Zoloft by Pfizer - Essay Example

Zoloft (setraline hydrochloride) Produced by Pfizer, Zoloft is the brand of setraline hydrochloride. The generic is simply Setraline. The indications for Zoloft include depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder, and postmenstrual dysphoric disorder. It has been used extensively for major depressive episodes by millions of people over the course of the last 15 years. Setraline belongs to the class of anti-depressants known as selective serotonin reuptake inhibitors (see Pfizer).

The ultimate function of these drugs is to increase the levels of serotonin in the central nervous system and treat the underlying cause of depression in many individuals. An interesting area of exploration for the use of Zoloft is in pregnant women who suffer from depression. Do the risks outweigh the potential benefits One study that examined the pharmacokinetics of setraline in pregnancy showed that the drug was metabolized at an increased rate, suggesting that a greater dose was necessary in these cases (Sit et al, 2008).

Setraline is excreted through the breast milk of nursing mothers in a highly efficient manner (Kristensen et al, 1998). So another consideration is the health of the infant. There have been no teratogenic effects associated with the use of Zoloft, however it may be wise to weigh all of the potential drawbacks. Setraline has been used in pediatric cases of major depressive episode. Children as young as 6 years old have taken this drug. Animal studies of Zoloft on pregnant rats showed a destructive influence to the unborn rat pups (Pfizer ibid).

Female rats who received setraline during the last third of the gestation period had an increased number of stillborn pups. The surviving pups had a lower birth weight than the pups in the placebo group. Researchers concluded that this effect was due to exposure to setraline in utero. The effects of Zoloft on the human fetus have not been well studied, and no inferences can necessarily be made concerning the significance of these animal models. Zoloft is tolerated well by most individuals, but there are a number of major adverse events and numerous minor side-effects associated with the use of this drug.

The possible major adverse affects of Zoloft are an increased risk of bleeding events, serotonin syndrome, hyponatremia, and damage to the fetus in pregnancy. Common side-effects are insomnia, ejaculation failure, and dry mouth (see Zoloft). The symptomology of depression can include some of these, so it is possible that Zoloft can exacerbate pre-existing conditions. As with all anti-depressive medications, the risk of suicide is a significant consideration. Proper use of these drugs entails taking every precaution to monitor patients and to educate their family members in recognizing the warning signs of a potential suicide.

There have been documented drug interactions between Zoloft and monoamine oxidase inhibitors with possible fatal outcomes. These two drug classes should never be used together because of the enormous potential for disastrous results. Serious consequences such as hyperthermia, fluctuations in blood pressure, and muscle rigidity have been recorded. The use of anticoagulants such as warfarin can cause severe bleeding when used with Zoloft. Precautions should be taken against mixing Zoloft with NSAIDS such as ibuprofen.

Cimetadine may increase blood concentrations of setraline and thereby increase its adverse effects. Setraline may increase blood concentrations of pimozide with concurrent use of the two products and can lead to sudden death. All evidence suggests that Zoloft does not have significant interactions with over-the-counter medications other than NSAIDS. Setraline is readily absorbed and steady-state plasma levels should be achieved after only one week of once-per-day dosing. Setraline is highly bound to plasma proteins (98-99%).

The liver metabolizes setraline through N-demethylation, oxidative deamination and subsequent reduction, hydroxylation, and glucuronide conjugation (Pfizer ibid). Because it is extensively metabolized, elimination through the urine of the unchanged product is minor. ReferencesOnline Sources"Pfizer." pfizer.com. 15 September 2008 "Zoloft." medicinenet.com. 15 September 2008 JournalsKristensen JH, et al. 1998. Distribution and excretion of sertraline and Ndesmethylsertralinein human milk.

Br J Clin Pharmacol 45:453-457.Sit DK, Perel JM, Helsel JC, Wisner KL. 2008. Changes in antidepressant metabolism and dosing across pregnancy and early postpartum. J Clin Psychiatry. Apr;69(4):633-4.