Talk:Sertraline

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[edit] Dates

Something is innacurate about this article- it says that Brittain banned zoloft for use in minors in 2003 in one part of the article and 2004 in another. It also says that it was only approved for use in minors in the USA in 2003- This needs to be double checked. --72.19.81.122 02:10, 21 September 2006 (UTC)

[edit] Generic Side Effects Versus Name Brand

Interesting fact: When I last had my prescription renewed by my doctor (a few months ago), she advised me that although there was now a generic for Zoloft available, I shouldn't switch to it unless there's a critical need. She stated that she's experienced with several other patients that the generic does not always have the same effects as the name brand, despite the fact that they should be the same. When I brought this up with my mother, who had recently made the switch to the generic without her doctor advising her of these potential side effects (reducing the potential for suggestion-induced placebo), she confirmed that the effects were not the same when switching to the generic. Additionally, she mentioned that the generic has a different coating, such that it starts melting on the tongue, causing a bad taste as opposed to the name brand of Zoloft. This does not seem to be relegated simply to generic Sertraline, either; I have hearsay evidence that for some people, the generic of Levoxyl (Levothyroxine) functions differently versus the name brand as well.


Another client remarks: I totally agree that the generic 100 mg Sertraline DOES NOT WORK the same as Zoloft. I switch from Zoloft about 2 months ago and have started a down-hill slide towards depression. It wasn't until thismorning that it dawned on me when this started. I called my pharmacist and told him I no longer wanted the Sertraline, I want the regular Zoloft because it works for me. Even though I can't really afford the double in price -- what are my options? Suicide is NOT AN OPTION!

This is supposed to be a forum for discussion of the article, not the subject, but that aside... I've heard stuff before about the generic being different from the name brand. This page at Crazymeds.org, while casual in tone and written by a non-professional, has links to some laws and studies about differences in bioavailability of brand and generic meds (in the US, a generic is allowed to be up to 20% more or less bioavailable than the brand name drug). I think it's important to note that while a brand and a generic may (or may not) be different, it's possible that for some people the generic will work better. Also, for some drugs (sertraline only went off patent recently, so I'm not sure about it) there are multiple manufacturers of generics, so you can try asking your pharmacist if you can switch to a different one. Failing that, I guess you could try a different SSRI that's cheaper (fluoxetine/Prozac and paroxetine/Paxil are both available in generic form in the US), or see if your doctor has samples of Zoloft or another SSRI. Good luck. --Galaxiaad 00:57, 8 February 2007 (UTC)

Hello, I am a long time contributor to wikipedia but this is my first post to a discussion forum as a registered user, so I apologize for not using correct formatting and style etc. My concern in this wiki is the lack of sources behind sources. Are there an experts on the subject that are willing to contribute? —The preceding unsigned comment was added by Christopher.hawken (talk • contribs).

There are several people having serious effects from the generic versions of Zoloft (Teva, Greenstone) since taking them. See

http://www.topix.net/forum/business/healthcare/T7R9P0NFHGN871B8J/

[edit] Random Comments

In the section concerning side effects: the part about increased incidence of suicidal thoughts and behaviour being questionable does not seem to be accurate. That data was assembled from double-blind tests where some depressed people (of various degrees of severity) were given Sertraline and others were given placeabos. It was found that while both groups exhibited a higher rate of suicidal behavior / actual suicides than the general population, the group taking Sertraline had a rate of suicide that was higher, and by a statistically significant margin. For this reason, physicians have been urged by the US's FDA to exercise caution when considering the prescription of Sertraline (and indeed all SSRI's) to patients who are exhibiting suicial thought patterns and/or who have a history of attempting and/or threatening to kill themselves (and/or others.) It is not known how or why these patients are apparantly made more suicidal when taking SSRI's, but some people have suggested that it may have to do with the way different individuals metabolize the SSRI's. It does not seem to be the case that a person who has a history of depression but no history of suicidal behaviour becomes more likely to exhibit such behaviours while taking SSRI's. -Random Bloke

Question for Random Bloke: How do you suppose a chemical can put complex thoughts ( commit suicide, write a novel, dance the rhumba, whatever ) into a patient's mind? Considering whether or not that seems possible might lend weight to the answer of whether this is a statistical hiccup or not. FireWeed 23:18, 22 January 2007 (UTC)
I don't think he's saying it can put the thoughts in there; as I understand some of the current thinking, the Sertraline may enable previously-unmotivated folks to act on suicidal thoughts that have been lingering for a long time, unacted upon.

Apart from their self esteem being shot to shit when they read up on the drugs they have become dependent on. No one seems to realise how FUCKING HORRIBLE it is to be on a drug that makes you dizzy, takes away your ability to orgasm, gives you heart palpitations and pins and needles and muscle twitches, but DOESN'T actually make you better. And then when you go off the drug all of it gets worse. And then they tell you it's non-addictive and you're overreacting and you should TAKE MORE. Fuck that! Ragnarokmephy 03:04, 22 January 2007 (UTC)

Have you ever considered that your experience isn't representative? I'm really sorry you have suffered through all this. Josephgrossberg 16:11, 22 January 2007 (UTC)
Yeah. I react pretty badly to this drug. The problem is a lot of doctors are so wrapped up in "man this chemical receives good feedback from Test Group A" they ignore the guy in Test Group B who's still curled in the foetal position listening to Hawthorne Heights. (ew) Ragnarokmephy 05:33, 24 January 2007 (UTC)

[edit] Talk

How come someone keeps deleting the article in external links that is a full-text medical article on how Zoloft.com provides misleading information? It's on the mechanism of Zoloft how could it be irrelevant, and it's provided as an external link?

it seems that some fans of antidepressants on here are really unwilling to allow critical information to be provided even in external links so that people can make up their own minds and that seems really unfair.

The article is at http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0020392, I keep putting it external links, and it keeps getting zapped. I don't see any reason why this article couldn't be linked to pages for each of the SSRIs that the article mentions as well as for SSRIs in general.

Well, I do. The article addresses the SSRIs as a group. You have been blasting that link onto 20-30 Wikipedia pages. This is annoying and distracting. Please stop. JFW | T@lk 22:29, 20 November 2005 (UTC)

It seems SSRIs tend to attract plenty of arguements because whether or not they work varies from person to person. For many people they can cause a great improvement, for some others, much harm. The details of this have been well studied and documented; in the medical world, both the pros and cons are well known. Of course, some of the people who were not treated well by Sertraline have taken a vendetta against it, and will not rest until the pill has been banned, or everybody has been warned against it. Others, whose mental health was saved by it, will rush to it's defense. Flame warriors: you do not need to change the article to alert the masses The medical community is aware of the risks associated with this and other medications of this type. Just because Medication X ended up making you feel like a zombie does not mean there is a global conspiracy to turn people into zombies. Stop adding to the list of side effects everything that happened to you while taking it. You do not need to add your own scientific discoveries. You snorted Wellbutrin and you think it worked better than swallowing? Great, tell all your Myspace friends, and keep it out of here. People should take benzos if they have too much psychic energy, you say? Gee, somebody better alert the American Psychiatric Association, they still think our brains are made of neurons. Here's a simple guidline to anyone taking it upon themselves to edit a medical article- if you aren't citing a well accepted, peer-reviewed source, you aren't being helpful! --72.19.81.122 06:23, 3 October 2006 (UTC)

[edit] Beware of this Editor

This editor thinks he is a Crusader protecting drug information. What is needed is balanced information, not one editor deleting anything negative about a drug entry which is what this fellow seems to do as well as dissing Wikipedia itself. Yes, he's right about using reliable sources,but the medical community is not always as well informed as it should be, and there are opposing scientific studies presented about particular drugs. When a drug is under a black box alert, it is responsible for knowledgeable editors to provide useful information so that readers are well informed. Since this editor has already proposed elsewhere that readers not use wikipedia as a reliable source for any information on drugs, he should now cease to do ANY editing in that area. There are many very capable editors who are knowledgeable in this area, as in other areas, as shown by the quality of the articles comprising Wikipedia. I recently read a review of Wiki that stated it was of amazing good quality even when compared to known encyclopaedias. It is certainly more up-to-date than printed encyclopaedias that are years out of date by the time they are printed.Any reader who has special interest in a drug can also research this drug through the internet accessing many different resources. I think anyone who does this will likely find that the Wikipedia entries are actually very good. —The preceding unsigned comment was added by Szimonsays (talk • contribs).

[edit] Obvious Questions

Who developed it? When? Is it patented? When do < math > InsertformulahereInsertformulahere</math>es the patent expire? Etc.

It is very interesting issue. It seems sertraline is a generic drug, because e.g. Slovenian pharmaceutical company Krka is selling sertraline hydrochloride tablets under trade name Asentra, and Pliva is (or was) selling it even under the name Sertraline. But there is Pfizer's patent on sertraline which expires in December 2005, and there is another sertraline patent which expires in 2010... I'm confused. Maybe it has something to do with polymorphism. Mykhal 21:51, 30 Oct 2004 (UTC)

in australia, all of the tablets are the same colour, white

  • here in Europe, too -Arny 02:13, 18 April 2006 (UTC)

[edit] suggestion for addition to Sertraline page

The adverse effects listing in the third paragraph omits a major one: sexual side effects, which is a major complaint with most of the SSRIs.

BTW, Canada also sells Sertraline (generic) in 50- and 100-mg capsules. The patents must apply on a country by country basis.

Another side effect is a tightness/discomfort in the throat; which can be a symptom of increased anxiety.

The adverse effects listing in the third paragraph omits a minor one: increased sweating. I use the drug and since then this has subsided, but in the sheets the pharmacy gave me along with sertraline "increased sweating" is listed. From personal experience (I am unsure who should be credited with this info; it is reported on various websites as well), during the "insomnia" phase while my body was adapting to its use (apparently), I would wake up very sweaty, from the first night I took it and decreasing afterward.

Setraline is sold in Australia, like it says, but in only white tablets. A few different generic names for it here like Concorz from Hexal, but you can of course get Zoloft itself. Pfizer sends Zoloft trial packs to doctors to give to patients, in the hope that the patient will want to continue using the same brand.

Another theory about the correlating suicide rate with antidepressant usage is that users feel the drugs were unsuccessful at curing their depression, and extrapolated that into there being "no" cure.

Why not post information about a less talked about side effect, "smelly farts"

[edit] Dopamine

It is mentioned in the article that sertraline also works on dopamin in high doses. So far I haven't found any source to confirm it, although I accept it is probably true since I've already heard that before. However, there should be a citation or link or something to confirm that. Arny 02:17, 18 April 2006 (UTC) P.S. And how high are those "high" doses? Some milligrams would be informative here...

  • Ok, I've finally found a medical article with some info about this and will add it to the article. --Arny 14:59, 1 May 2006 (UTC)

[edit] "Evidence against Effectiveness"

This cites just one study and completely neglects the countless other studies which have shown Zoloft to be an extremely effective medication for the treatment of depression. It is a first-line SSRI that is often used before any others for treating typical depression, in most psychiatric units. The "Evidence against Effectiveness" section sends a very bad and misleading message. It should be changed or removed completely. --Muugokszhiion 18:59, 22 July 2006 (UTC)

To be fair, it seems to me it's a first-line antidepressant because of its relative lack of side effects and probably marketing too. However, I mostly agree: having a separate section for this one study, and none describing studies that support its effectiveness is misleading. Maybe we could change the section to "Studies of effectiveness" and include more. --Galaxiaad 19:38, 22 July 2006 (UTC)
I'm commenting (hiding) the section until more NPOV sources can be added. Since Zoloft (along with the rest of the SSRIs) has been shown to be highly efficacious in the treatment of major depressive disorder, it is important that studies proving its effectiveness be shown as well. Otherwise, the section is very POV. Furthermore, the title should indeed be changed to something more neutral, such as Galaxiaad's suggestion, "Studies of effectiveness." --Muugokszhiion 18:52, 19 September 2006 (UTC)

[edit] 80 year olds

What's with the line about 80 year olds in the first paragraph? Should it be removed?

[edit] Bioavailibility

I noticed that the bioavailibility percentage went from 95% to ~45% just recently. Do we have a source for this change?

Also, I've found several sources claiming that taking sertraline with food increases the bioavailibility (http://psyplexus.com/pt/index.php/2004/10/24/increasing_the_bioavailability_of_sertra), and another that claims taking it with food has no effect (http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=18935).

[edit] Medication for childhood experiences?

It seems a lot of research is being done to prove the effectiveness of anti-depressants such as Zoloft. But why, after so many years since the drugs first release to the public, are results still inconclusive? Pfizer’s own Zoloft official web site (www.Zoloft.com) states in every page the risk of increased suicidal rates in children under the age of eighteen is doubled when taking antidepressants. Yet, in another article entitled, “Zoloft Effectiveness in Childhood depression” by Sid Kirchheimer, a study comparing the effects of Zoloft with placebo showed that while 69% of patients taking Zoloft had improved symptoms, 59% of the patients taking placebos also improved their symptoms. Is this a significant enough difference to say that Zoloft is effective? The FDA, based on the data submitted to them by antidepressant drug companies, disagrees. However, “placebo response is very high in short-term studies like this one” comments the researchers Karen Dineen Wagner, MD, PhD, and Clarence Ross Miller Professor and vice chairwoman of psychiatry and behavioral sciences at the University of Texas Medical Branch in Galveston. Their research, funded by Pfizer, was for the duration of only ten weeks. Both agree that further research is needed to make a clear decision in prescribing it to children. In a more recent study by Gregory E. Simon (American Journal of Psychiatry, January 2006; vol 163: pp 1-7.) Suicide rates showed a decline in both adults and children after a six-month period. The risk of suicide rates remained high in the first months of treatment. This study included mostly adults, however. Although child depression is a serious subject, perhaps antidepressants aren’t the solution. Part of being a kid is having the resilience to grow up and overcome certain obstacles that may or may not contribute to depression. If placebo pills can show an improvement in symptoms of children, perhaps doctors shouldn’t “jump the gun” on prescribing antidepressants to them. That is not to say that antidepressants aren’t effective, but that to express extreme caution when dealing with children under the age of 18 until further research has been done to finally put an end to the ongoing debate about the side effect increasing the risk of suicide rates in kids. Perhaps an understanding of the causes of depression in today’s younger generation can provide insightful reasons in determining whether their condition can be helped by antidepressants or if the depression is a normal part of life. Are we creating a need to medicalize normal human experience?

[edit] Depressed?

While depression and anxiety disorders are now generally viewed as viable diseases, I wonder how it would have been preceived in the past if it were medicated. As a society, we give everything a name and call it illness as soon as it causes discomfort. Don't get me wrong, I believe that being depressed can severely limit your ability to live life the way you want. But drugs like Zoloft are pushed so hard to consumers that many times people are misdiagnosed and mistreated. The commercials and websites that publicize Zoloft are aimed at people who feel bad about themselves. They are the people who are more likely to buy into a disease whether or not they have it or not. Big drug companies are usually the ones that market these drugs because their name has power in the minds of consumers. They even encourage us to diagnose not only ourselves, but others if we care enough about them. How can we diagnose a disease who's symptoms can be considered to be a swing of a mood? When can we find a better way of diagnosing depression and other likewise diseases?

--I agree that people should not seek medication because of a "swing of a mood." Serious depression is far more than a mood swing -- it is an utterly debilitating and sometimes life-threatening condition. I didn't start taking Zoloft because of an ad; I started taking it so I wouldn't kill myself. And guess what? It works for me, and not because of some placebo effect, as I had never heard of it before and was skeptical that it would work in the first place.

Your questions are valid; I'm just giving you my take on it. 71.192.117.240 02:33, 19 December 2006 (UTC)Greg

I would agree that medication should not be marketed directly to the consumer. In fact I think it's almost criminal for a pharmacology company to encourage niave individuals to diagnoss themselves and others. Be that as it may, depression is more than a "viable disease," and people who suffer from it ( in the medical sense - not as a mood ) deserve the best treatment science can find. FireWeed 23:15, 22 January 2007 (UTC)

[edit] Suicide

This is common amongst all anti-depressant treatments, including ones that are not SSRI-based, and even non-drug treatments ( ie talk therapy ). Many who are depressed describe a lack of "mental energy." These individuals recognize things they could/should be doing to improve their condition, but can't actually carry the task out. ( Excersize is among the best treatments for depression, but (catch 22) you can't get a depressed person to excersize. )

It's a very small logical leap to assume some individuals with major depression symptoms have often contemplated suicide, but, like with excersize, simply do nothing, caught in the depths of their depression. When this type of patient, determined but unable to commit suicide, begins treatment, when their "heavy fog" begins to clear, the worst cases are still suicidal, suddenly find the wherewithall to carry out their long-standing wish.

In fact doctors ( either psychologists or family practicioners ) are alert for early signs of manic happiness in patients who had been morbidly depressed, as this is often an indicator that the patient is considering something rash. FireWeed 23:11, 22 January 2007 (UTC)

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