14 Zoloft (Sertraline) Interactions

Zoloft Interactions

1. Amphetamine Drugs

Serotonin syndrome is a potentially life-threatening condition that can occur when too much serotonin builds up in the body. It is most likely to occur when taking more than one drug that increases serotonin levels. Since Zoloft increases serotonin levels, taking it with other drugs that increase serotonin levels can increase the risk of serotonin syndrome. Amphetamines, such as Adderall, can also affect serotonin levels. If these drugs are used together, you will need to watch closely for signs of serotonin syndrome.

Symptoms can include:

• Agitation
• Confusion
• Fast heart rate
• Flushed skin and excessive sweating
• Movement changes, such as tremor, muscle rigidity, or involuntary movements
• Restlessness

2. Other Antidepressants

Many people are prescribed more than one antidepressant. Taking more than one drug in this class can raise serotonin levels and increase the risk of serotonin syndrome. Healthcare providers typically avoid prescribing SSRIs like Zoloft in combination with other SSRIs, as well as with drugs from a similar class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs). However, you will still need to watch for signs of serotonin syndrome.

3. Certain Antipsychotics

Certain antipsychotic drugs are contraindicated with Zoloft, meaning they should never be used together. For example, Orap and other brands of pimozide should not be taken with Zoloft, as the combination can cause serious heart rhythm problems. Healthcare providers will typically try to avoid prescribing these antipsychotic drugs with Zoloft due to the serious risk.

4. Blood Thinners

Blood thinners (anticoagulants) are prescribed to prevent blood clots, but they can also increase the risk of bleeding. Zoloft is also associated with a bleeding risk. When taken together, these medications can increase the risk of bleeding. If your provider approves this combination, you should be alert to signs of bleeding, such as:

• Bleeding gums
• Blood in the stool
• Easy bruising
• Nosebleeds

5. Triptans

Triptans are a class of drugs used to treat migraine. Both triptans and Zoloft increase serotonin. The combination of a triptan with Zoloft can increase the risk of serotonin syndrome, especially after starting Zoloft or with a dose increase.

6. Saint-John’s-Wort

Saint-John’s-wort is an herbal dietary supplement that many people take for mild to moderate symptoms of depression, as well as various other conditions. Taking this supplement with Zoloft can increase the risk of serotonin syndrome. Check with a healthcare provider before combining Saint-John’s-wort and Zoloft.

7. Other Interactions

Other interactions to be aware of include:

• NSAIDs, such as Advil or Motrin
• Opioids, such as oxycodone or hydrocodone
• Certain mood stabilizers, such as lithium
• Monoamine oxidase inhibitors (MAOIs), such as Nardil or Zyvox
• Herbal supplements, such as Saint-John’s-wort

When to Avoid Zoloft Completely

The prescribing information for Zoloft lists several contraindications, which means Zoloft should never be taken under these circumstances. These include:

• People who are allergic to sertraline or any ingredient in the medication
• People who are taking the medicine pimozide
• People who are taking an MAOI or have stopped taking an MAOI within the past 14 days
• People who take the drug disulfiram should not take Zoloft oral solution (liquid)

Summary

Zoloft is a medication commonly prescribed to treat depression and other mental health conditions. There are various drug interactions to be aware of when taking Zoloft. Some medications must be completely avoided, while others may be used cautiously with close monitoring. Before taking Zoloft, tell your healthcare provider about all the medications you take, including prescription and OTC drugs, vitamins, and supplements. Your healthcare provider can give you medical advice on potential interactions and how they may affect you.

FAQs

• What is serotonin syndrome?
  • Serotonin syndrome is a potentially life-threatening condition that can occur when too much serotonin builds up in the body.
• What are some examples of substances that can increase serotonin levels?
  • Amphetamines, such as Adderall, and other antidepressants, such as Prozac or Cymbalta, can increase serotonin levels.
• What are some signs of serotonin syndrome?
  • Symptoms can include agitation, confusion, fast heart rate, flushed skin, and movement changes.
• Can I take Zoloft with other antidepressants?
  • Healthcare providers typically avoid prescribing SSRIs like Zoloft in combination with other SSRIs or with drugs from a similar class of drugs called serotonin-norepinephrine reuptake inhibitors (SNRIs).
• Can I take Zoloft with triptans?
  • The combination of a triptan with Zoloft can increase the risk of serotonin syndrome, especially after starting Zoloft or with a dose increase.