How is Zoloft Used in the Treatment of Social Anxiety Disorder?

Zoloft and Anxiety

A bottle of antidepressant pills named Zoloft March 23, 2004 photographed in Miami, Florida. The Food and Drug Administration asked makers of popular anti-depressants to add or strengthen suicide-related warnings on their labels as well as the possibility of worsening depression especially at the beginning of treatment or when the doses are increased or decreased.
Joe Raedle/Getty Images

Zoloft is the brand name of the generic medication sertraline hydrochloride. Zoloft is a prescription medication used to treat depression, anxiety disorders, and other serious mental health problems.

Manufactured by Pfizer, Zoloft has been approved by the Food and Drug Administration (FDA) for the treatment of social anxiety disorder (SAD) since 2003, and is the only medication approved for long-term treatment.

A selective serotonin reuptake inhibitor (SSRI), Zoloft slows reabsorption of the chemical serotonin in the brain. Serotonin is believed to play a role in the regulation of mood and anxiety.

How to Take Zoloft:

Zoloft comes in tablet or liquid form. You must swallow the tablets whole -- not chewed or crushed.

You must combine the liquid form of Zoloft with one of the following before use: water, ginger ale, lemon-lime soda, lemonade or orange juice. Combine the prescribed amount of medication with one half cup of the chosen liquid, and be sure to prepare each dose immediately before you take it, not in advance.

In general, Zoloft is taken once daily, with or without food. If you forget to take a daily dose, take it when you remember. However, if it is close to the time of your next dose, it is better to skip the missed dose altogether.

It is important to continue taking Zoloft as long as your doctor instructs, even if you begin to feel better.

If you abruptly stop taking Zoloft, you may experience withdrawal symptoms such as nausea, tremors, lightheadedness, muscle pains, weakness, insomnia, and anxiety. To avoid these symptoms, your doctor will slowly taper your dosage when you stop taking Zoloft.

Dosage Guidelines:

For people with SAD, typical dosage of Zoloft starts at 25 mg, with an increase to 50 mg after one week.

Weekly increases up to a maximum dose of 200 mg are permitted for patients who do not respond to lower doses.

Who Shouldn't Take Zoloft:

Zoloft should be used with caution if you:

  • have impaired liver or kidney function, heart disease, diabetes, or a history of seizures
  • have bipolar disorder or a family history of bipolar disorder
  • are pregnant or planning to become pregnant
  • are breastfeeding
  • are allergic to sertraline
  • are being treated with medication for alcohol abuse

Zoloft has not been approved for the treatment of SAD in people under 18 years of age. There is some evidence to suggest an increased risk of suicidal thoughts and behaviors in children taking Zoloft.

Medication Interactions:

Zoloft should not be taken in combination with, or within weeks of taking monoamine oxidase inhibitors (MAOIs). Use of Zoloft with pimozide is contraindicated.

Use caution when taking a number of other medications in combination with Zoloft. Consumption of alcohol is also not advised while taking Zoloft. In general, you should tell your doctor about any prescription or over-the-counter medications, or any other substances that you are taking or plan to take.

Side Effects:

Side effects of Zoloft may include nausea, drowsiness, sweating, dizziness, dry mouth, diarrhea, decreased appetite, sexual dysfunction and insomnia.

When first starting Zoloft, or when changing dosage, watch for more serious side effects such as agitation, nervousness, suicidal thoughts and behaviors, tremors, seizures, persistent vomiting or nausea, severe abdominal pain, changes in urine or stools (dark or increased urine, black stools), or yellowing of the eyes or skin. If you experience any of these symptoms, be sure to report these to your doctor right away.

It is also important to contact your doctor right away if you experience symptoms of a serious allergic reaction such as trouble breathing, severe dizziness, swelling, itching, or a skin rash.

Zoloft may make you feel drowsy and less alert. It is important not to drive, operate dangerous machinery, or participate in hazardous activities unless you are sure that Zoloft is not affecting you in this way.

Associated Risks:

The risk of a fatal overdose of Zoloft is low. Symptoms of an overdose include dizziness, drowsiness, nausea, vomiting, increased or slow heart rate, and coma.

When combined with some medications, there is risk of Serotonin Syndrome, a potentially fatal condition. Symptoms of Serotonin Syndrome include agitation, confusion, sweating, hallucinations, abnormal reflexes, muscle spasms and rapid heartbeat.

Other Anxiety Medications

Sources:

Bezchlibnyk-Butler KZ, Jeffries, JJ, eds. Clinical Handbook of Psychotropic Drugs. Toronto, Canada: Hogrefe & Huber; 2003.

Pfizer. Zoloft: Tablets and Oral Concentrate. Accessed January 17, 2016.

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