Zoloft (Sertraline) for the Treatment of Depression

What is Zoloft?

Zoloft, generic name sertraline, is an anti-depressant medication. Sertraline is approved to treat depression, panic attacks, obsessive compulsive disorders, post-traumatic stress disorder, social anxiety disorder (social phobia), and other conditions.

Zoloft is classified as a type of drug known as Selective Serotonin Reuptake Inhibitors (SSRIs). It positively affects chemicals that exist in the brain and that may be unbalanced in people with depression, anxiety, or other similar diseases.

Zoloft comes as a tablet or a liquid to be taken by mouth once daily, and should be taken at the same time every day. It may take a few weeks or longer before the full benefit of Zoloft is noticed.

What are the side effects?

Zoloft side effects are usually not severe, and typically decrease with continued treatment. The most common Zoloft side effects are gastrointestinal disturbances such as nausea and diarrhea. Sexual problems are fairly common in both men and women. Fluctuations in weight are not uncommon if Zoloft is effectively treating depression. Individuals, who have atypical depression, may have a decreased appetite and lose weight, while individuals who have classic symptoms of depression may see slight increases in their weight, as their appetite returns. Rarely, severe Zoloft side effects can occur, which can be due to an allergic reaction, or if an individual is prescribed multiple antidepressants that have similar effects on serotonin. High levels of serotonin, called serotonin syndrome, can cause erratic behavior, vomiting and dizziness, which requires prompt medical attention.

How long does it take for Zoloft to work?

Appetite and sleep energy may get improved in one or two weeks of Zoloft usage while depressive disorders may get resolved in six to eight weeks of usage. How long does Zoloft take to work is usually subjective.

Other Options for Depression

Zoloft is not the only choice for treating depression. There are several different types of SSRI's, and if these don't work there are other types of anti-depressants. Talk therapy, with a psychologist, therapist, or social worker, is also an option.

Selective Serotonin Reuptake Inhibitors (SSRIs) for Depression

SSRIs are the most widely prescribed type of antidepressants. They're usually preferred over other antidepressants, as they cause fewer side effects. An overdose is also less likely to be serious. Fluoxetine is probably the best known SSRI (sold under the brand name Prozac). Other SSRIs include Citalopram (Celexa), Cipralex (Escitalopram) and Zoloft (Sertraline).

How SSRIs Work

Medicines known as reuptake inhibitors increase the amount of particular neurotransmitters in the brain by preventing unused neurotransmitters from moving back into the pre-synaptic neuron. Selective serotonin reuptake inhibitors, or serotonin-specific reuptake inhibitors - as they are also known - increase the amount of the neurotransmitter serotonin in the brain. Serotonin has many roles in the body, including the regulation of your appetite, your sleeping patterns, your body temperature and your memory. It also plays a primary role in regulating your mood, which is the main reason why supplemental serotonin, the most common form of antidepressant, is prescribed for people experiencing anxiety or depression. People of both the male and female gender with anxiety disorders exhibit lower levels of serotonin than normal.

How effective are SSRI antidepressants?

About 5-7 in 10 people with moderate or severe depression have an improvement in symptoms within a few weeks of starting treatment with an antidepressant. However, up to 3 in 10 people improve with dummy tablets (placebos), as some people would have improved in this time naturally. So, if you have depression, you are roughly twice as likely to improve with an antidepressant compared with taking no treatment. But, they do not work in everybody. As a rule, the more severe the depression, the greater the chance that an antidepressant will work well.

People who should take extra care with SSRIs
Make sure you tell your doctor if you have, or have had in the past, any of the following conditions (you might need to take extra precautions, or another medicine might be more suitable):
- epilepsy or reduced seizure threshold
- bipolar disorder
- stomach bleeding
- liver problems
Get advice about the risks of taking antidepressants, directly from your doctor or from a specialist information line, if you are pregnant, breastfeeding or thinking about becoming pregnant.

When to take a sleeping pill for insomnia?

Insomnia is defined as difficulty falling asleep, difficulty staying asleep, or waking up early in the morning and not being able to return to sleep. In general, people with insomnia sleep less or sleep poorly despite having an adequate chance to sleep. The poor sleep causes difficulty functioning during the daytime. Insomnia is not defined by the number of hours slept because the amount of sleep needed varies from one person to another.

In many cases, insomnia occurs when there is another problem, such as stress, pain, or a medical condition. In these cases, treatment of the underlying problem may help to improve sleep. In other cases, either the cause of insomnia is not clear or the insomnia does not get better when the co-existing problem is treated; therefore, the insomnia itself needs to be specifically addressed.

Sleeping pills can be an effective treatment for chronic insomnia. But like any other drug, sleep medications can have side effects. One potential side effect of sleeping pills is daytime drowsiness.

Sleep medications are powerful hypnotics. They can be helpful because they cause a strong urge to sleep. But you don’t want this sleepiness to persist after you wake up. 

One way to minimize the risk of daytime drowsiness is to take a sleeping pill at the right time of night. Most sleeping pills – such as Zolpidem (Ambien) or Zimovane (Zopiclone) - should be taken right before you get in bed. 

You should only take these sleeping pills when you are able to get a full night of sleep. This means that you should take the medication at least seven to eight hours before you need to wake up. 

In every case you should follow your doctor's advice with regard to medication – starting, changing or finishing a course of medication can have serious effects. Ensure that you consult your GP if you have any questions on this.

Depression and the Elderly

Depression is a mental health condition. It is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with daily life for weeks or longer.

Depression in older adults is a widespread problem, but it is not a normal part of aging. It is often not recognized or treated.

Major depression (also known as clinical depression) is a medical illness. It is a chemical imbalance in the brain and can appear in people regardless of age, race or economic status. The illness can appear after a triggering event or for no apparent reason at all.

Depressive symptoms that occur in the older patient are similar to the symptoms in younger adults.

Signs & Symptoms

- Constant “blue” or sad mood that does not improve even with happy occurrences

- Reduced total sleep time

- Frequent waking during the night

- Frequent physical complaints (example: stomachaches, headaches, dizziness, and/or joint pain that does not respond or responds inconsistently to treatment, despite a thorough medical evaluation and therapy)

- Increased fatigue or lack of energy

- Decreased interest in usual pleasurable activities

- Withdrawal from social interaction · Hopelessness

- Thoughts of suicide

- Decreased appetite

- Guilt or preoccupation with past events

- Decreased concentration and/or increased forgetfulness

- Irritability

- Frequent tearfulness or crying without an obvious precipitating event.

A complete physical examination to rule out other problems is critical before a diagnosis of depression is made. A complete physical examination to rule out other problems is critical before a diagnosis of depression is made. Other physical diseases (Parkinson's, multiple sclerosis, diabetes, thyroid disorders, certain viral infections, strokes, tumors) and certain medications (steroids, hormones, blood pressure and arthritis medications) used to treat those illnesses can mimic the symptoms depression; they can cause a chemical imbalance in the brain. Therefore, a thorough exam is extremely important, as well as a complete medical history and list of medications currently being taken (both over-the-counter and prescription drugs). Family history of depressive illness should also be noted, due to the genetic component of brain illnesses.

Antidepressants For Anxiety Disorders

Depression and anxiety are two separate disorders. They are related in some ways - there is a high comorbidity between anxiety and depression, indicating that they have something in common - but they're technically different disorders that cause different symptoms and require different treatments.

There are a number of different medications that are currently used to treat anxiety disorders. Antidepressants, although originally intended to treat depression, have been found to be effective in relieving symptoms of anxiety. Medication does not “cure” anxiety. While some people may not feel relief from anxiety symptoms and some may not be able to tolerate side effects, the majority of people do find relief from the debilitating impact of anxiety in their lives.

There are a number of antidepressant medications on the market today used to treat different types of anxiety:

- Selective Serotonin Reuptake Inhibitors (SSRI) Examples include Lexapro (Escitalopram), Celexa (Citalopram), Fluox (Fluoxetine), and Zoloft (Sertraline).

- Serotonin-Norepinephrine Reuptake Inhibitors (SNRI) Examples include Cymbalta and Effexor.

- Tricyclic Antidepressants Examples include Adapin, Anafranil, and Elavil.

- Monoamine Oxidase Inhibitors (MAOI) Examples include Aurorix, and Emsam.

While the drugs themselves are all different, they all affect the serotonin system in the body. There is little medical reason to choose one over another. Most often, a doctor will choose based on their own personal preference, the history of side effects, the allergies of the person with anxiety, other medications, etc.

It should be noted that antidepressants can also take weeks to work and do not always affect everyone. Doctors may prefer a different course of treatment to provide immediate relief or to benefit those with a different type of anxiety disorder.

Treat anxiety disorders with Atarax (Hydroxyzine)

Atarax (Hydroxyzine) is an antihistamine drug that is sometimes used to treat generalized anxiety or panic disorders. Taking Atarax (Hydroxyzine) for anxiety is generally very effective in the short-term, but it is not a good long-term solution due to its high incidence of side effects, especially sedation. Hydroxyzine is more effective when taken on a regular schedule, but may also be taken as needed.

Like other antihistamines, Atarax (Hydroxyzine) works by slowing the body's central nervous system, which in turn reduces fight-or-flight responses like rapid heart rate, halts the onset of a panic attack, and relieves general anxiety. It tends to take effect very quickly and wears off within six to eight hours. Hydroxyzine is generally prescribed at doses of 25 to 100 milligrams up to four times a day, but many patients prefer to take it only as needed. Patients should not take this medication at a higher dose or more often than was recommended by a healthcare professional. They also should not stop taking it without first consulting the professional who prescribed it.

Taking Atarax (Hydroxyzine) has advantages over other sedative treatments, such as Alprazolam, for some patients. Unlike Alprazolam, Atarax (Hydroxyzine) is not habit-forming, and very few patients build up a tolerance to it. The effects, however, are not as strong as those of some other medicines.

As with other anti-histamine drugs, taking Atarax may cause one to be dizzy and sleepy even after several hours from intake. Some people may also get blurry vision and so many doctors advise that those taking this drug must not drive a vehicle or handle machines that require alertness and full attention. This drug can also have adverse interactions with other drugs and so it is best to fully discuss with doctors what other drugs one is taking and/or what other medical concerns are being experienced or treated.

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Why Antidepressants Take So Long To Work?

A common treatment for clinical depression is a type of medication called an antidepressant. Antidepressants come in a variety of forms, but all of them work by impacting certain neurochemicals in your brain, such as serotonin and norepinephrine. Antidepressants are most commonly prescribed by a psychiatrist, but may also be prescribed by a family physician or general practitioner to treat depression.

Antidepressants do not work immediately for many individuals hoping to get relief from their depression symptoms. In fact, the general consensus is that they take 4 to 6 weeks to kick in and for the antidepressant effect to take place. This basically means that most people should not get any relief from their depression until about a month into treatment.

Below are some factors that may influence the ability of an antidepressant to work immediately.

Reasons why antidepressants take so long to start working / kicking in

1. Low dose – Taking a low dose of an antidepressant may be part of the reason that it hasn’t kicked in yet. Many times it is actually a good idea to start low and work your way up via a process called titrating. So if you are in the early stages of titrating your medication upwards, the reason that it’s taking longer for you to feel the effects is due to the strength (usually in milligrams) of the dosage that you are taking.

2. Out of shape – If you are a bigger individual, out of shape, or bigger, any drug is usually going to take longer to kick in. This is simply because you have more mass and more overall body for the drug to be distributed. Additionally, the fact that you are out of shape may result in you having a slower baseline metabolism in comparison to someone who is in good shape and works out. Therefore the drug may not be cycling through your body at as quick of a rate for you to feel the effects.

3. Other drugs – If you do other drugs, you may not be able to feel the effects of the antidepressant medication compared to people that are pure (i.e. not doing anything else). Other drugs can affect brain chemistry as well as other bodily functions and change your natural homeostatic state of functioning. If you don’t do other drugs, the likelihood is greater that you will feel an antidepressant sooner than someone who gets a buzz from other substances.

4. Alcohol – Drinking alcohol is a personal preference and many people do it to socialize. At the same time, many individuals don’t realize that it does affect mental performance and cognition. It can increase irritability and slow mental performance in certain situations even far after the alcohol has been consumed.

5. Chemistry – How your body reacts to the drug has a lot to do with your chemistry. One antidepressant may work well for your friend, but not for you. Additionally, something that works within the first week for one person may take another 3 weeks. A lot of this has to do with how your body responds to the medication.

Treat Symptoms of ADHD with Tomoxetin (Atomoxetine) 25 Mg

Tomoxetin (Atomoxetine) is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). Atomoxetine is classified as a norepinephrine reuptake inhibitor, and is approved for use in children, adolescents, and adults. However, its efficacy has not been studied in children under six years old. Its advantage over stimulants for the treatment of ADHD is that it has less abuse potential than stimulants, is not scheduled as a controlled substance and has proven in clinical trials to offer 24 hour coverage of symptoms associated with ADHD in adults and children.

Tomoxetin effectively treats symptoms of adult ADHD and can help:

- Focus your attention

- Listen more easily to what others are saying

- Be less forgetful in daily activities

- Concentrate and be less distracted

- Better organize tasks and activities

- Start and finish projects

Tomoxetin works differently from the other ADHD medicines available. The advantage of Tomoxetin over stimulants for the treatment of ADHD is that it has less abuse potential than stimulants, is not scheduled as a controlled substance and has proven in clinical trials to offer 24 hour coverage of symptoms associated with ADHD in adults and children.

Common side effects

Decreased appetite, Irritability, Increased blood pressure, Itching of skin, Mood swings, Indigestion, Nausea, Depression and depressed mood, Abdominal pain, Vomiting, Insomnia, Red and itchy skin, Decreased weight, Tics, Constipation, Loss of appetite, Dizziness, Sleepiness, Anxiety, Rash, Mydriasis, Agitation, Headache, Increased heart rate.

Contraindications

Contraindications include:

- Hypersensitivity to atomoxetine or any of the excipients in the product

- Symptomatic cardiovascular disease including: moderate to severe hypertension, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, ventricular flutter, advanced arteriosclerosis.

- Severe cardiovascular disorders

- Concomitant treatment with monoamine oxidase inhibitors

- Narrow angle glaucoma

Men and Depression

Depression is an illness that affects both men and women. But people working in mental health services see far fewer men with depression. It seems likely men suffer from depression just as often as women, but they are less likely to ask for help. Male depression is treatable and best treated as early as possible. 

Signs and symptoms of depression in men

Depression has a number of signs and symptoms. Men are each affected in different ways, but three of the most common signs are pain, risk taking, and anger.

Pain. 

Depression may show up as physical signs like constant headaches, stomach problems, or pain that doesn’t seem to be from other causes or that doesn’t respond to normal treatments.

Risk Taking. 

Sometimes depressed men will start taking risks like dangerous sports, compulsive gambling, reckless driving, and casual sex.

Anger. 

Anger can show itself in different ways like road rage, having a short temper, being easily upset by criticism, and even violence. 

Here are some other common signs, especially if they last for a few weeks or months: feeling guilty, worthless, or that you always fail; feeling restless and/or irritable; having no energy; problems sleeping (not sleeping or sleeping too much); feeling angry or violent; feeling like you can’t work or get things done; using alcohol or drugs to feel better; sexual inability; losing interest in hobbies, work, and/or sex; having problems focusing, remembering, or making choices; always feeling sad or nervous; feeling alone; being negative about everything; thinking about death or suicide.

Treatments for depression

There are effective treatments for depression. In fact, more than 80% of men respond to treatment for depression. Your primary care doctor or a psychiatrist can create a treatment plan for you. That plan for treating depression may include:

- Antidepressants. The medicines most often used for depression treatment today are selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These antidepressants increase the levels of specific chemicals in the brain.

- Talk therapy. Many kinds of psychotherapy or talk therapy are effective in treating depression. Cognitive therapy, also called cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and "insight-oriented psychotherapy" are frequently used.