The People's Perspective on Medicine

Sertraline (SER tra leen)

Overview

Sertraline is available as sertraline hydrochloride (Zoloft), an antidepressant, in a tablet form and an oral solution.  Sertraline (Zoloft), like the earlier antidepressant fluoxetine (Prozac), works by enhancing the action of a brain chemical called serotonin. It belongs to the class of antidepressant drugs called serotonin reuptake inhibitors (SSRIs).

This medication is prescribed to treat major depression, obsessive-compulsive disorder, panic disorders, social anxiety disorder, post traumatic stress disorder, and premenstrual dysphoric disorder.

Although the FDA has not specifically approved its use for other purposes, doctors sometimes prescribe sertraline (Zoloft) to treat generalized anxiety, impulse control, and eating disorders.

People’s Pharmacy Perspective

Since the introduction of fluoxetine (Prozac) in 1987, the serotonin reuptake inhibitor (SSRI) class of antidepressants (citalopram-Celexa, escitalopram-Lexapro, fluoxetine- Prozac, fluvoxamine-Luvox, olanzapine plus fluoxetine-Symbyax, paroxetine-Paxil, sertraline-Zoloft) has been wildly popular with physicians, patients, and insurance companies.

Doctors believe SSRIs generally produce fewer side effects than traditional tricyclic antidepressants, though it is not clear whether there are fewer adverse events or just different ones. These drugs are perceived as less costly and time consuming than talk therapy, though a monthly prescription for a brand name SSRI-type antidepressant can cost more than $100.

The FDA now recognizes suicidal thoughts as a potential complication of virtually all antidepressant therapy for children, adolescents, and young adults (18-24 year olds) during the first few months of treatment and whenever there are dosage changes.  Why one would assume that suicidal thoughts would instantly stop at age 25 is a mystery to us. We think that anyone who is put on this type of antidepressant should be aware of the potential for violent, suicidal thoughts. Family members and friends must also be vigilant for any unusual changes and encourage immediate consultation with the prescriber.

When it comes to effectiveness, antidepressants can be helpful for some people, but trial and error may still be the only way to determine whether a given antidepressant is helpful.  There is no clear evidence that any one drug (including duloxetine-Cymbalta or venlafaxine-Effexor) is better than others.(1) There is also no clear data to demonstrate that these antidepressants are substantially better than placebo more than half the time.(2) More significantly, there is little evidence to show that they affect long-term outcomes or suicide rates.(3)

A recent review demonstrated that the medical literature is incomplete with regard to clinical trials. Favorable trials are published more frequently than trials showing no benefit beyond placebo.  As a result, doctors reading the published studies are likely to get a far more favorable impression of an antidepressant than may be warranted.(4)

For many, a long acting medication like fluoxetine (Prozac) is preferred for avoiding withdrawal symptoms (dizziness, nausea, insomnia, headache, sweating) experienced when stopping or switching from other antidepressants.  We have heard from many people that getting off drugs like venlafaxine-Effexor, paroxetine-Paxil or sertraline-Zoloft can be difficult.

The bottom line is that there are no “best choices” when it comes to antidepressants.  Patients must be open to trial and error when starting, be cautious to taper off antidepressants when ending or switching therapies, and constantly be under knowledgeable medical guidance throughout therapy.

Be certain to consult a physician about your health, especially with regard to any signs or symptoms that may require diagnosis or medical attention.  Information provided is not a substitute for the medical advice or care of a physician or other health care professional.

Special Precautions

There is increased risk of suicidal thoughts in children, adolescents, and young adults with major depressive or other psychiatric disorders especially during the first months of treatment with antidepressants.  Antidepressants are not approved for pediatric patients except for treating obsessive compulsive disorder.

Pregnancy/Breastfeeding:  Consult your prescribing physician and/or obstetrician if you are pregnant or planning a pregnancy, or will be breastfeeding while taking this medication.

Not recommended:  People who have had an allergic reaction to SSRIs, sertraline (Zoloft), or its components or who are taking the MAOI class of antidepressants (isocarboxazid-Marplan, phenelzine-Nardil, tranylcypromine-Parnate, selegiline-EmSam) or drugs with MAOI activity such as pimozide (Orap) or linezolid (Zyvox).  Potentially fatal interactions could occur between MAOI and SSRI antidepressants so MAOIs must be stopped for 14 days prior to beginning SSRI therapy and vice versa.

Those who are on disulfiram (Antabuse) should avoid liquid sertraline (Zoloft) due to its alcohol content.

Another potentially fatal drug interaction could result from taking another SSRI with sertraline. This may lead to serotonin syndrome. Patients taking sertraline should avoid other SSRIs such as escitalopram (Lexapro) or a SNRI antidepressant (duloxetine-Cymbalta, venlafaxine-Effexor, Effexor XR), St. John’s wort, tramadol (Ultram), and migraine medications (sumatriptan-Imitrex, Zolmitriptan-Zomig).  The doctor must be notified immediately if there are sudden changes in cognition (confusion, agitation, headache) accompanied by shivering, sweating, fever, increased heart rate, muscle twitching or tremor.

Carefully monitor:  For people who have bipolar disorder and have had an episode of mania, there is a risk that manic symptoms could be triggered by sertraline (Zoloft).  Anyone with a history of seizures or suicide attempts must also be extremely vigilant. Family members and other caregivers should help monitor people on sertraline for suicidal thoughts, self-destructive behaviors, panic attacks, impulsivity, aggressiveness, or other unusual changes in behavior or symptoms of worsening depression or anxiety especially in the early months of treatment and when the dose is adjusted. The doctor must be notified immediately in such cases.

People with liver problems may need to start on a reduced dose, as they may eliminate Zoloft less efficiently than otherwise healthy people.  Be certain to inform your doctor of any other conditions you may have as it may affect your dose, whether you should even take this medication, or require you to take special tests during treatment.

Taking the Medication

Sertraline (Zoloft) tablets should be taken with a full glass of water roughly at the same time each day (to help you to remember to take it), with or without food.

Stopping the Medication

It may take up to 4 weeks or longer before effects are felt.  Do not stop or change doses suddenly without first talking with your doctor.  If sertraline (Zoloft) is abruptly discontinued, withdrawal symptoms such as irritability, agitation, dizziness, electric shock sensations, anxiety, headaches, and increased manic episodes may occur.  Discontinuation is usually handled with a gradual reduction in dose.

Common Side Effects

  • Dizziness, drowsiness, nausea
  • Dry mouth, appetite changes
  • Sexual difficulties, changes in sex drive

Serious Side Effects

Call for emergency help if you have these signs of a potential allergic reaction: difficulty breathing, swelling of the face, throat, lips, or tongue, skin rash or hives.

Call your doctor promptly if you have any of these serious side effects:

  • Seizure (convulsions)
  • Serotonin Syndrome (rare, but potentially fatal condition in which serotonin levels are elevated to toxic levels by the action of a single or a combination of medications)
  • Uncontrolled muscle twitching, tremors, stiffness, or shivering
  • Fast heart rate, unusual sweating, fever
  • Agitation, confusion

There may be other side effects not listed here. Talk to your doctor if your condition worsens and about any side effect that seems unusual or is especially bothersome.

Drug Interactions

I. DO NOT TAKE WITH sertraline (Zoloft):

The following drugs have additive effects to SSRIs, so may increase the risk for serotonin syndrome, a (rare, but potentially fatal condition in which serotonin levels are elevated to toxic levels by the action of a single or a combination of medications):

  • Migraine medications: sumatriptan (Imitrex), zolmitriptan (Zomig), and others
  • Tramadol (Ultram), Lithium
  • All other antidepressant drug classes:  SNRIs (duloxetine-Cymbalta, venlafaxine-Effexor, Effexor XR), SSRIs (escitalopram-Lexapro, fluoxetine-Prozac, etc.), tricyclics (nortriptyline-Pamelor, protriptyline-Vivactil)
  • MAOI antidepressants; drugs with MAOI like activity: Phenelzine (Nardil), isocarboxazid (Marplan),  tranylcypromine (Parnate),  selegiline (EmSam) and linezolid (Zyvox).  These need to be stopped at least two weeks prior to starting sertraline (Zoloft). If sertraline is taken first, two weeks should elapse before starting on one of these other medicines as potentially fatal side effects could occur.
  • Pimozide (Orap):  increases risk of fatal cardiac complications.
  • Sibutramine (Meridia):  not recommended by manufacturer.  Use only under close medical supervision, particularly for signs of serotonin syndrome, since effects are additive to sertraline (Zoloft)
  • Muscle relaxers and cold, pain, anti-seizure, anti-anxiety and antidepressant medicines that could make you sleepy should also be avoided.
  • Alcohol: increases drowsiness and dizziness

II. TAKE with CLOSE MEDICAL MONITORING

Propafenone (Rythmol):  Certain SSRIs, including sertraline (Zoloft), may increase the level of this drug, so cardiac function should be carefully monitored.  Or, use an alternate antidepressant, such as citalopram (Celexa).

III. DOSE ADJUSTMENT may be required

  • Clozapine, risperidone, cyclosporine, seizure medications (phenytoin-Dilantin, ethotoin-Peganon), propafenone (Rythmol):  The dose of these drugs may need to be adjusted if they are taken with sertraline (Zoloft).
  • Cyproheptadine:  This antihistamine/allergy medication may block the activity of SSRI antidepressants, so its discontinuation may be advised if antidepressant effects seem blunted or the sertraline (Zoloft) dose may need to be adjusted.
  • Carbamazepine (Tegretol): Decreases effectiveness of sertraline (Zoloft), so sertraline dose may need to be adjusted.
  • Aspirin, ibuprofen, naproxen, diclofenac (Voltaren), etodolac (Lodine) warfarin (Coumadin) or other drugs that affect blood clotting:  Drugs that interfere with serotonin reuptake and these agents have been associated with an increased risk of abnormal bleeding, so the dose of these agents may need to be adjusted.

Other Interactions

  • St. John’s wort (5): Avoid taking the herb St. John’s wort with sertraline (Zoloft), since the effects are additive and could lead to serotonin syndrome. Switching between antidepressants and herbal treatment calls for medical guidance (physicians can find a suggested protocol for gradual substitution of St. John’s wort in Hyla Cass’s book, St. John’s Wort: Nature’s Blues Buster).
  • Grapefruit Juice (6):  Avoid taking sertraline (Zoloft) with grapefruit juice as this may result in elevated drug levels in the bloodstream

There may be other herbal and dietary supplement or food interactions not listed here.  We are concerned for instance, about the potential for bleeding with herbs that may affect coagulation (Ginko biloba, etc).  Check with your doctor and pharmacist before taking any other supplements or over the counter medications to make sure you are aware of the risks the combination may carry.

References

  1. Khan, A. and Schwartz, K.  “Study Designs and Outcomes in Antidepressant Clinical Trials.”  Essent. Psychopharmacol.  2005;6:221-226
  2. Moncrieff, J. and Kirsch, I.  “Efficacy of Antidepressants in Adults.” BMJ 2005;331:155-159
  3. Rubinow, D.R. “Treatment Strategies After SSRI Failure–Good News and Bad News.” N. Engl. J. Med. 2006;354:1305-1307
  4. Turner, E. H., et al.  “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy.” N. Engl. J. Med. 2008; 358(3):252-260
  5. Lantz MS, et al. “St. John’s wort and antidepressant drug interactions in the elderly.” J Geriatr Psychiatry Neurol. 1999;12:7-10. PubMed
  6. Lee AJ, et al. “The effects of grapefruit juice on sertraline metabolism: an in vitro and in vivo study.” Clin Ther. 1999;21:1890-1899

Be certain to consult a physician about your health, especially with regard to any signs or symptoms that may require diagnosis or medical attention.  Information provided is not a substitute for the medical advice or care of a physician or other health care professional.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I’m a bit disappointed there are NO comments in 2016. I wondered if people found that Northstar Sertraline works better than Green Stone? Thanks.

I was on legacy for a couple months. Tried to get Zoloft brand but couldn’t. Heard everyone say Greenstone is the most like Zoloft brand. I’ve been on it for 3 days and having what I think is reaction. Although I’m not sure because I’m 5 weeks after stopping benzos.

If this doesn’t stop, I may try the legacy again. Very confused right now and really sick from this benzo withdrawal. Damn psych drugs…..

Been taking sertraline for 7 weeks camden low dose of 25 then 50 2 weeks then at 75 for only 2 days and started getting the worst jaw pain and muscles aches and severe watery eyes, helps the anxiety, ocd a lot but does anyone have these side effects?

Hi my name is Colin im 28 years old I have been taking Sertraline for 14 days now and haven’t really noticed any change maybe its takes months to work, I don’t know as it’s my first time taking them. For the last few months I was taking alot of cocaine something I’m not proud of but I have completed stopped taking it about a month ago. When I stopped I just started feeling weird not myself. I was confused struggling to concentrate and found it hard to remember things. I just started shutting myself off from friends and family and the world basically. I didn’t want to get out of bed for work. So I presumed I was depressed and went to the doctor he prescribed me 50mg of Sertraline. I’m thinking now that maybe it was withdrawal symptoms from cocaine I had and not depression I just don’t know what to think anymore I’m struggling to cope!

These are all very common side effects. Just stick with it. It will eventually subside. I have been on 50 mg for over 2 years. I was on 75 for a year, then down to 50. That is my ideal dose. It will take you a couple of months to really get set and Start feeling 100%. But it is so worth it.

I have been taking lupin brand sertraline 200 mgs over the last 18 months for psychotic depression and anxiety. It is amazing I lost over 21 lbs in weight my mood is really stable no anxiety. I can honestly say it has changed my life.

I am also a qualified psychiatric nurse. I couldn’t take the generic brand it made me so
ill. This medication is amazing, yes I feel drowsy sometimes and I forget things but I have my life back. I owe it all to this medication no doubt in my mind.

Brand name Zoloft works but Greenstone sertraline did not work AND caused problems. Zoloft costs a great deal more than the generic but I have to take the brand name.

I’m having the same exact problems with my new prescription. Its the greenstone generic. How long before the stomach pain went away???????? I stopped taking it immediately as the pain was VERY bad. Have you tried Zoloft?? I used zoloft in the past and had NO problems of any kind with it. and now this???

This is the first time I’ve taken antidepressant medications and my Dr. prescribed Asentra/Sertraline for me but when I took the first pill I had a burning feeling in my stomach, esophagus and throat plus having problems in balance. I lost my appetite and it’s like my stomach is inflamed. Now, after about 15 hours I still feel my stomach is enlarged and then although I get hungry but I can not finish my normal meal.

After having been on Sertraline in the past (with little side effects but no real mood improvement), I wanted to try the drug again. This time around (three months ago), Walgreens gave me the Northstar generic. It was horrible! I asked myself, how could two generics of the same drug be so different? The answer is simple: they can be and they often are! That is, judging from personal experience. Due to the side effects, I was forced to quit the med. Thereafter, I gave generic Effexor and Prozac a try with no real success. I am going back on Sertraline but will never take Northstar or Teva (bad experiences also), again.
People forget that many of these generics are manufactured in countries like Israel (Teva) or India where the FDA does not have the same type of influence as it does in the U.S. Although the FDA claims to inspect these international facilities regularly, there is clearly something to all of the claims regarding generic drug problems versus their brand name counterparts, particularly regarding anti-depressants. I assume there are many generics that work as well as brand drugs, but not so with most anti-depressants for some reason. On a side note, I recently received a $4 co-pay card for brand Zoloft in the mail and will go that route if I have to. In the end, it’s worth it.

I don’t mind taking generics, I can’t afford the brand names, but their efficacy varies so widely it’s frustrating. I’ve been on the Walgreen’s Greenstone sertraline for a few weeks now and I am feeling better. Camber made me dizzy, gave me tremors and only worked at about 50% efficacy compared to the dosing of other generics on depression & anxiety. Hopefully I will be able to get the Greenstone one for years to come.

I agree too. I switched to generic Lupin for Zoloft. I started to feel badly. I would not recommend to anyone using generic medicine in mental health!

In December I transitioned beautifully from Effexor XR to Northstar sertraline from Target. I continued to take Northstar sertraline in January. When I switched my rx from Target to CVS in February they gave me the Camber sertraline, after a week I started feeling more depressed, my p-doc doubled the dose and that kept me from sinking farther but did not have the same wonderful effects as the Northstar sertraline at the lower dose (huge reduction in anxiety and depression). In March I switched back to Northstar sertraline from Target. It’s time to refill now, in April, and Target has also switched to Camber! So has Walmart. So I am frantically trying to find Northstar or another sertraline that is also effective for me.

Thank you all for your comments and thoughts. This website has been such a comfort this past year to learn of other people’s experiences w/zoloft/zoloft generics. I’d like to share my experience and see if anyone might know Zoloft (I use the Greenstone generic) works over time, as well as when one weans oneself off of it.
I took 50 mg of Zoloft for about seven months, and after the first couple of weeks felt much better. Then I dropped to 25 mg for about a month. After something had happened in my life, I increased again to 50 mg thinking I might need the higher dosage. The funny thing is though, I started to feel worse. In January of this year (after taking Zoloft for about 11 months), I was feeling very bad, and very tired. It was as though Greenstone (the manufacturer of my generic) had changed the formulation or labs that makes their drugs.
Anyway, after contacting Pfizer with the simple question to see if they had changed anything in their formulation and not getting a response from them, I dropped from 50 mg to 25 mg and IMMEDIATELY started feeling better. About a month after that, still feeling a little tired, I dropped to 25 mg every other day. Again I started feeling better. It’s as though at this point the less Zoloft I take the better I feel.
I’m now down to 25 mg ever three days. Interestingly, it’s the morning after taking the zoloft (I take it at night), that I feel the worst! Does anyone know why this would be? Do your neurotransmitters get full and then the drug has an opposite effect, ie, no longer makes you feel better, but actually makes you feel worse?
Thank you in advance for any thoughts you might have. Best wishes to everyone and Happy Easter!

> Generics
It could be the case. I mean, I’ve been taking 100mg of sertraline twice daily for the past two or three years. However, last Thursday (03/07/2013) I switched from Greenstone to Northstar. I know that, partly from imagination, the Northstar sertraline does not seem to be as effective as the Greenstone version. I’ve been feeling dazed, nausea, hypomanic, aggressive, dizzy, and anxious.
See, here is the funny thing about generics: the active ingredient needs to be FDA approved. Inactive ingredients (polymers, dyes, starches, etc.) are not subject to regulation. In addition, some of these generic medications are made in places that lack proper heating/air conditioning. Like with foods, excessive heat and/or cold may damage the medication, making it less effective. For example, the pharmaceutical powerhouse GlaxoSmithKline has a manufacturing plant in India (http://en.wikipedia.org/wiki/Pharmaceutical_industry_in_India). I doubt that any sensitive product could make the journey from India to America (I’m just assuming you live here; please forgive me if I am incorrect) unscathed.
So here’s my solution: Find out what company manufactured your sertraline. Once you do that, see if your pharmacy can special order it. I don’t know what pharmacy you obtain your medication from, but I suspect that they would be able to acquire it. The only problem with this is insurance. You’d have to check, but I would think that your insurance provider wouldn’t fully cover it. Still though, it’s worth a shot.
Anyway, I hope this helps you out! Stay strong!

The generics seems to vary quite a bit. The original insert said SSRIs do not create dependency and there is no withdrawal effect. This of course was not true. Given the nightmare of w/d from Paxil, et. al. — the total inadequacy of manufacture or FDA warning about this devastating aspect of these drugs,it may be prudent to question everything that the manufacturers have ever said about this class of drugs.
It may be that not only is a huge dependency created, but that the dependency is to the particulars of a brand, and that this is the reason for differences in efficacy.
Also, SSRIs have a well known “poop out” effect–meaning they all decline in effectiveness over time.

Hi Sam,
Yes, a decline in the quality/efficacy of the Greenstone generic. I feel like the quality has deteriorated, it’s effects are almost like those I experienced using the Lupin pharmacy product. I feel better when I DON’T take the pills!! : )

Hi, LT –
Just to be perfectly clear, you’re talking about a declining efficacy of the Greenstone generic, not a switch *to* Greenstone generic, right?

Hello,
Has anyone noticed any changes to the efficacy of the Greenstone Sertraline general 50mg?
Thank you very much!

Zoloft is a terrific help to me. I have suffered with anxiety since childhood with ebbs and flows. I finally got on an antidepressant in my forties. However, being a person who is desirous of no medications, if at all possible, I got off. I made the disastrous mistake of getting a family practice doctor to prescribe an antidepressant during one of the flows when I was experiencing acute anxiety. When I found no relief, I got off too quickly and asked for a different seratonin uptake inhibitor.
The doctor complied with that and also gave me a prescription for my lack of sleep. When nothing worked to relieve my anxiety and I lacked sleep and I could not get in to see a psychiatrist for weeks and I was reeling from getting on and off of prozac and lexapro, I took an overdose in desperation. Long story short, it was not God’s timing for the end of my days. With hospitalization, support from loved ones, therapy, exercise and submission to a good and wise psychiatrist, I am very healthy and blessed.
I tell all this story in order to urge others to not take treat medications with any lack of respect. Submission to a doctor who has mental health expertise is important. I am only on 50 mg. of Zolofft and was on multiple times stronger meds at my worst point. It was a slow uphill climb from that low point but there is help available and I rejoice that it was there for me. I do not care to wean off and really only will if my doctor advises me that way.

do you mean Camber?

After reading these posts I now believe I know what happened when I was switched to Camber brand Zoloft after many years on Northstar. I went into full SSRI withdrawal. When taking the camber brand results in nausea –it’s a symptom of withdrawal from SSRIs. Finally there is awareness of ssri dependence and severe withdrawal, contrary to the manufacturers insistence that there is no dependence cased by SSRIs. That’s a big fat lie.
In 2004 there was a large settlement awarding those who suffered from Paxil withdrawal. But it was one of the many big pharma closed door settlements that received little publicity. Paxil Plaintiffs got big cash settlements in return for verdict of no drug company liability. Those million dollar secret settlements are a tiny cost of doing business for big pharma. I have tried many times to withdraw from zoloft but the harrowing withdrawal effects have been too disabling. So I know well the withdrawal effects and I am certain that taking the Camber brand of zoloft after many years on a different generic is why I went into withdrawal.
As we know, many generic drug maker facilities around the world have been shut down due to shoddy conditions. Whether the Camber brand has the active ingredient or not, the fillers or the way its suspended in the pill caused me great harm. I also believe that after one has been on a particular generic of sertraline for a long time that the dependency created is a dependency to the particular action of the specific generic one takes and that is why people can’t just switch generics without devastating results.
The managers of FDA are former pharmaceutical company employees. It is indeed the fox guarding the hen house.

by “camden” do you mean Camber brand of Zoloft?

Northstar

yes. I had severe effects from Camber sertraline. It put me into full ssri withdrawal.

Amen!

I am so sorry! I threw up for two weeks, but prob from the panic attacks. I am on a different generic (greenstone) everyone seems to like.

Does anyone else get severe nausea (as in, I throw up every time I take my medicine) from the Camden generic of Zoloft? I am so frustrated!!!

Zoloft can be really helpful (18 years on it!). However, it does kill emotional life and sex drive at certain doses. Tried going off twice, and too much anxiety/fear, etc, so went back on. But when I went off last time and back on (maybe 5 years ago) when I went back I was more or less aware of where to stop the dosage so that I wouldn’t be numbed emot. or sexually. That dose is 50 mg for me. I remember going back on it, as it was kicking in, I was crying, and thanking God for the med! I have to have something, but I don’t need super high does. Would they help me ‘function’ better, etc. Probably most likely. But I need my emotions, libido, etc. to feel human. I love that part of life too!
So all in all in, Zoloft has been very good for me. However, right now, August 2012, I read about some research that they are not connecting it to bone loss! I am 66 and have bone loss. So now I am going to go off it. Also had began to get more depressed, but did not want to up Zoloft for reasons stated. Am starting on Cymbalta, very low doses, except I feel ‘weird’ on it also, spacey, and I know that can lower libido also, but as get lower on the Zoloft, my sex drive is coming back. That part feels good, to feel alive and human! I’m not sure about the Cymbalta, I feel spacey, etc. Time will tell. But overall, my experience with Zoloft was very positive, at low doses it did what I needed. Thank you.

My mother was prescribed sertraline 100mg. She took it for 5 days then died. She was 69 years old with no known heart disease or high blood pressure. We are still awaiting the detailed toxicology report. Right now the coroners report states “accidental”. This happened in May.

I think your Doctor prescribing it should know.

I take 300 mgs of Zoloft per day. I’m wondering if there are certain organs in the body that could be hurt from taking such a large dose?

I too was taking sertraline for 10 mths and for the first time in my life my insides felt calm and comfortable. I’ve developed pain in my thigh muscles and doctors haven’t figured out why yet so my psychiatrist started me on Cymbalta (I had a free coupon). Now after two weeks I feel tense. My stomach is in a knot and it hasn’t helped my pain much so I want to go back to sertraline. I left a message for my doctor yesterday but haven’t heard back yet. Can I just start taking setraline again? The prescription info’ says to wait five days before taking something else.

I take two ssri’s also because they are indicated for different things. I take sertraline 100mg and paxil 20mg. It’s what works, been on them ten years and always get a hassle at pharmacies. I see a Dr. regularly. The main concern would be ssri syndrome.

I am on sertraline 100mg and on citalopram 10mg and I would love to hear from some people about their side effects if using both..

I am beyond happy about this website. I have been taking zoloft for over 15 years for depression, but mostly anxiety.
Our insurance changed this year and the pharmacist gave the a different type of zoloft. I have been having the craziest of times… wringing my hands again, over-reacting, thinking of car accidents, and I have been incredibly dizzy…it just came to me, that perhaps zoloft is no longer working, but now I believe it is the generic brand which is no longer working.
What a relief. I shall go to my pharmacist tomorrow and talk with them.

Hello,
I was so happy to find this website this morning. A few years ago I took what turns out to have been Greenstone generic Zoloft for a year and a half. It worked wonderfully to help me through a period where I had just exhausted myself. This past November I wanted to try it again to help through a rough patch, and I got 50 mg of the Greenstone version through Walgreens. Then Anthem Blue Cross and Walgreens discontinued their service contract in December 2011(at one time Athem was a good company, they have deteriorated significantly – both my doctor and now my pharmacy have discontinued service with them).
I transferred my prescription to CVS, and I assumed I would receive the same quality of a generic. Wrong! Almost immediately I could tell there was a difference, and this morning I did an online search for Lupin Pharmacy. Their generic does not work for me at all, and even makes me feel worse than before. It also makes me jumpy and interrupts my sleep pattern. I called Greenstone, confirmed they only make one version of the 50 mg generic (which is blue), and learned I can request Greenstone from any pharmacy as my generic.
CVS has ordered this from their distributor, and I will be able to pick-up my prescription tomorrow. And all this, thanks to the above information provided by contributors on this site!!! Thank you so much! It is too bad they don’t make Teva anymore from what I’ve read on this site. To all, I would avoid the Lupin Pharmacy product.

You know, I have looked back at my scripts and I am pretty sure that one I got was NOT Greenstone, It said Greenstone and Camber or some other brand name on it, I am thinking that was their way of telling me that they had changed from Greenstone. So there must not be two versions of Greenstone as I had thought.
There was no sticker telling me that there had been a change, so I had no reason to think anything was different from before, until I saw the actual pill. Anyway, since that experience I have switched from C.V.S. and get the Greenstone filled at Walgreens. So I hope I didn’t make anyone worry about getting the “bad” version of Greenstone.
The way people talk about the Teva version, I wish they still had it. But, I have had good success with Greenstone. I think it is a good one. I wish everyone much luck and peace! Hopefully, something even better than anything so far will come out soon! It will work amazingly and be super cheap, like $2.00 for a month supply. It will be so cheap and so good, because the drug companies just want people to be healthy and happy! That is my input! :) Happy New Year to everyone and I hope you find something that works wonders for you soon.

Okay, I need some help. I relied on TEVA Zoloft for years to get me through very stressful times. Now I’m at the most stressful pt in my entire life and no TEVA Zoloft to help. I’ve tried the Brand Name zoloft, and all kinds of generics. Nothing works like the TEVA zoloft. Yes it cause bloating of stomach and face, and wt gain, but mentally it worked great. Did cause me not so have much emotion, but I understand you have to give up some things to get others.
Thinking of trying small does of Prozac 10mg at this pt. I don’t know what to do.
I’ve also tried Paxil, Efexor, Luvox, Lexapro, ect.
The Brand Name Zoloft totally tears up my stomach and doesn’t work near as good as TEVA. I could take 25-50mg of Teva a day and be fine.
Just at whits end and so ticked that TEVA just cut off it’s customers. I don’t know what was in it that made it work so well, but something the others are missing for sure. Any help appreciated.

………and one more thing to add, once I stopped lying about how I felt and was brutally honest with my doctors, that is when I started feeling better and getting the help I needed. You cannot help anyone else, including the others in therapy or your husband when you need the help yourself. People often tend to ignore their own feelings or put them on a back burner and try to help someone else with mental illnesses or issues, but all that does is stall the therapy you need and the anxiety will never leave.
I lavished all of my attention on my parents and my young children but in the end, I almost lost my own life to panic disorder. I could no longer eat, sleep, think, etc., and my chest hurt so bad I thought I would die. I cried all the time. It was when I hit that “bottom” that everyone talks about that I finally quit lying about how awful I felt and all of the symptoms. My family had no clue how horrible I was feeling because I hid it so well – with what? Laughter and “not taking things so seriously.” I thought the same way as you.
If you are still having panic attacks, even 1 or 2, laughter will not help, taking things less seriously will not help – you cannot help yourself, you need professional help. I thought being a good Christian and praying would cure me, but God put those doctors on the earth for a reason, and I believe one of those reasons was for me to learn to swallow my pride and get the help I so desperately needed. I know if I hadn’t gone in when I did, I would not be alive today.
Also, if you think it takes a lot of money for the therapy, or if you have no insurance, think about it this way. Therapy without insurance might be subsidized by the government. Therapy with insurance is almost all paid for, at least the first 8 visits are for sure, and then you have just the copay. That’s how my insurance worked, except at first we didn’t have insurance. Therapy costs around $3000.00 – seems like a lot of money, until my therapist put it this way – a funeral costs around $7,000.00 and causes a lot of grief, not to mention taking a mother away from her child. Is your life worth $3,000.00? You can’t put a price on your health – go get some help.

This is EXACTLY what I went through. There is no shame in wanting to go to the ER and being admitted to the psychiatric ward. You did the right thing in order to help yourself. The professionals in this horrible disease are there to help you and people need to see psychiatric problems as the actual medical illnesses that they are.
If you had hypertension, you would take any medicine to get the blood pressure down or suffer the consequences of a stroke or heart attack; same with diabetes and a number of other illnesses. You would take care of yourself. It seems that when it comes to mental illness, people shy away from the very experts that are the only ones who can REALLY help them.
I, too, first went to my general practitioner who prescribed Xanax and Zoloft. It helped at first but my dosing just wasn’t right. I finally “bit the bullet” and went to a psychiatrist who put me on the correct doses of Zoloft and eventually (10 years later) switched me to the Greenstone sertraline which was “okay” at 50 mg but I eventually bumped it up to 100 mg. The thing that helped me the most, even more than drugs, was talk therapy and biofeedback. Biofeedback was so helpful in controlling my symptoms I can’t even begin to tell you. If you haven’t done it, try it.
It took a long time but eventually I was able to get back to a normal life. I will never be off of my medication but I am now able to recognize panic when it hits, know it’s not going to kill me, and I can control the symptoms. All I can say is thank God for the psychiatrists, psychotherapists, and biofeedback expert who helped me get my life back. God bless them.

Hi. I am taking 75 sertraline and was trying to gradually up it to 100.
Got severe panic and anxiety the first of November. I felt like I was going to drop my baby and my family wasn’t going to be taken care of. I felt like I was going to pass out. I was shaking and had the pins and needles feeling in my arms and hands and neck. My baby was 3 weeks old. I knew this was the beginning of Postpartum depression and anxiety.
My brother in law called in some xanax for me and that seemed to help the panic. The next day I went to my OB and she prescribed 100 sertraline. I took it and that night I had diarrhea and severe anxiety still and could not sleep still. I lost my appetite completely and continued having loose bowelsas well as attacks of panic and anxiety for several weeks.
I could hardly take care of myself at all. I was so weak, thirsty, severe head aches formed, pressure behind my eyes, felt very dizzy, throat felt very tight, palpitations in my throat, hard heart palpitations, high blood pressure, burning sensations on my neck and arms and fingers. My toes were always freezing cold. I would go back and forth between sweaty and freezing cold. I just wanted to sleep all the time or scream and cry and hold my parents or husbands hand. When it would get dark I would start panicking and wanted to die. I felt so guilty for the burden I was to my Mom cause she was feeding my baby at night and taking care of him a lot during the day. I was still breast feeding for the first few weeks of all of this. I fought hard to keep my milk supply up and continue feeding my baby breast milk because I truly enjoyed it!
One night I all of a sudden really was scared that I might hurt myself. I told my husband to not let me do anything to myself. I said I didn’t want to be in this world anymore. That there was no comfort here. I was terrified. I took a xanax but immediately started throwing up from the anxiety I think. My mom said be careful who I told I wanted to die because they would commit me to the psych ward. And she would rather help me at home. One day I knew something was physically wrong- why was I soo dizzy, why did my eyes and head hurt soo bad, why was I soo weak. My mom took me to an insta care and the doctor recommended going down to 50 sertraline and that I would start feeling better in a few days. I did start feeling a bit better physically. But one night I tried feeding the baby all night on my own. Before bed I started panicking. I asked my dad to come sleep by me and help me feed the baby with a bottle and hold my hand through the torture of panic. He talked me through my fears but he would fall asleep and I wouldn’t. My mind was racing and created a horrible wakeful nightmare. It was all I could do to not call 911.
In the morning when my Mom was going to work I told her it was the worst night of my life and I needed someone to stay home with me. She gave me a xanax. My Dad ended up staying home from work. (I was living with my mom and dad and my husband would visit on the weekends so my older two girls could continue going to school and he could go to work and my in-laws were taking care of things at my house). That morning I felt extreme shame and guilt and a lack of hope. I felt like I wanted it all to end. I was scared of what it would do to my family if I killed myself. I knew I wouldn’t be with them in heaven if i killed myself and I was scared my husband would kill him self if I did. I talked to some counselors and one told me to check myself into the hospital. I made my Dad take me to the ER. They asked me questions and committed me to the psych ward. My mom was furious and scared for me! I couldn’t eat all day in the ER and went into shock when they committed me. I was sooo disoriented, slow speech, confused, in and out of coherence.
My mom told me to remember my family loved me and to get better quick and come home. Everyone was praying so hard for me. once at the hospital I was very slow to answer questions. They had to repeat themselves so I could answer. I lied about being suicidal, but I couldn’t lie about all the physical symptoms because I was so out of it. I got some good sleep on some drug that starts with a T. The next day I tried to act fine. No one could tell what a horrible headache I had and how I was anxious and shaky and dizzy. But the second day when I tried to force feed myself I threw up every where. I got to leave the next day and didn’t have any more suicidal thoughts. I truly was feeling better. I even made friends and tried to help some of the patients there. I felt like myself again, but more laid back. I was laughing about everything. I knew life had to be different from now on. I had to be a laugher and never take things so seriously again. So I had only one or two more anxious minutes and ever since have felt pretty good.
I tried to always get really good sleep and exercise, eat healthy and take my 50 sertraline from Walgreens, Greenstone version. I started upping it to 75 a week ago and then I started taking it in the evening again and have noticed I’m a little more sleepy and less motivated. A little more burning neck and hands feeling and lump in the throat again. Should I just get over the last bit of anxiety and stay with the 50 in the evening?
I have noticed it is harder to come to orgasm when making love with my husband in the evening and wondered if it will get better since I started taking it at night again. I guess we have to be happy with things when they are just ok right? I am so happy to have my health back and be able to take care of my family again!!! But I really want to be careful cause I am sure I am still fragile emotionally right now. My baby is two months old and my husband has chronic ocd with depression and anxiety. Some things react with his sertraline at times and he has super bad days some times- very infrequent. My husband started feeling better and that helped the most. I have always felt like the strong one, but I cant be that right now. We both have to take care of ourselves right now. Doing well, but what do you think of my story?

I echo others’ comments about Northstar. When I took the TEVA version of sertraline, I responded well. With the Northstar version, I have heartburn and other unpleasant reactions. I wish the quality control with generics was better.

Same here – tried others but had to have Greenstone.

That’s weird because greenstone is what does work for me, but Camden did not. I guess everyone reacts differently.

OK, so I’m back on sertraline, doc wants me to try it out again because it worked so well for me before. I have to tell you that there is DEFINITELY a difference in the manufacturers in my opinion. I tried to go back on it in August. The first time I got it the manufacturer was Greenstone, I had MAJOR side effects from it (increased panic attacks, severe dizziness, migraine headaches, stomach issues, felt like I wanted to crawl out of my own skin, etc.) I even started at 12.5.
After 2 weeks of pure hell I stopped taking it. This time around however, I got the script filled and the manufacturer is Northstar. And guess what… I have hardly ANY side effects. I even started at a higher dosage (25), I was expecting to get even worse side effects (if they could even get any worse than that) this time from starting out on a higher dose, and I am totally shocked! I have taken it for 2 days now and the only thing I seem to feel is a little bit of lightheadedness, a slight headache, and some shakes.
I felt good enough yesterday that it didn’t even feel like I had to take my xanax, but I did anyway because I have to wean myself off of them. So, I really do think that these fillers they put into the generics make a TON of difference in how a person reacts. Just thought I’d add my input on the subject. Hope this help some of you. God Bless!

Did you try walgreens, they have greenstone generic zoloft, it really does make a difference, some pharmacist are clueless but a psychologist would tell you a few changes will make a difference. They only have to make the generic 80 percent of the real thing.

My CVS pharmacist laughed at me when I recently inquired why the tablet was a different shape than before. She replied they’re all the same. Maybe for her…. but NOT TRUE. CVS recently switched manufacturers and the generic zoloft (sertraline) is now supplied from InvaGen or something, whereas before it was from Greenstone. The Invagen version was horrible the first day, but I gave it a go for 1 month. Nightmares every night, couldn’t sleep, became lethargic, lazy, didn’t care about anything.
So when I asked to switch back to the previous manufacturer, she basically said I’d have to go to another pharmacy because they used a different supplier now. They couldn’t even get the name brand ZOLOFT, even if I paid full price, w/o any copay.
AMAZING. I’ve been researching where these pills are made, with no luck. Most everything is made in China or India.

I did have a friend that broke out in rashes from using an ssri, it probably is a different chemical camden uses, I did not like Camden.

Here is my long story.
I was on Teva for 10 years 100mg and did great. Went off for a year and had some life problems and Dr prescribed Camber sertraline back in May. Within a week I got a sharp pain on my scalp. I kept upping the dosage 25mg per week. Around 100mg I was getting pins and needles in face and arms. Plus the sharp scalp pains like someone drilling into my skull.
I figured it was my anxiety, but mentally I was feeling great except for dealing with this. So since I thought it was anxiety my counselor decided I should bump up to 150mg. That’s when my face started burning around my eyes, sometimes down into my cheeks. Mostly on the left side but sometimes on the right. Also when I would stand I felt tingling on the crown of my head. This burning would be worse under stress, some days not too bad but never gone. It also seems to peak around 3-7 in the evening. I take my Zoloft at 7 am. I stayed on 150mg with these symptoms for 2.5 months thinking it was anxiety symptoms.
I emailed my sister and she said it sounded like side effects. I am now on day 15 of tapering off. Currently 100mg now for 9 days. Going down to 75mg for 14 days etc… I really haven’t seen much improvement in two weeks. Pharmacist says its probably the meds and not the amount of dosage. That these might continue until I am completely off.
Anyone else have a similar experience. Does this sound like meds or my anxiety? I have never had these type of symptoms before I was taking this.

Hey Mary, The good generic by Greenstone that I have had great success with is yellow and oval. It looks almost identical to the brand. The one that was totally different and awful was also yellow but a bigger oval and had different imprints on it. I think it had #’s on both side and more of them than the good generic. I can’t remember what they were on the bad one. I hope this helps! Good luck. You should be able to find the good one. Take care

Lucy, is the good one your taking the yellow oblong shape? I had no idea there were two, I thought I was safe getting my Dr. to say on script “greenstone” because I had problems with camden.

I too am glad that I found this website, not happy that everyone is having to deal with this, but happy that I am not alone. I have recently discovered that Greenstone has two different versions of a generic zoloft out. I have been taking the one that looks almost identical to the brand and it has been working wonderfully for me. I had been filling it at CVS. I recently went to refill it and came home to realize the pill was different, a little larger with different imprints on it.
There was no sticker even indicating that they had changed it. Well, I took it and honestly I immediately noticed a difference the very first day. I had heart palpitations, nausea, and after a couple of weeks of trying to stay with it, I had a day where I had several panic attacks all in a row, it was awful.
I haven’t had one in forever, as the other version I had been taking was working like a dream. I finally called my Dr. and just got the brand name because I was afraid I would end up with something bad again. It costs 130.00 after coupons and insurance! I called around and found that Walgreens has the generic that I had been getting originally, which as I said, is also made by Greenstone. I am back on it, and I find it to be even more helpful than the brand, not to mention it only costs 13.00!!
I am praying that Walgreens doesn’t end up switching to that horrible other version Greenstone makes. The pharmacist there told me that they have had that version for a long time and had no plans to change it. I don’t know why Greenstone would make two versions of the same thing. The bad one must be cheaper to make. I am going to tell my pharm. again to please not switch! I am thinking this is probably the reason why several people said Greenstone was awful and others said they had great success with it. They were like night and day, and honestly the one should be called a different drug, because it was clearly NOT the same thing.
I have had this experience with other generics too. It is so upsetting to have to worry whether or not your medicine is going to work and do what it is supposed to do. It is definitely not right or fair to us. I wish everyone luck in finding something that helps you and works well to get you back on the good path you are meant to be on!! Even just one day of feeling bad, because of bad medicine, is too much. We deserve better than that! Way better.

Well, I decided to stop taking it. I really don’t think it was gonna work for me at all this time. I had such severe s/e from it. I was dizzy for a week straight to the point I felt like I was going to pass out, severe stomach trouble, no appetite at all, migraine headache, and it made me have HORRIBLE panic attacks. Never had these start up s/e when I took it the first 3 times. I guess I’m just gonna stick with my Xanax. Good luck to all of you who are taking it already, or just starting up. :)

Heather, I would recommend finding a pharmacy with Greenstone you can call around, it took about two weeks after taking generics for me to be able to tell the difference between manufacturers. Two differences can make a difference. I noticed that Walgreens has greenstone.

I have been reading all of the comments on here about generic Zoloft and I’m a little concerned now. After going to the pharmacy today to get my refill, I noticed that the manufacturer on my old bottle is Greenstone and the new bottle is Northstar. I am going to take the new ones next week to see what happens, if anything, from switching. I just got done looking up the inactive ingredients in each, they are mostly the same, but there are a few differences. (like 2) Here’s a link if anyone is interested in seeing what they are.
This one is for Northstar http://www.drugs.com/imprints/a-1-7-14515.html And this one is for Greenstone http://www.drugs.com/imprints/g-4900-50-mg-13166.html Hopefully it won’t be a bad experience for me, as I’m just starting back on them and still have some of the initial side effects. Has anyone here ever switched from Greenstone to Northstar? If so, what was your experience?

I am one of the lucky ones who has a psychiatrist who told me right off that the generics are NOT the same as the brand name. He is very knowledgeable about the fillers, etc., and also told me that Greenstone was the original manufacturer of Zoloft, so I request Greenstone all the time on my prescriptions. I have had no problems with Greenstone at all, but did with the other generics before I brought it up to my psychiatrist. He is not a fan of generic medication.

Hi Maria-
I think almost everybody here is working with healthcare professionals as they attempt to find a medication that works for them. For the most part, medications such as Zoloft and generic sertraline are not available without a doctor’s script.
However, many of us have also been given incorrect information by the healthcare pros we trusted, when they told us that generic sertraline is “identical” to brand Zoloft. Our painful experiences have revealed to us that generics differ in dosage and effectiveness. When we brought this forward to the professionals we rely on, some received support, others were told our problems were “all in our heads.”
So, although I agree that healthcare professionals are an important resource, we have discovered that often leaving it to professionals is not enough, and that if we want to be healthy, WE must step up and take an active and informed role in our treatment.
Regards,
Sam

I have taken the Mylan and Greenstone. Then I was given the medication from Lupin which comes from India. I took a nosedive and felt as I did years ago. I found another pharmacy that was able to refill with Greenstone. I was right back to being happy again. Don’t hesitate to talk to your doctor if you need to increase the amount.

I see a lot of people here sort of experimenting with dosages and medicines. I would never dare to do such a thing and I think that such things should be handled by professionals.

I was on lexapro in my early 20s. It worked well but killed my sex drive. Job/life changes and my insurance didn’t cover lexapro, so I was put on citalopram. It never really helped but it kept me stable and I would notice a change if I missed a dose but still had feelings of sadness and depression.
Now I’m on generic zoloft (sertraline 50mg) and because my new insurance doesn’t cover Lexapro since may of this year. At first, it was great, but now the usual side effects have begun.

Hello,
Ever since TEVA quite making Zoloft its been a nightmare trying to find something to replace it. Tried about everything.
The brand name Zoloft aggravates my stomach, doesn’t work as well, and causes me to gain weight in face and stomach more than TEVA brand ever did. At least TEVA brand worked so well mentally it was worth the tradeoff.
I tried Wal Mart brand Zoloft. Worked like TEVA mentally, but made me gain tons of wt in just 2 months time.
Tried Greenstone brand and that didn’t work for anything.
Tried Paxil and that makes me more anxious.
So does anymore have any advice on what I could try? So pissed off at TEVA. I relied on that drug for over 10 yrs. Helped me through my worst times. Now at my lowest pt with health issues, financial issues, etc I don’t have it.
Should also mention I recently was diagnosed with lymphatic colitis which is somewhat similar to celiac disease. Zoloft along with other antidepressants were listed as a possible cause.
Also want to mention never take a Benzo like Klonopin or Xanax for any length of time. I found out it is tremendously hard to get off of. Tried getting off of it twice now, but caused too many problems. Only on 1mg at nt. Anyway, any help about an antidepressant would be much appreciated. already tried, prozac, lexapro, eflexor, pristiq, ect. What form of Zoloft works most like the old TEVA did???????? thank you

I had my Dr. write my scripts specifically with generic makers name on it, it is way too important to take chances I agree.

I’ve been taking 50 mg sertraline (Mylan brand) for major depression for 8 months, starting with 25 mg and increasing gradually. It worked immediately for me, and it’s almost a miracle. Recently my pharmacy changed generic brands to Lupin. The old sadness & depression and inability to deal with the normal stresses of life started to creep back (it’s only been about 5 days). I found another pharmacy that could refill my prescription with Mylan brand. This is too important to me to take any chances!!!

I am so thankful to have discovered this site! I had been taking Zoloft for over 10 years and in the last 6 months was switched to generic sertraline when a new prescription was required by CVS Mail Pharmacy and generic was approved. I have gradually become more emotional (crying over nothing), self-critical, irritable, etc. Living with those changes seemed acceptable UNTIL one Sunday, about a month ago, I had tremors or seizures that lasted 15-20 minutes and was taken to the ER.
There, several less severe events of the same symptoms occurred. After being monitored, having an EKG, Cat Scan, etc., I was told that I must have had an anxiety attack and was given Lorazepam (I understand) through an IV. Upon release, I was given a prescription to fill for Lorazepam and advised to contact my primary physician on Monday.
My primary physician (who had prescribed my original medication for depression) reviewed the reports, talked to me and my husband regarding the symptoms I had experienced and since all of the test results were in the normal range, he referred me to a neurologist, after advising he did not believe I had an anxiety attack. Upon seeing the neurologist, more tests were ordered to rule out something serious that may have been overlooked.
I have now had two EEG’s, EKG, Cat Scan, blood work and who knows what else… amounting to thousands of dollars. The only results that came back, other than “normal” was that I have Tachycardis (heart rate over 100). He recommended an increased dosage of the Sertraline, and my primary physician concurred and it was done.
When I received the prescription in the mail and read the possible side-effects include seizures, tremors and increased heart rate I was (and still am) livid!!! What do I do now?

My doctor suggests taking sertraline in the mornings, because it does tend to have an energizing effect on some people. Personally, it makes me sleepy, so I take it at night. Best advice I could give you is to try taking it in the mornings if she’s having trouble going to sleep at night.
I’m sure you have read all the scary stuff about Zoloft/Sertraline and are worried to death, as we moms all tend to be, but I can assure you that I have been taking Zoloft and then Sertraline for 20 years at a very high dose, and I have had no adverse effects from it. It probably saved my life, and it has certainly given me a quality of life I never would have enjoyed otherwise.
I began taking it at age 43 and am now 63 and don’t intend to ever stop it. Your daughter may have a better chance of going off of it after awhile, though, since she is beginning treatment at an early age. The longer you wait to begin treating depression, the more likely it is to recur if you stop meds.
Just watch your daughter closely until she’s been on this medication for awhile. There is a suicide risk associated with it in young people, and that’s the thing you want to talk with her about and keep communication open so she can tell you if she starts having that kind of thoughts.
I’ll say a prayer for your daughter, and let her know she can come on this site and ask questions and get encouragement from other people with the same kind of struggles. She is fortunate to have a mom who is taking such good care of her! God Bless you both!

Three days is pretty quick to be seeing results, but certainly not impossible.
Sleeplessness is definitely a possible side effect of antidepressants.
Hopefully, your doctor has made you aware of the possibility that if your daughter is bipolar she may have a bad reaction to antidepressants (or a bad reaction to antidepressants alone).
If this is the case, zoloft could tip her into mania, so you should monitor her carefully, because bipolars who take antidepressants are at an increased risk of suicide. If she is showing other signs of mania – being very “up,” talking fast, having rushing thoughts or intrusive ideas, engaging in risky behavior (like driving fast), irritability – be sure to take note and discuss with your doctor.
I’m not trying to freak you out, but finding the right medication can be tricky. God bless you for protecting your daughter and taking proactive steps to help her!
Good luck,
Sam

Hi. I’m brand new. My daughter has just been prescribed zoloft. We went to Walgreen’s and they suggested the generic (Greenstone is on the bottle) and I said sure, less expensive. We’ll see. I just got on this site this morning because it’s been three days at just half a pill, 25mg and she seems to think it’s making a difference already? – but is having a hard time going to sleep at night.
Maybe it’s placebo affect… I don’t care, she seems more balanced. NOW all of a sudden I’m freaking out after reading all the comments! OK – my question. She’s having trouble sleeping. NEVER been a problem before. Could it be from this pill? We meet w/ the therapist Tues and I want to journal every symptom, etc to give her.

Are thee any contraindications on oral care when taking Zoloft (the generic brand)? I have a funny taste in my mouth and have used many mouth rinses and am concerned for what the drug is doing to my teeth, gums or roots. Thanks for any help
A

My pharmacy just switched from Greenstone Sertraline to Camber Sertraline and I’ve been having an allergic reaction (hives, rash, itching). Anyone else experience this? What in the inactive ingredients could cause this besides artificial dyes? I’ve looked for a listing of the inactive ingredients and cannot find a listing – on the Camber website they only list what is NOT in the inactive ingredients.

I can’t believe I found this website. I thought I was losing my mind and here you all are with the same experiences! TEVA’S generic zoloft was absolutely hands down the one that worked best for me. To this day I haven’t found one that works well enough. I tried different generics and different meds and NOTHING compares.
The brand name didn’t even come close. I lost my job after they pulled it off the market! My fiance and I were evicted, I couldn’t function. It’s been years and I’m still ill. There should be a law that protects patients… in other words they shouldn’t be allowed to pull it off the market unless it’s harming people. If money is the issue… then the gov should subsidize them to keep it on the market… especially if the gov gave them the ok to PUT it on the market in the FIRST place!!

Sharon, Thanks for the reply about the Camber Zoloft. I will contact RiteAide and see what they can do. I don’t think there is a RiteAide pharmacy in my area. I’ll certainly check though. Does anyone know another pharmacy that carries the Camber brand??? I’ve got to get on something soon. Between the chronic pain with my neck that will need surgery soon, my Dad’s passing, and reduced pay with my job I’m under more stress than ever in my life and currently not taking any antidepressant. Not a good combination. Afraid I’m going to end up having a heart attack, or being put in a place if i don’t get on something. All just too much.
Also, has anyone that had success with TEVA Zoloft had any success with other meds such as Paxil, and if so what brand???
Any help would be greatly appreciated. I’m certainly on the ropes rt now.
Thank you , Gary

Gary, I did take the TEVA brand once, and it seemed to do fine, but MEDCO stopped getting it from them and replaced it with one that I actually had an allergic reaction to. Because MEDCO switches generic brands so frequently, I opted to get my meds from our local RiteAide pharmacy, one month at a time.
They just switched from Greenstone to Camber for generic sertraline, and the pharmacist advised me that it will be their generic brand indefinitely, so I know I can get it there. You might check with the RiteAide in your area and see if they carry the Camber brand; if not, they might be able to get it for you.
I do have bloating and weight gain, but I have had that since beginning Zoloft, so I don’t think any particular generic brand is at fault – I think it’s just a side-effect of sertraline in any form. But I’ll take “fat and happy” over slim and depressed any day!
I actually got a lot better when I accepted the fact that life is sometimes just HARD – it’s part of the normal cycle of things – and we just have to feel the pain and let it run its course. But those of us who suffer with clinical depression can have a more difficult time “bouncing back” than those who don’t, so I pray that you will be able to find a medication that will help you through these difficult days. May God bless you with His presence and give you peace, my friend.
Sharon M.

Sharon,
I haven’t had luck with anything since TEVA quit making Zoloft. Teva Zoloft worked well for me for so many years. Even the brand name doesn’t work as well for me as the TEVA. Really put me in a bad spot right now cause recently lost my Dad, having financial problems, and health problems. On overload. I need to be on something. I was thinking about trying the Camber brand you’re talking about.
The TEVA zoloft worked really well, but I did have to fight the problem of wt gain and bloating especially in face and stomach, but the anxiety relief I got from it was worth it.
Did you ever take the TEVA brand and did it work for you? Does the Camber brand seem to cause you bloating and wt gain?? Lastly and most important, where can I get this CAmber Zoloft from. What stores carry it???
Thanks, Gary

Hi rs-
Have you tried adjusting your dosage? It doesn’t work for everybody (some people just have a bad reaction to the generic, period), but my wife had a good resolution to similar experience of the medication not working after switching to the Greenstone generic.
She switched to taking the 100mg pills from the 75mg ones, and found that she could get an equivalent effect. It’s obviously a bit scary to tinker with a medication that is important to your well-being, and it can take up to 2 weeks to really know if it’s working – but if it’s an economic necessity it may be workable.
Good luck,
Sam

I switched from 150 mg Zoloft to generic (Greenstone) sertraline about a year ago because of the cost of the brand. I did well for awhile but then went into a decline and eventually was almost as ill as before I began Zoloft. When I refilled my Rx a few weeks ago, I noticed that the pharmacy gave me the Camber sertraline. The results are amazing.
I feel better than I have in years, even on the brand Zoloft. I am going to ask the doctor to specify that I get the Camber sertraline with every refill. Apparently, what works well for some of us doesn’t for others, but the Camber generic works amazingly well for me.

I took Zoloft for years and years and then the same thing happened to me and I had to go to a generic, which didn’t work at all. Finally I went back to my psychiatrist and he gives me a specific prescription for Greenstone sertraline. Greenstone is the pharmaceutical manufacturer of Zoloft and the ingredients are identical. With a prescription written like this, the pharmacy has to purchase the sertraline from Greenstone and no other manufacturer. This way, you don’t end up with who knows what from who knows who. You can even ask the pharmacist to make sure the sertraline is from Greenstone. Hope this helps – it sure helped me!

I have been taking brand name Zoloft for approximately 10 years because of perimenopausal hormone fluctuation resulting in low levels of serotonin. This Past January, I was told by CVS that Z is no longer covered on the tier and I would have to take sertraline instead which would be the same.
Well, my nervousness and anxiety as well as hot flashes have returned threefold!! I would be willing to pay a portion of the $300/month cost but not entire amount. Any suggestions?

Greenstone makes Zoloft, so the generic you are getting is the exact same thing as Zoloft. It should work the same. My psychiatrist specifically put me on this brand. I am on the Greenstone generic and I didn’t notice any difference like I did with the other makers of sertraline.

I too have had problems with pharmacies switching generic brands of sertraline. I was on for about two years taking greenstone the last refill I picked up was from camber. I started taking it for a few days and noticed my panic attacks were slowly starting to come back. I thought that was very odd, looking at the bottle it said this is the same medication you have been getting, color size or shape may appear different.
I knew that was the problem then. I called around and found a pharmacy that carries the greenstone. I will be switching to a different pharmacy. If its not broke why try and fix it?

I’ve been on Zoloft, then CVS’ generic Sertraline since 2002 for OCD. Does anyone else have a problem with very explicit and disturbing dreams? Also, I’ve recently begun having some trouble with recall – I’m 40, used to have no trouble remembering facts/figures/names, but some days, now, it feels like I’ve got mud for brains. Anyone else have this problem?

Hey, I have had withdrawal symptoms (tired, weepy, anxious) from switching from Greenstone to Camber, so I am requesting the pharmacy to order mine from Greenstone, llc. I don’t see how its legal for the meds to be different.

So thankful to find this online site!
After reading the posts above, I am thinking now… This may be why I haven’t felt 100% for so long, i.e the fillers or inactive ingredients in my generic Zoloft RX which I’ve used for years.
Over the years, I too have had pharmacies switch to different companies selling the generic Z. But before now, I never really gave it much thought, always believing generics were pretty much the same.
I was taking Walmart’s “horse pill” sized generic, which honestly was a crap shoot for me. Some months the refill worked great, other months…nada After researching it a bit online, I discovered that their manufacturer overseas, had some problems. Walmart then assured me they had addressed it and all further refills were fine.
I decided to switch to Rite Aid b/c they have an Rx assist card which lessens the cost for me. I was getting the original looking Pfizer brand of Zoloft.
However, my most recent refill of Zoloft is by Camber Pharma, and obviously not the same pill as I was taking before. And the bottle has the sticker saying “this is same meds you have been getting, color, size or shape may appear differently.”
Maybe it should also include: note: Take at your own risk? It might work great, but then again….
I’m going to return to the store tomorrow and ask for the brand Z again, or find another pharmacy that can deliver upon my request.
Thanks again for all the info and testimonials. These generic manufacturers really should be accountable to their customers’ concerns.
Thank you!

Has anyone had a problem with being switched and causing jitters, anxiety and nervousness?

I have just recently had the switch done on me by CVS. I went from North Star liquid to Greenstone. Within a week I almost had a panic attack, but luckily the xanax was handy. I also had insomnia and shortness of breath. These symptoms are like the start up of a new SSRI.
I got on the phone and called every pharmacy in my area to find North Star and Target had it. I called my NP, which is also a good friend, and he wrote the script up for Northstar only. I thankfully have xanax handy until I go pick it up in the morning. Of, course I had to wait a extra day to avoid paying full price. Of course I am a very medicine sensitive person, so any little change throws me for a loop. Love this website! I am glad I am not the only one with switching issues.

Thank you all. Today I looked at my bottle of Sertraline. I have been taking this new refill for about 2 weeks and I am back to where I was 10 years ago. The holiday season can be depressing, but right now it is very depressing for me. When I received this refill, the pills were a different color and smaller. They are from LUPIN. I will be calling my physician in the morning.

My daughter has been on the Greenstone Sertraline for over a year and was doing great. We recently sent her prescriptions through our mail order and we received the Lupin Sertraline. Within a week of starting the new generic, her panic attacks are worse than ever. She couldn’t function and go to school.
We talked to her psychiatrist about the coincidence of medication change and her worsened anxiety and she agreed that we should switch back to the Greenstone. After reading all the comments, I would consider refilling your RX with the Brand Zoloft if you can afford it. Switching to different manufacturers is too dicey.
Anna

My health-care requires that I use medco for my prescriptions. They recently switched my Zoloft generic to Greenstone and it has been horrible. After suffering this switch for a couple of months now, which includes anxiety, extreme irritability, and head shivers/brain freezes, I have asked that my doctor prescribe me the band name. My father-in-law was switched to Greenstone it as well and noticed the difference. He was smart and got prescribed the brand name as soon as he noticed something wasn’t right
This isn’t the first time my generic was changed. I don’t remember my previous generic, but as soon as I went on it, withdraw systems kicked in and my dose had to be increased 25mg.
Clearly there needs to be more regulation of generics because the system isn’t working.

I look back ironically: I accepted anxiety and depression as my “norm,” until I finally took Zoloft: and optimism and hope gradually returned. Even so, this very anxiety prompted me to fixate on “the least effective dose”–to avoid any side-effects like agitation–so, lo and behold, it didn’t really work that well for the first two years.
Finally, at 75-100 mg. it worked well (and has for several years). I too felt the Greenstone was not quite as strong, but this is very subjective and uncertain. Ultimately, depression is an emotional response to loss, hurt,and self-criticism (rather than, as Freud noted, directing the anger properly outward at those who indeed have hurt and damaged us). Renewed faith in one’s self is also strengthened by the transcendent meaning about life we can experience through great truths (Buddha, Gandhi, etc.) and great art (say, Beethoven, Tolstoy, etc.)

Mylan brand was good for me.
Greenstone brand was bad for me.

My boyfriend is taking Sertraline. Some days he is fine, then somedays he has no patience with anyone. I hesitate to ask if he has taken a pill as he can get very defensive. How fast does the pill effects wear off and is not working? Do you have to take it the same time every day to make it effective? Want to be a good friend and let him be aware of his emotional changes.

WOW. Thank you fro all these comments. I had a very successful first 9 months on Sertraline made by Camber.
I truly am a skeptic, and very rational and believed there would be no difference in efficacy when my pharmacy switched me to Greenstone. It was a HORRIBLE month before I realized that the switch might have caused it. I actually got so down, so low energy, and so emotional – I was truly SCARED. What a nightmare. Can I have these pills evaluated? Something doesn’t seem quite right about Greenstone brand.

Hi STL mom- thanks for clarifying, and sorry if I came off like I was jumping down your throat. I agree, in fact, that generics can work- in my case, a simple dosage adjustment was ultimately enough. But I was slowed down and put through weeks of misery and fright because the pharmacists were telling me that there was no possibility it was the change to generics that was responsible for the different in effect.
Ultimately, moving from 75mg/day of Zoloft to 100mg/day of generic was a workable solution- and, as you say, financially important given the price of staying on brand name.
There are people who need encouragement to “shop around” for generics, or to try a different dosage; it’s just hard, sometimes, to choose our words carefully so we don’t disparage people’s experiences.
Thanks again for participating in this conversation- as you can see from the comments, it is an important forum for people seeking to understand their situation.
No hard feelings,
Sam
P.S. I think I posted this here before, but there is another longer thread for those who are interested @ http://www.topix.com/forum/business/biotech/T7R9P0NFHGN871B8J

I’m sorry Sam. I think I may have not explained my comment about ‘it is all in our minds’ very well. I totally agree with the realities that you have described. The fact of the matter is that some people suffering may feel like a generic is inferior to a brand. Because we think that we may be getting something at lesser quality. Millions of people take a generic and are just fine. Some of us are forced to take a generic over a brand for insurance reasons. I was simply trying to offer peace of mind.

Dear STL Mom,
Thanks for sharing your experience… and your experience apparently is different from the other posters. Yes, there are times to be strong, to suck it up, to martial on. However, most of the folks who are posting to this site are on this med because of a chemical imbalance in the brain.
Before I started Zoloft (generic was not available) I tried the no-refined sugar, wheat, etc. I exercised 2 hours per day, and tried to “buck-up.” It didn’t work. I went to therapy and was told that I was well adjusted and after 5 weeks was told that it wasn’t how I was looking at things, that the issue was a chemical imbalance. Sure enough, the Zoloft worked.
I had taken the Zoloft, then generics for years– different generics with no problem. However, when my pharmacy changed manufacturers this last time, the result was miserable. My side effects (when I later researched them) were those listed as those typical with abrupt discontinuance. I hadn’t dc’ed it, I simply took another manufacturer’s product.
We keep being told generics are the same (equivalent) as the brand name and other generics. I would have agreed with this — up until recently. I can no longer support that position.

Hi Judy,
Here-here. Medco switched me from Cobalt to Lupin-manufactured Setraline HCL. What a crash and burn. After some intense telephone wrestling, (I don’t think they liked dealing with me on the Cobalt stuff!) and upon my insurance co. insistence, Medco agreed to send me the Cobalt again. Thank goodness for overnight mail (they paid!).
I too had the trouble with the burning esophagus when taking the Lupin brand.
Yes… brand named Zoloft worked great. I’ve been on generic Setraline HCL for years with no problem until Lupin came into my life.
Thanks to everyone for the postings. They’ve helped me to see the light through the fog of the last week.
GG

Hi STL mom- thanks for sharing your story and adding your two cents to our collective knowledge base!
I would like to disagree with you on one point, however- the differences between generics and brand, and between generics of different manufacturers, are not all “in our minds.”
Certainly, everyone who has struggled with psychiatric illness knows how complex the brain is, our tremendous capacity to shut out things we can’t fix and shift our focus to those things we can- and that this shifting can seem like we are “creating our own symptoms.”
For many of us, even realizing that our psychiatric conditions were real and could be helped by medication at all was a gradual one, drawn out over many years of blaming ourselves for our problems and trying to “choose to be stronger.”
For this reason, we have reacted strongly to doctors and pharmacists telling us that “these are the same pills” and that if we are experiencing any difference it is “in our minds.” Some of us have despaired, thinking that one of the things that made life possible is lost or no longer works; many of us have lashed out in anger as we became educated about the differences between different preparations of the “chemically” equivalent medicines.
Fact is, the FDA guidelines are exceedingly loose in terms of dosage- and Sertraline is a highly dosage-sensitive medication- not to mention all issues attendant to different “inactive” filler ingredients.
Thank you for coming to this forum and sharing your experience and wisdom, and I wish you the very best luck on your journey- but please don’t tell us it’s “all in our minds.”

Please Help!!!!!!!!
I relied on TEVA Zoloft since 1997 whenever i was under extreme stress. My a couple of years also took it on regular basis. Problem as many of you know is that TEVA quit making Zoloft as of July 2009. This has cause major, major problems for me. Teva zoloft wasn’t exactly without side effects, but it worked great for the mental deal. Did cause face and stomach bloating and increased appetite which i didn’t like. However it was my go to med when I encountered extreme stress.
Now, I’m in the worse shape in my life. My Dad is about to die of Leukemia. The job I had for 11 yrs I had to resign from due to a variety of health issues. I had a botched sinus surgery in 2004 that has caused sleep issues and anxiety issues. After two trip to Ohio, and a reconstructive surgery this past month to rebuild my septum that is better. However I’ve had 11 or so surgeries in the past 3 yrs. 5 meniscus tears, two shoulder ops, neck fusion, sinus surgery, colon and stomach problems. So physically I’m beat up and have relied on physical type jobs my whole life. Let’s add in two bulging discs in my back. So presently at a job for half the pay and hurting financially.
I’ve tried the brand name Zoloft, Lupin , Greenstone, Cobalt, and one by Invagen (wal mart brand).
The only one that worked similar to TEVA is the Invagen brand, but that caused excessive bloating and wt gain. Tremendous wt gain.
Brand name Zoloft helped some, but also cause bloating and wt gain. Didn’t help as much as Invagen or TEVA brand.
Currently, I’m on 15 mg of Paxil, but still so depressed and all I can’t get stuff done. I’ve also tried CElexa, Efexxor, Prozac, Pristiq, Luvox, ect. Nothing replaces the TEVA zoloft.
I figure my only options are to stick with the Paxil and keep going up on the dose, or go back to the brand name Zoloft and just deal with the bloating and wt gain. Not as bad as the INvagen brand. Any help or suggestions would be greatly appreciated as I can’t hardly function like this.
Thank you, Gary

I have been taking generic Zoloft mfg by Cobolt for a long time with good effect. Then I got a refill of my meds and after a week or so, I found I was more depressed and jumpy. After 3 weeks of feeling pretty bad, I checked my meds and found out that my last refill from Medco was manufactured by Lupin.

I also have been on Zoloft for long time. Take 200mg a day….
I was then switched to Sertraline (Greenstone) no problems….Then Medco changed the mfg. and I started getting dizzy and having tremors. I found a store that carried the Greenstone Mfg. and everything is fine now. Now they have switched my Wellbutrin XL (300mg) to Bupropion XL–Fine. Mfg. is same as Wellbutrin. Now the same place I get my Sertraline from changed MFG. on this one and same thing is happening.
Now I need to find a place who carries the original MFG. By the time I’m done I will be using several different drugstores. It’s not even the insurance co. It’s the Pharmacies for me…….STOP playing with our lives. The people who really need the meds are the one’s suffering and not just financially. There ought to be a law……
Can anyone explain to me why my insurance will pay for 90 100mg Wellbutrin a month. 1 three times a day. But won’t pay for 30 300mg once a day???? It’s a bad thing to miss doses which happens when you have to take 3 times a day vs. 1 time a day. DUH….

I too have been on Zoloft for years (brand name) worked well. The last batch from Medco (generic) has caused a downward spiral. Actually all of the generics did not work as well as the brand name. I have a call in to my Dr. to prescribe brand name and will just have to bite the bullet with the costs of it. I don’t want to go to work anymore and that will cause more money problems for me, so the cost of the name brand is worth it.

About ten years ago my physician put me on an anti depressant. I had ‘electric zings from my head to every part of my body. When put on Zoloft, I didn’t have this problem, however, I had a new one. When I started to break down on this drug I got the same ‘electric zinging’ only worse, to the point that my entire body would jerk from the jolts. I can not seem to get off this drug because of this. I would like to know why this happens and what part of the body is it affecting to do this.

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