Zoloft is a selective serotonin reuptake inhibitor primarily used as an antidepressant. It acts through increase of the serotonin amount. Its effect starts in about a week after first intake. It can be prescribed for patients with major depression of different etiology, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), anxiety disorders, panic disorder, social phobia (social anxiety disorder), bulimia, nervous anorexia, chronic pain syndrome and for depressive episode prophylaxis.
Up to 30% of patients taking Zoloft experience side effects. The most common side effects are:
Gastro-intestinal side effects: loss or increased appetite, anorexia, weight loss or gain, eructation, nausea, vomiting, dyspepsia, dysphagia, esophagitis, gastroenteritis, stomach pain, diarrhea or constipation.
Neurological side effects: headache, dizziness, migraine, abnormal weakness, drowsiness or sleep problems, nightmares, mood and behavior changes (apathy, irritability, aggressiveness, panic attacks, anxiety, hostility, exaggerated feeling of well-being, depressiveness, hyperactivity), memory problems, rigid muscles, loss of coordination, hypoesthesia or hyperesthesia, facial paresthesia, yawning, overactive reflexes, abnormal gait, leg cramps, myalgia and myoclonic jerking, tremor, ringing in the ears (tinnitus), abnormal accommodation, mydriasis, nystagmus
Urogenital side effects: decreased bladder control, urinary retention, polyuria, nocturia, dysuria, decreased sex desire and impotence, persistent or painful erection (priapism), abnormal ejaculation, difficulty having an orgasm/ anorgasmia, dysmenorrhea (up to amenorrhea), leucorrhea.
General side effects: increased salivation, dry mouth, flu-like symptoms (rhinitis, sinusitis, epistaxis, pharyngitis, cough, dyspnea, high fever, rigours, hot flushing, sweating), conjunctivitis, eye pain, periorbital edema
Skin side effects: dry skin, pruritus, acne, alopecia, erythematous or maculopapular rash
Like any other medicine, Zoloft can cause allergic reactions – rash, urticaria, itching, difficulty swallowing or breathing, tightness in the chest, swelling of the mouth, hands, eyes, face, lips, tongue and throat, unusual hoarseness, angioedema, anaphylaxis, anaphylactic shock and anaphylactoid reactions. These reactions are serious and require urgent medical help.
Rare side effects
In rare cases, Zoloft can cause such side effects as seizures, increased odds of a hip fracture, akathisia (in patient with an AV malformation), somnambulism, hyperacusis, dysphonia, speech difficulties, hiccup, irritation of the nasal passages, photophobia, ptosis, exophthalmos, xerophthalmia, visual field defect, diplopia, abnormal lacrimation, anterior chamber eye hemorrhage, blindness, glaucoma, acne, eczema, dermatitis, bullous eruption, hypertrichosis, photosensitivity, skin discoloration, pustular rash, laryngitis, stomatitis, glossitis, gum hyperplasia, teeth-grinding, gastritis, colitis, proctitis, tenesmus, muscle pain, arthralgia, arthrosis, cystitis, pyelonephritis, increased libido, breast pain in women, balanoposthitis, atrophic vaginitis, gynecomastia, acute mastitis in women, vaginal hemorrhage, galactorrhea.
Changes in laboratory tests
Zoloft may also cause some changes in laboratory tests. So keep in mind that the drug can cause such abnormalities in your blood as anemia, agranulocytosis, leukopenia, thrombocytopenia, increased coagulation time, asymptomatic elevations of the hepatic enzymes levels (alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase), total cholesterol, triglycerides and HDL cholesterol, and/or LDL cholesterol elevation, hyponatremia, hypoglycemia, hyperglycemia, hypothyroidism, hyperprolactinemia and decrease in serum uric acid can be due to Zoloft intake. Blood may also be found in your stool and urine.
Serious side effects
Zoloft may cause some very serious side effects that may require urgent medical help.
As it is a drug, which mainly acts in the brain, the biggest part of serious side effects is neurological. This includes suicidal thoughts and behavior, worsening of depression, extrapyramidal symptoms, hallucinations, seizures, coma, activation of mania in patients with bipolar disorder, optic neuritis.
Cardio-vascular problems that may develop due to Zoloft intake include pulmonary hypertension, arrhythmias, angina pectoris, myocardial infarction, worsening of the hypertention, palpitations, peripheral ischemia, vasculitis.
Pulmonary serious side effects: hyperventilation, hypoventilation, shallow breathing or breathing stop (apnea), bradypnea, stridor, hemoptysis (bloody sputum due to pulmonary bleeding).
Gastro-intestinal serious side effects: pancreatitis, hepatitis, liver failure, aphthous or ulcerative stomatitis, hemorrhagic peptic ulcer, rectum hemorrhage, melena (black stool due to upper gastrointestinal bleeding).
General serious side effects: septic shock due to agranulocytosis, hypoglycemic reaction, Stevens-Johnson syndrome
Besides, discontinuation of Zoloft can lead to the development of withdrawal syndrome. It can manifest as dizziness, fever, insomnia, lethargy, paraesthesia, nausea, abdominal cramps, vivid and bad dreams, irritability, emotional lability and lowered mood
Side effects in pregnant women
In women in their first trimester of pregnancy, Zoloft intake can raise the possibility of birth defects (omphalocele, anal atresia, limb reduction defects, and septal defects).
Side effects in children
Besides the other adverse reactions common in adults, children may develop such side effects as hyperactivity, aggressiveness, fever, sinus inflammation, bloody nose, purpura, urinary incontinence.
You may never experience any of the side effects listed above. and your doctor cannot predict your body’s reaction to Zoloft until you have tried it. Therefore, you should immediately inform your doctor of any changes in your health condition after taking the drug. So when you feel something is wrong, consult your doctorand he or she will diagnose if your problem is connected with medicine intake. You should also be carefulbecause some of the side effects of Zoloft require urgent medical help. It is also important not to stop intake of Zoloft suddenly because it can cause side effects and worsening of your symptoms