive juices creating the dark color in the bowel movement.
  1. Zoloft withdrawal - Micturition Urgency – A sudden desire to urinate usually followed by leakage.
  1. Zoloft withdrawal - Mood Swings – An emotional shifting as from a state of happiness to a state of depression for a period of time.
  1. Zoloft withdrawal - Myocardial Infarction – The blood going to the heart is delayed or stopped causing middle muscle tissue in the heart wall to die.
  1. Zoloft withdrawal - Nasopharyngitis – Irritation, redness and swelling tissues in the nose and the tube leading from the mouth to the voice box as well as the tubes leading to the ears.
  1. Zoloft withdrawal - Nephropathy – An abnormally functioning or diseased kidney.
  1. Zoloft withdrawal - Nervousness – Jumpy, jittery, anxious, and troubled with an irritable temperament.
  1. Zoloft withdrawal - Night Sweats – The water-salt, waste product the skin releases is called sweat or perspiration.   With night sweats you become wide awake in the middle of the night shivering and cold and wet with your sheets/pajamas soaked in perspiration making it difficult to go back to sleep.
  1. Zoloft withdrawal - Nightmare – Dreams that make you afraid or leave feelings of fear, terror, and upset long after waking up.
  1. Zoloft withdrawal - Orgasm Abnormal – Unable to have an orgasm with normal sexual stimulation.
  1. Zoloft withdrawal - Oropharyngeal Swelling – A swelling in the area from the soft part of the roof of the mouth to the back of the mouth.
  1. Zoloft withdrawal - Pain in Extremity – A painful feeling in the legs, arms, hands, and feet.
  1. Zoloft withdrawal - Pharyngolaryngeal Pain – Pain in the area of the respiratory tract (organs of breathing) from the throat to the voice box and above the windpipe.
  1. Zoloft withdrawal - Photopsia – A condition where a person sees lights, sparks or colors in front of your eyes.
  1. Zoloft withdrawal - Photosensitivity Reaction – An exaggerated sunburn reaction that is not normal in proportion to the amount of exposure to the light.
  1. Zoloft withdrawal - Pollakiuria – Urinating much more frequently than normal – as often as once every five to fifteen minutes.
  1. Zoloft withdrawal - Pressure of Speech – A condition where the individual cannot voice his ideas fast enough with the pressure of there being not enough time to say it.
  1. Zoloft withdrawal - Pruritic Rash – Extremely itchy, red, swollen bumps on the skin.
  1. Zoloft withdrawal - Pyrexia – Fever or the increase in body temperature that is usually a sign of infection.
  1. Zoloft withdrawal - Retinal Detachment – The thin layer lining the back of the eyeball (the retina) detaches from the back of the eyeball.  This thin layer is like the film of a camera because it sends the images a person views to the brain.  When it detaches it causes a reduced ability to see.
  1. Zoloft withdrawal - Rigors – Shivering or shaking of the body as if chilled, preventing normal responses.
  1. Zoloft withdrawal - Skin Ulcer – An open sore or infected skin eruption with swelling, redness, pus, and irritation.
  1. Zoloft withdrawal - Sleep Disorder – These are a list of sleep disorders such as teeth grinding, insomnia, jet lag, sleep walking, abnormally falling asleep during the middle of a conversation after a full night’s rest, uncontrolled body motions keeping one awake, etc.
     
  2. Zoloft withdrawal - Suicide, Completed – An attack on oneself that results in death.
  1. Zoloft withdrawal - Upper Respiratory Tract Infection – Where the organs of breathing near the mouth such as the nose and sinuses, become infected and are usually treated by antibiotics.
  1. Zoloft withdrawal - Urinary Hesitation – Hard to start or hard to continue emptying one’s bladder.
  1. Zoloft withdrawal - Urinary Incontinence – Urinating without intending to do so because of a weakening of the muscles in the hip area from the drug affecting the nerves or the drug blocking a persons thinking process.
  1. Zoloft withdrawal - Urinary Retention – The inability to completely empty the bladder despite having the urge to do so.  This can lead to infections or damage to the urinary organs.
  1. Zoloft withdrawal - Urine Flow Decreased – Dehydration of the body causing a lesser flow of urine than normal with the body reabsorbing the waste.
  1. Zoloft withdrawal - Urine Output Decreased – A condition where the output of urine produced in a 24-hour period is less than 500 ml.
  1. Zoloft withdrawal - Weight Decreased – Unintentional weight loss.
     
  2. Zoloft withdrawal – Weight Increased – An unusual, usually rapid weight increase.

Partial Zoloft description:

FDA ALERT [07/2006] – Possible Life- Threatening Serotonin Syndrome When Used With Triptan Medicines

A life-threatening condition called serotonin syndrome (serious changes in how your brain, muscles and digestive system work due to high levels of serotonin in the body) can happen when medicines called selective serotonin reuptake inhibitors (SSRIs), such as Zoloft, and medicines used to treat migraine headaches known as 5-hydroxytryptamine receptor agonists (triptans), are used together.  Signs and symptoms of serotonin syndrome include the following:

  • restlessness
  • hallucinations
  • loss of coordination
  • fast heart beat
  • increased body temperature
  • fast changes in blood pressure
  • overactive reflexes
  • diarrhea
  • coma
  • nausea
  • vomiting

Serotonin syndrome may be more likely to occur when starting or increasing the dose of an SSRI or a triptan.  This information comes from reports sent to FDA and knowledge of how these medicines work.  If you take migraine headache medicines, ask your healthcare professional if your medicine is a triptan.

Before you take Zoloft and a triptan together, talk to your healthcare professional.  If you must take these medicines together, be aware of the possibility of serotonin syndrome, and get medical care right away if you think serotonin syndrome is happening to you.

This information reflects FDA’s current analysis of data available to FDA concerning this drug. FDA intends to update this sheet when additional information or analyses become available.


FDA ALERT [07/2006] – Infant Persistent Pulmonary Hypertension

The results of a study that looked at the use of antidepressant medicines during pregnancy in  mothers of babies born with a serious condition called persistent pulmonary hypertension of the newborn (PPHN) were recently published in a medical journal.

Babies born with PPHN have abnormal blood flow through the heart and lungs and do not get enough oxygen to their bodies.  Babies with PPHN can be very sick and may die.

The study results showed that:

  • babies born to mothers who took selective serotonin reuptake inhibitors (SSRIs), the family of medicines Zoloft belongs to,
  • 20 weeks or later in their pregnancies,
  • had a higher chance (were 6 times as likely) to have persistent pulmonary hypertension (PPHN),
  • than babies born to mothers who did not take antidepressants during pregnancy.

The FDA plans to further look at the role of SSRIs in babies with PPHN.

Talk to your doctor if you are taking Zoloft and are pregnant or are planning to have a baby.  You and your doctor will need to talk about the best way to treat your depression during pregnancy. 

This information reflects FDA’s current analysis of data available to FDA concerning this drug. FDA intends to update this sheet when additional information or analyses become available.

What is Zoloft?

Zoloft is in a class of medicines called selective serotonin reuptake inhibitors (SSRIs).  Zoloft is used to treat:

  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder
  • Posttraumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PTSD)
  • Social anxiety disorder (SAD)

Who Should Not Take Zoloft?

Never take Zoloft if you are taking another drug used to treat depression, called a Monoamine Oxidase Inhibitor (MAOI), or if you have stopped taking an MAOI in the last 14 days. Taking Zoloft close in time to an MAOI can result in serious, sometimes fatal, reactions, including:

  • High body temperature
  • Coma
  • Seizures (convulsions)

MAOI drugs include Nardil (phenelzine sulfate), Parnate (tranylcypromine sulfate), Marplan (isocarboxazid), and other brands.

  • Never take Zoloft if you are taking Orap (pimozide), a drug used to treat Tourette’s disorder, because it can result in serious heart beat problems.

     
  • Never take Zoloft oral concentrate if you are taking Antabuse (disulfiram), used to treat alcoholism, because Zoloft oral concentrate contains alcohol.

What Are The Risks?

The following are the major potential risks and side effects of Zoloft therapy.   However, this list is not complete.

  • Possible life-threatening serotonin syndrome when used with triptan medcines:  See FDA Alert [07/2006] above.
     
  • Infant persistent pulmonary hypertension:  See FDA Alert [07/2006] above.
     
  • Suicidal thoughts or actions: Persons taking Zoloft may be more likely to think about killing themselves or actually try to do so, especially when Zoloft is first started or the dose is changed.  People close to persons taking Zoloft can help by paying attention to changes in user’s moods or actions.   Contact your healthcare professional right away if someone using Zoloft talks about or shows signs of killing him or herself.  If you are taking Zoloft yourself and you start thinking about killing yourself, tell your healthcare professional about this side effect right away.
     
  • Stopping Zoloft: Do not stop taking Zoloft suddenly because you could get side effects. Your healthcare professional will slowly decrease your dose.
     
  • Bleeding problems: Zoloft may cause bleeding problems, especially if taken with aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen), or other drugs that affect bleeding.
     
  • Mania: You may become unusually hyperactive, excitable or elated.
     
  • Seizures: You may experience a seizure (convulsion), even if you are not taking Zoloft close in time with an MAOI.
     
  • Weight loss:  Zoloft can cause weight loss.  Children who take Zoloft for a long time should have their growth and body weight measured regularly.
     
  • Pregnancy: Tell your healthcare professional if you are or may be pregnant (see FDA Alert [07/2006] above).  In addition to the issue described in the alert, babies delivered to mothers taking Zoloft late in pregnancy have developed problems, such as difficulty breathing and feeding.
     
  • Sexual problems: You may have problems with impotence (erectile dysfunction), abnormal ejaculation, difficulty reaching orgasm, or decreased libido (sexual desire).
     
  • Other side effects include nausea, diarrhea, difficulty sleeping, dry mouth, and sleepiness.

Tell your healthcare professional about all your medical conditions, especially if you have liver or heart disease.  Tell your healthcare professional if you are breast-feeding or plan to breast-feed your baby.

Are There Any Interactions With Drugs or Foods?

  • Zoloft may interact with medicines other than the ones already mentioned in this information sheet.  These interactions can cause serious side effects.  Tell your healthcare professional about all medicines, vitamins, and herbal supplements you take, especially those
    • that affect bleeding
    • used to treat anxiety, mental illness, depression, or heart problems
  • If you plan to drink alcohol, talk to your healthcare professional.

How Do I Take Zoloft?

  • Zoloft is taken by mouth, with or without food, once a day.
  • Dilute Zoloft oral concentrate, but only in ½ cup of water, ginger ale, lemon/lime soda, lemonade or orange juice.  Take immediately after mixing.  Tell your doctor if you are allergic to latex because the dropper to measure Zoloft oral concentrate contains natural rubber.

The purpose of this communication is to inform healthcare professionals about a change in the prescribing information for Zoloft ® (sertraline hydrochloride) tablets and oral concentrate. This change, made at the request of the Food and Drug Administration, articulates a pimozide/sertraline interaction and arises from the results of the study entitled, “Phase 1 Open Study Designed to Determine the Potential Interaction of Sertraline With Cisapride or Pimozide in Healthy Male and Female Subjects.”

Based upon these study results, the CONTRAINDICATIONS and PRECAUTIONS sections of the Zoloft prescribing information have been revised as follows (underlined text indicates new text):

CONTRAINDICATIONS
Concomitant use in patients taking monoamine oxidase inhibitors (MAOIs) is contraindicated (see WARNINGS). Concomitant use in patients taking pimozide is contraindicated (see PRECAUTIONS).

PRECAUTIONS—Drug Interactions—CNS Active Drugs
In a study comparing the disposition of intravenously administered diazepam before and after 21 days of dosing with either ZOLOFT (50 to 200 mg/day escalating dose) or placebo, there was a 32% decrease relative to baseline in diazepam clearance for the ZOLOFT group compared to a 19% decrease relative to baseline for the placebo group (p<0.03). There was a 23% increase in Tmax for desmethyldiazepam in the ZOLOFT group compared to a 20% decrease in the placebo group (p<0.03). The clinical significance of these changes is unknown.

In a placebo-controlled trial in normal volunteers, the administration of two doses of ZOLOFT did not significantly alter steady-state lithium levels or the renal clearance of lithium.

Nonetheless, at this time, it is recommended that plasma lithium levels be monitored following initiation of ZOLOFT therapy with appropriate adjustments to the lithium dose.

In a controlled study of a single dose (2 mg) of pimozide, 200 mg sertraline (q.d.) co-administration to steady state was associated with a mean increase in pimozide AUC and Cmax of about 40%, but was not associated with any changes in EKG. Since the highest recommended pimozide dose (10 mg) has not been evaluated in combination with sertraline, the effect on QT interval and PK parameters at doses higher than 2 mg at this time are not known. While the mechanism of this interaction is unknown, due to the narrow therapeutic index of pimozide and due to the interaction noted at a low dose of pimozide, concomitant administration of ZOLOFT and pimozide should be contraindicated (see CONTRAINDICATIONS).

The risk of using ZOLOFT in combination with other CNS active drugs has not been systematically evaluated. Consequently, caution is advised if the concomitant administration of ZOLOFT and such drugs is required.

There is limited controlled experience regarding the optimal timing of switching from other drugs effective in the treatment of major depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, and premenstrual dysphoric disorder to ZOLOFT. Care and prudent medical judgment should be exercised when switching, particularly from long-acting agents. The duration of an appropriate washout period which should intervene before switching from one selective serotonin reuptake inhibitor (SSRI) to another has not been established.

Zoloft was launched in 1992 for the treatment of major depressive disorder. It is also approved for the treatment of panic disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). It has been shown to be safe in the long-term treatment of pediatric OCD. Zoloft is the only SSRI approved for the long-term treatment of PTSD. Over the past decade, Zoloft has been used for more than 10.2 billion patient days of therapy worldwide.*

We trust this information is useful in providing guidance on the appropriate use of sertraline concomitantly with pimozide.

Sincerely,

Cathryn M. Clary, MD
Senior Medical Director
Medical and Scientific Affairs
Pfizer Inc.

 

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