Will Zoloft make me sleepy at work?

Zoloft (generic name: sertraline) is one of the newer antidepres-sants that patients like most. Zoloft is called an SSRI, but studies show that it helps the brain increase serotonin at low doses, dopamine at moderate doses, and norepinephrine at higher doses. Studies also show that Zoloft stimulates the production of brain factors that help repair and regrow damaged brain cells and protect them from further damage, as many other antidepressants do. Zoloft is licensed to treat unipolar major depression, premenstrual depression, social anxiety disorder, panic disorder, and obsessive-compulsive disorder (OCD).

Patients report that Zoloft does not cause them any mental clouding or sedation. It sometimes causes a mild energizing effect, and many people prefer to take their Zoloft during the day for this reason. As sadness gradually lifts, patients report that they are able to think more clearly. Zoloft helps take away their saddest emotions and keeps negative emotions from growing. Along with relief from depression, Zoloft also may provide a reduction in irritability and anger.

My patients seldom gain weight while taking Zoloft, although they often complain of stomach and intestinal troubles right after starting the medication. These may include slight nausea, stomachache, cramping, or diarrhea. Like other serotonin antidepressants, Zoloft can delay ejaculation in men. If these problems occur, they usually get better with time and adjustment of the medication.

When you swallow your first Zoloft, it will take about six hours to get to peak levels in your system. When you stop Zoloft, all the medication and its breakdown products will be gone from your body in eight days. It comes in capsule-shaped generic tablets of 25-, 50-, and 100-milligram strengths and a menthol-scented oral solution that contains 100 milligrams per teaspoon. The Zoloft dose suggested by the Physicians’ Desk Reference (PDR) is 50-200 milligrams per day. Occasionally patients have been prescribed 25-50 milligrams of Zoloft, but this is usually not enough to stop unipolar major depression. The most effective dose for unipolar major depression seems to be between 100-250 milligrams daily, and some studies have used 300 milligrams daily or higher.

Doctors use Zoloft for treating unipolar major depression in elders because Zoloft tends to have fewer undesirable side effects than other antidepressants. Clearance is slower in elders, and they should receive smaller doses.