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Zoloft (Sertraline)

  • Generic name: Sertraline HCL
  • Trade names: Zoloft, Lustral
  • Drug class: Selective serotonin reuptake inhibitor
  • Dosages: 25 mg, 50 mg, 100 mg tablets
  • Manufacturer: Pfizer Inc.
  • FDA Approved: December 30, 1991


Zoloft (Sertraline hydrochloride) is in a class of antidepressants called selective serotonin reuptake inhibitors. There is a solid evidence for choosing sertraline as the first antidepressant when treating depression.

This medication is approved to treat depression, social anxiety, posttraumatic stress disorder (PTSD), panic disorder, obsessive-compulsive disorder (OCD), and premenstrual dysphoric disorder (PMDD). It is also approved for OCD in children and adolescents age 6-17 years.

Distinguishing features of Sertraline

One of the differences of sertraline from other SSRIs is its relative potency for dopamine reuptake inhibition.

Sertraline has lower potential for drug interactions involving cytochrome P450 enzymes than other SSRIs, so it may be a useful choice for elderly people who are taking a variety of other medicines.

There are reports in over 20 cases of the use of sertraline in mothers who are breast-feeding with no evidence of an increased risk to the baby. Although the usual caution concerning prescribing for lactating mothers needs to be observed, sertraline should be considered if SSRI treatment is necessary.

And now the analysis of Zoloft (sertraline) vs other SSRI antidepressants.

Zoloft versus Paxil (Paroxetine)

Delusional depression
Zoloft beats Paxil in depression with psychotic features. European trial comparing sertraline vs paroxetine for delusional depression found response rates to sertraline to be higher (75%) than those to paroxetine (46%).

Panic disorder
Paroxetine and sertraline are equally effective in panic disorder. But paroxetine is associated with more clinical worsening during tapering.

A well-designed study of SSRI treatment for clinical depression in primary care settings found that paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft) were equally effective for the treatment of depression.

Both paroxetine and sertraline appear similarly effective for generalized anxiety disorder.

Side effects
Paxil compares unfavourably with Zoloft, in terms of side effects and tolerability.

You are more likely to put on extra pounds on Paxil. Paroxetine provokes more delay of orgasm and ejaculation and impotence than sertraline does. Furthermore, withdrawal symptoms are significantly more frequent with paroxetine than with other SSRIs.

Zoloft versus Prozac (Fluoxetine)

The analysis of many clinical studies showed that Sertraline is more effective for the treatment of depression than fluoxetine (Prozac), with a 1.4 times higher probability of response, and is better tolerated [1]. The greatest advantage of sertraline over fluoxetine was seen among patients with melancholia and severe depression and low anxiety [2].

Sertraline is superior to fluoxetine in improving cognitive function in depressed elderly. In the comparative study of fluoxetine and sertraline, although both SSRIs had equivalent antidepressant efficacy, the older depressed patients on sertraline showed significant improvement in digit-symbol substitution and shopping-list tasks.

Obsessive-compulsive disorder (OCD)
Sertraline generally has an earlier onset of effect than fluoxetine in the treatment of obsessive-compulsive disorder [3]. Also, sertraline yields a greater likelihood of remission.

Side effects
Fluoxetine is more stimulating, causing agitation, irritability, daytime restlessness, and nighttime insomnia. Sertraline causes more dyspepsia, somnolence, and diarrhea.

  • 1. Cipriani A, Brambilla P, Furukawa T, Geddes J, Gregis M, Hotopf M, Malvini L, Barbui C. Fluoxetine versus other types of pharmacotherapy for depression. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004185.
  • 2. Flament MF, Lane RM, Zhu R, Ying Z. Predictors of an acute antidepressant response to fluoxetine and sertraline. Int Clin Psychopharmacol. 1999 Sep;14(5):259-75.
  • 3. Bergeron R, Ravindran AV, Chaput Y, et al. Sertraline and fluoxetine in obsessive-compulsive disorder: results of a double-blind, 6-month treatment study. J Clin Psychopharmacol. 2002 Apr;22(2):148-54.

  • There is evidence that sertraline may be effective in the treatment of refractory neurocardiogenic syncope in children and adolescents.
  • A study has shown that Zoloft is an effective treatment for impulsive aggressive behavior in personality disordered patients.

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