Can i take melatonin with sertraline
Melatonin and Zoloft: Is It Safe to Take Them Together?
Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/14/2022
Melatonin is a common over-the-counter sleep aid. It’s widely available and equally widely used, with millions of Americans reportedly using it every year, according to National Health Statistic Reports.
Common uses for melatonin supplements include helping with sleep in people who are battling jet lag or affected by delayed sleep-wake phase disorder (DSWPD). It is a condition where people have “great difficulty initiating sleep at an appropriately early time, and, as a knock-on effect, waking at a desirable time in the morning, leading to chronic, and often quite severe sleep restriction trying to conform to a nine-to-five schedule,” according to an article published in the Journal of Thoracic Disease.
If you’re prescribed Zoloft® (a.k.a., sertraline, a selective serotonin reuptake inhibitor), you may have wondered whether or not it’s safe to take melatonin with your antidepressants.
The use of melatonin with antidepressant drugs may potentially increase your risk of some side effects, including sedation. As such, it’s important that you talk to your healthcare provider before you use these medications together.
Below, we’ve explained more about what you should be aware of if you’re prescribed Zoloft and want to use melatonin to fall asleep. We’ve also explained how supplements such as melatonin works in your body.
Learn more about sertraline in our complete guide.
What Is Melatonin?
Melatonin is a hormone. It’s produced naturally by your body in response to darkness. As the sun sets and light levels begin to decrease, your pineal gland secretes melatonin, causing you to feel tired and sleepy late at night, according to an article published in the journal, Brain Disorders and Therapy.
You can purchase melatonin as a supplement, typically in the form of capsules or tablets, to help if you have trouble sleeping. Because it is considered a health supplement, melatonin is regulated less strictly by the FDA than medications and can be purchased over the counter from drugstores, health food stores and online.
Melatonin is not a prescription drug.
Although research overall is mixed, some studies have found that higher melatonin levels may make it easier to fall asleep and have benefits for a quality sleep pattern, according to an article published in the journal, Neurological Research.
For most people, melatonin is a safe supplement for short-term use in controlling sleep problems. However, like many other supplements, it may cause side effects, according to an article published in the journal, StatPearls.
Of these, the most common are nausea, drowsiness, dry mouth, daytime sleepiness and headaches. Additionally, melatonin could worsen blood pressure in people who take blood pressure meds, according to a study published in the British Journal of Clinical Pharmacology.
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Can You Take Melatonin With Zoloft?
Yes, you can use melatonin and Zoloft together. Zoloft (sertraline) and other SSRIs can cause insomnia, which means it wouldn’t be unusual for people prescribed Zoloft to consider sleep aids such as melatonin.
Currently, there isn’t very much research on the effects of melatonin and Zoloft together. While there are no reported drug interactions between melatonin and Zoloft, melatonin may make certain antidepressants less effective.
Because of this, it’s best to talk to your healthcare provider before using melatonin and Zoloft at the same time. They’ll be able to tell you about potential safety risks and offer personalized help to make sure that you stay safe while using your medication.
Other Ways to Treat Insomnia from Zoloft at Home
The sleep disorder insomnia is one of the more common side effects of antidepressants such as Zoloft. In fact, data from clinical trials shows that 20 percent of people who use Zoloft report at least some degree of insomnia during treatment.
If you find it difficult to fall or stay asleep while using Zoloft, making a few changes to your habits and lifestyle can often help. Try the following techniques to make falling asleep easier while you use Zoloft:
Take Zoloft in the morning.
If you find it difficult to sleep at night, try taking Zoloft earlier in the day. The best time to take Zoloft for sleep would be in the morning. Make sure to talk to your healthcare provider first to check that it’s okay to take your medication at this time. Exercise regularly during the day. Exercise, especially in the morning and afternoon, may help to improve your sleep quality. Try to do at least 30 minutes of exercise, five days per week, ideally at a moderate to vigorous intensity level.
Make sure not to drink alcohol. Drinking alcohol is not recommended while you are prescribed Zoloft. Alcohol, especially in excess, may also have a negative effect on your sleep quality.
Avoid caffeinated drinks after midday. Caffeine’s elimination half-life may be as long as 9.5 hours, meaning a single cup of coffee can have a lasting negative effect on your ability to fall asleep, according to the book, Caffeine for the Sustainment of Mental Task Performance: Formulations for Military Operations.
As such, it’s best to avoid caffeine after midday.Turn off technology an hour before you need to sleep. Finally, try switching off your computer, tablet or any other electronic device with a screen one hour before you want to sleep. This may help to stimulate your body’s own melatonin production.
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Melatonin and Zoloft: Final Thoughts
If you’re currently prescribed Zoloft, talk to your healthcare provider before you use melatonin or any other sleep aids. Also, try using the techniques listed above to relax, unwind and fall asleep more easily while you’re taking Zoloft.
Good sleep is essential for your mental health and wellbeing. Unfortunately, it isn’t always easy to come by. Our complete guide to science-backed techniques for better sleep explains what you can do to improve your sleep for better health and a higher quality of life.
12 Sources
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current.
We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.
- Alcohol and sleep. Sleep Foundation. (2022, January 31). Retrieved February 17, 2022, from https://www.sleepfoundation.org/articles/alcohol-and-sleep
- authors, A., & Xie, Z. (n.d.). A review of sleep disorders and Melatonin. Taylor & Francis. Retrieved February 17, 2022, from https://www.tandfonline.com/doi/full/10.1080/01616412.2017.1315864
- Barnes, et al. (2015, February 10). Trends in the use of complementary health approaches among adults: United States, 2002-2012. National health statistics reports. Retrieved February 17, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573565/
- Can Electronics Affect Quality Sleep? Sleep Foundation. (2020, November 6). Retrieved February 17, 2022, from https://www.sleepfoundation.org/articles/why-electronics-may-stimulate-you-bed
- Fogari, et al.
(2000, May). Cardiovascular effects of melatonin in hypertensive patients well controlled by Nifedipine: A 24-hour study. British journal of clinical pharmacology. Retrieved February 17, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014953/ - Girardin, et al. (2014). Melatonin, the hormone of darkness: From sleep promotion to ebola treatment. Brain disorders & therapy. Retrieved February 17, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334454/
- How can exercise affect sleep? Sleep Foundation. (2021, December 9). Retrieved February 17, 2022, from https://www.sleepfoundation.org/articles/how-exercise-impacts-sleep-quality
- National Academy Press. (2001). Caffeine for the sustainment of mental task performance formulations for military operations.
- Nesbitt, A. D. (2018, January). Delayed sleep-wake phase disorder. Journal of thoracic disease. Retrieved February 17, 2022, from https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC5803043/ - Office of the Commissioner. (n.d.). Dietary supplements. U.S. Food and Drug Administration. Retrieved February 17, 2022, from https://www.fda.gov/consumers/consumer-updates/dietary-supplements
- Savage, R. A. (2021, August 15). Melatonin. StatPearls Internet. Retrieved February 17, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK534823/
- U.S. Department of Health and Human Services. (n.d.). Melatonin: What you need to know. National Center for Complementary and Integrative Health. Retrieved February 17, 2022, from https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
Can You Take Melatonin with Zoloft? • San Diego Health
It is not recommended to take Melatonin with Zoloft (sertraline). There is no evidence that there is an interaction between the two – but that is because taking melatonin and Zoloft together is largely untested. For safety, it is not recommended that you take Melatonin with Zoloft.
If you are unsure, you should speak to your doctor or a medical professional before using them both together.
If you want to know more about natural sleep aids, check out our Performance Lab Sleep review.
Why would you take Melatonin with Zoloft?
You may take Melatonin with Zoloft if you’re currently experiencing sleep problems alongside depression.
People who take Melatonin are usually using it to treat the following conditions:
- Insomnia – Inability to get good quality sleep.
- Jet Lag – Irregular sleep pattern from changing time zone.
Whereas those taking Zoloft may use it to treat:
- Depression
- Major Depressive Disorder
- Obsessive Compulsive Disorder
- Panic Disorder
- Post Traumatic Stress Disorder
- Postpartum Depression
- Premenstrual Dysphoric Disorder
- Social Anxiety Disorder
It is not uncommon for someone suffering from one of these mood-related conditions to also have trouble sleeping.
So the leap to taking Melatonin on top of this medication is definitely a possibility.
Our concerns with taking Zoloft and Melatonin together
Although both can be useful to treat their respective problems, we believe that taking Zoloft and Melatonin together may cause problems – as there is little recorded evidence of what happens when the two are taken together.
Our main reasoning is that they are both potent and powerful drugs.
That and it’s also highly advised against taking Zoloft with alcohol. Alcohol can cause dizziness, drowsiness and difficulty concentration – which can amplify the drowsiness and dizziness you experience with Zoloft.
Melatonin’s main function is to cause drowsiness. Combined with Zoloft, it may be to much of a negative effect on your nervous system and may cause some discomfort and instability.
As we’ve said, there’s not a lot of evidence for the effects of Zoloft and Melatonin taken together – we can only speculate by how they both work independently.
If you want to get better insight, you should definitely speak to your doctor or a medical profession before taking the two together.
Risks from taking Zoloft
When taking Zoloft you should be aware that is been known to cause the following side effects:
- Sleepiness
- Drowsiness
- General Fatigue
- Nervousness
- Sleep Problems (insomnia)
- Dizziness
- Nausea
- Skin Rash
- Headache
- Diarrhea
- Constipation
- Upset Stomach
- Stomach Pain
- Dry Mouth
- Changes in Appetite
- Abnormal Ejaculation
- Impotence
- Decreased Sex Drive
- Difficulty having an Orgasm
- Dry Mouth
- Weight Loss
As always, you should always have a prescription for taking Zoloft from a doctor / qualified medical professional. This is not something to be self-medicating with.
The main ones to note here related to Melatonin are the sleepiness, drowsiness and fatigue.
Combined with those effects you’re already getting from Melatonin, you may get more than you bargained for.
Risks from taking Melatonin
Taking pure Melatonin straight may cause side effects, especially if you’re taking a high dosage.
Potential (although unlikely) side effects from Melatonin include:
- Headache
- Dizziness
- Nausea
- Drowsiness
Again, the drowsiness is expected as this is the main purpose of supplementing Melatonin but with Zoloft having the risk of causing this too – it could exacerbate problems.
We highly advise anyone who is thinking of taking Melatonin and Zoloft together should speak to their doctor before doing so.
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- Performance Lab Sleep Review: #1 Natural Sleep Aid?
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Pablo Garduno
Hi, I’m Pablo Garduno. I am a biohacking enthusiast, and Head Writer of SanDiegoHealth.org. I write the majority of the content on this site, and appreciate you taking the time to read my work.
how it works in the body, how it works in pills and whether it can be drunk without a doctor's prescription
Daniil Davydov
medical journalist
Author's profile
The short answer is: it depends on the dosage.
But you need to keep in mind that melatonin is in principle contraindicated for some people.
Go see a doctor
Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations.
Relying on our point of view or not is up to you.
What is melatonin
Melatonin belongs to the class of neurohormones — this is the name of all hormones that are synthesized in the brain. Based on available data, melatonin has many biological functions, from fighting inflammation to lowering blood pressure.
What is melatonin - an international textbook for medical students StatPearls
But the main task of melatonin is to maintain the daily rhythms of the body. Simply put, melatonin is responsible for the regulation of our biological clock: it moves it from the "sleep" to the "wake" position, and vice versa.
Why do we need melatonin - an international directory of medicines Drugs.com
This is necessary to separate different physiological processes in time: to make sure that the mechanisms responsible for digestion and, for example, learning, turn on during the day. And at night, during rest, it is more convenient to do other things - for example, the restoration of cells damaged during the day and the formation of a long-term memory that stores the knowledge gained during daylight hours.
As a result, the body really starts to work like a clock: it does everything on time, so that different processes do not interfere with each other.
The biological clock, which ensures the smooth functioning of the body, consists of three elements:
- The retina of the eye, which captures light.
- The suprachiasmatic nucleus of the hypothalamus, or SCN, is an area of the brain that is sensitive to the change of day and night.
- The pineal gland is a part of the brain where melatonin is synthesized.
If no light hits the retina, it relays the information to the suprachiasmatic nucleus so that the pituitary gland tells the pineal gland to begin melatonin synthesis. Melatonin is the message “night has come” encrypted in the chemical.
When this neurohormone enters the bloodstream, the brain and internal organs understand that it is time to do night activities.
As a result, we begin to feel sleepy. And the more melatonin in the blood, the more you want to sleep.
Influence of light on circadian rhythms, sleep and mood of people - the journal "Somnology"
healthy people is the strongest.If even a little light hits the retina, it sends another signal to the suprachiasmatic nucleus, and the hypothalamus tells the pineal gland to stop melatonin synthesis. As a result, the body decides that morning is coming, and gradually begins to wake up, that is, it turns off the night processes and turns on the day ones.
The more light, the less melatonin: during the day, the concentration of this hormone in the blood drops 10 times to 20 pg/ml. That is why it is not recommended to use a smartphone and other devices with luminous screens at night: blue light from gadgets suppresses melatonin synthesis and it becomes more difficult to fall asleep.
6 things for healthy sleep
How melatonin drugs and supplements work
People have created melatonin drugs to manually reset their body clock.
The body does not care where melatonin enters the bloodstream - from the pineal gland or from a pill.
How melatonin drugs work - an international guide for doctors Uptodate
And if so, then theoretically such drugs can help with insomnia and other conditions in the regulation of which melatonin is involved. For example, with the jet lag syndrome that occurs due to long-haul flights - jet lag. People suffering from jet lag complain of fatigue, insomnia, headache and loss of appetite.
However, medicines and preparations in which melatonin is the active substance have not been fully studied, and their effect is still relatively modest. The strongest evidence for the effectiveness of melatonin is associated with sleep disturbances in blind people, as well as in those who have trouble falling asleep and disturbed sleep-wake cycles. Some authors add jetlag to the list.
Melatonin is only effective for sleep problems - International Drug Directory RxList
Melatonin may be effective for jet lag MSD
Sleep disorders.
Results from 19 clinical trials involving more than 1,500 children and adults showed that people who took melatonin for 2-5 weeks fell asleep 7 minutes earlier and slept about 8 minutes longer than those who received placebo. True, it was not possible to prove that in the end they slept better. The dosages of melatonin taken by the participants varied, ranging from 0.5 to 5 mg on average.
Jetlag. Four studies involving 232 people showed that people who took 3-6 mg of melatonin tablets for 5 days before and after a flight rated the severity of jet lag symptoms on a 100-point scale at 27 points. Those who took the placebo rated the severity of their symptoms on the same scale at 45 points.
Melatonin may well be effective for endometriosis, high blood pressure, anxiety before surgery, jaw pain, low platelet counts, as an adjunct to chemotherapy for certain tumors, or as sunscreen. But to say for sure, more research is needed to clearly show its effectiveness.
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Why participate in cancer clinical trials and how to find them
Most likely, melatonin does not help to stop drugs, does not alleviate senile dementia, does not help correct sleep patterns in shift workers, does not improve performance in the gym, does not cure infertility and depression.
At the same time, most researchers note that melatonin is a rather promising substance. To finally admit it to the world of big medicine, several large clinical trials will be required. Without this, it is difficult to figure out which diseases benefit from melatonin the most and in what dosages it works best.
Until such studies appear, the attitude towards melatonin in the world is ambiguous. In the USA, for example, there are no drugs with melatonin, but only nutritional supplements that can be bought in any dosage without a doctor's prescription. Both OTC medicines and melatonin supplements are available in our country.
But in the UK, the European Union, Japan, Australia and Canada, melatonin is available only in the form of a prescription drug.
Why melatonin is only sold in the European Union in drug form - Bulletin of the European Medical Agency
The sale of melatonin supplements in these countries is in principle prohibited, and this ban has serious justifications.
What happens if you take melatonin without consulting your doctor
It depends on the concentration of melatonin in the supplement or medication. Studies show that the effect depends on the dosage.
At a daily dose of 0.3-0.5 mg melatonin levels in the blood do not exceed the natural nocturnal peak. As a result, the effect of it is the same as that of "natural" melatonin, that is, a person falls asleep faster and more soundly. Melatonin in such dosages does not harm health.
At a daily dose of 1-10 mg of the level of melatonin in the blood increases by 3-60 times. Although melatonin itself is not poisonous, at such concentrations it has an overly powerful biological effect on the body. A person who has taken a supplement or medication may experience severe daytime sleepiness, reduced performance, and a drop in body temperature that will feel like an unpleasant chill.
Melatonin 0.3-0.5 mg is considered safe and can be taken by most people without discomfort.
Side effects of melatonin - Drugs.com International Drug Directory
However, it can still cause side effects in some people:
- Daytime sleepiness.
- Depressed mood, feeling of irritability.
- Headache or dizziness.
- Abdominal pain.
Pregnant women, children under 18 and people with medical conditions should definitely consult a doctor before buying melatonin products. In pregnant women and children, melatonin sometimes behaves unpredictably.
And in people with diseases, the consequences can be very severe.
Melatonin supplements and medicines do not work well with certain medicines. For example, caffeine and the antidepressant fluvoxamine can increase plasma concentrations of melatonin, increasing the risk of side effects from taking this drug.
Melatonin: 7 things you need to know - International Medicines Guide Drugs.com
Melatonin can lower the concentration of nifedipine. This is quite dangerous, because nifedipine is a drug for high blood pressure. If such a medicine does not work or is not effective enough, it is life-threatening.
Melatonin supplements and medications cause severe side effects in some patients. For example, they can cause bleeding in people with bleeding disorders, increase blood sugar levels in people with diabetes, provoke seizures in people with seizure disorders, and increase depression symptoms in people with depression. And melatonin can lead to transplant rejection - this is true for people who have recently undergone an organ transplant.
What's the bottom line
Based on available data, non-pregnant adults without medical conditions who have difficulty sleeping or experienced jet lag do not benefit from melatonin at a dosage of 0.3-0.5 mg. But before buying, it is better to consult a doctor: it is quite possible to do without an additive or medicine with melatonin.
Fighting depression: 10 modern drugs
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Articles
Fighting depression: 10 modern drugs
Depression is an urgent problem, the number of visits to doctors is growing every year.
It can be solved by contacting a psychotherapist and taking antidepressants . These are drugs that regulate the production of hormones and biochemical processes in the body. It is strictly forbidden to prescribe them to yourself, as these are complex drugs with certain restrictions, side effects . The doctor must authorize their appointment and control the intake. We will tell you which of them are the most effective and common in medicine, how many they have pluses and minuses.
What is meant by
depression Doctors have known it since ancient Greece and Egypt. Hippocrates described it as melancholy - a condition that is accompanied by anxiety, despondency, insomnia, refusal of food, irritability. Most often, the cause is childhood trauma or severe, frequent stress in adulthood. There are many provoking factors: the death of a loved one, deterioration of living conditions, alcoholism, brain diseases.
Such cases are referred to as psychogenic depression.
The second type is endogenous. The problem appears not from large external shocks, but because of internal causes. A person is constantly dissatisfied with himself, subjecting himself to criticism. Many patients have panic attacks , haunted by a feeling of fear, anxiety.
How long the period of depression lasts
Many people mistake ordinary periods of low mood for depression. If they do not last long and are quickly replaced by periods of recovery, then we are not talking about a depressive state. The problem is obvious when the symptoms persist for months and dramatically change a person's life. Then you need to see a doctor.
What happens to the body
The most common theory is that there is a malfunction of neurotransmitters located in the brain. These substances transmit signals from neuron to neuron and are responsible for a person's mood.
Dysfunction leads to a slowdown in the rate of this transmission and a decrease in the number of neurotransmitters themselves. Serotonin, which is called the "hormone of happiness", suffers the most. For clarity, this biochemical process can be compared, for example, with a drop in blood sugar levels in diabetes mellitus.
How is
treated depressionDepression has been treated in different ways. In the ancient world - emetics and laxatives. In the Renaissance - wine and sunbathing. In the Age of Enlightenment - external stimuli, for example, insects. The 19th century brought new recipes - in particular, a solution of camphor in tartaric acid. The treatment also included the use of drugs, which are now no longer allowed for sale, and some are recognized as narcotic.
Obviously, all these drugs had no effect on increasing the amount of serotonin. And the treatment is precisely to normalize its production. This was done after creating modern antidepressants , which have a minimum of side effects, are safe for the body and are not addictive.
These are drugs, whose action is aimed specifically at balancing the disturbed balance of neurotransmitters: serotonin, norepinephrine, dopamine.
Prescription
If a healthy person takes antidepressants , there will be no effect . For a depressed patient, taking them will help:
- improve psychological state;
- get rid of irritability;
- panic fear;
- increase mental and physical activity;
- overcome the dreary mood.
Psychiatrists prescribe antidepressants for chronic back pain, headaches. And also with irritable bowel syndrome, incontinence and other cases when the body stops producing its own painkillers. Medication helps restore pain suppression mechanisms.
You can only take these drugs with a doctor's prescription, as many of them are strong stimulants.
Self-administration may cost dearly - the condition may worsen. Only a doctor will correctly calculate how many medicines to take per day. In parallel with the treatment by a psychiatrist, a neurologist, a consultation of a psychotherapist is required.
Precautions
- Prescribed drug start drinking from a small dose - the first couple of days they take a quarter of a tablet. Gradually increase the dose to normal. So the body adapts better. Finish the course by reducing the dose.
- The first effect of appears only 2 weeks after the start of administration. Steady action - six months later. All this time, you need to take the remedy without making passes, breaks.
-
Products are not combined with melatonin, St. John's wort, products and dietary supplements based on sibutramine, 5-HTP. Their combination can raise serotonin to dangerous levels.
Also, you can not combine them with monoamine oxidase inhibitors, for example, Cipralex. When writing a prescription, the doctor takes these points into account. - Drinking antidepressants is better in parallel with visits to a psychotherapist. If the drugs normalize the biochemical processes in the body, then this doctor will help normalize the psychological state after depression.
The best antidepressants
In medicine, they have long argued that some drugs give only a placebo effect. The purpose of the study was to find out which of them are the most effective and valid . The project involved 116 thousand patients, and its results were published by the authoritative edition of the Lancet. We offer a list of the best.
1. Agomelatine
New generation drug. Agomelatine is used for severe depressive disorders, high levels of anxiety. Enhances the release of dopamine and norepinephrine, stimulates melatonin receptors.
The standard therapeutic dose is 25-50 mg 1 time / day. Helps to restore the normal structure of sleep, get rid of anxiety and panic attacks attacks
Pros
+ Does not adversely affect attention and memory.
+ No lethargy during the day.
+ No sexual deviations.
+ No correlation with blood pressure.
+ Do not reduce dosage upon discontinuation.
Cons
— In 1-10% of cases, increased sweating, diarrhea, constipation.
- Possible increased fatigue, drowsiness.
- There are no evidence-based safety studies for people with renal or hepatic insufficiency, therefore, such patients are advised to refrain from taking drugs with active ingredient agomelatine.
2. Amitriptyline
Tricyclic antidepressant. Moreover, the World Health Organization considers Amitriptyline the most reliable in this group. The standard dose is 200-250 mg / day. The action is to block the reuptake of neurotransmitters.
A good remedy for moderate to severe disorders of the endogenous type. Additionally, it has a sedative and hypnotic effect. Effective in the treatment of neuropathic pain, for the prevention of migraine.
Pluses
+ Drugs with active ingredient amitriptyline are inexpensive.
+ High reliability, minimum side effects.
+ Relatively safe during breastfeeding.
Cons
— Possible side effect in the form of blurred vision, dry mouth.
- Lowering blood pressure.
- Some patients experience constipation.
- Drowsiness.
3. Escitalopram
Belongs to a group of modern serotonin reuptake inhibitors (SSRIs). Most often, it is recommended to take for anxiety, panic attacks. It is taken once, the standard dose is 10 mg per day. Escitalopram has a milder effect and is prescribed to patients for whom tricyclic drugs are contraindicated.
Pluses
+ A lasting effect occurs after 3 months.
+ Indicated for patients with disorders of the cardiovascular system.
+ Soft action.
Cons
- In some patients, the functions of the gastrointestinal tract are disturbed, which is most often expressed in diarrhea.
— Anxiety may increase in the first 2 weeks, therefore it is recommended to start treatment with low doses and gradually increase them.
- Contraindicated in pregnancy and lactation.
4. Mirtazapine
A drug of the tetracyclic group. Mirtazapine - good stimulant for anxious depressions, has a moderate sedative effect. The average amount is 30 mg / day, it must be consumed once. Usually it is prescribed to patients who lose interest in life, cease to experience joy, pleasure. Effective in the correction of sleep, in particular, early awakenings.
Pros
+ Earlier onset of action than SSRIs (1 week).
+ Combines well with most drugs in the general group.
+ Full effect in 4 weeks.
+ Does not affect sexual function.
Cons
- The active substance mirtazapine is contraindicated in diabetes mellitus, arterial hypotension, increased intraocular pressure.
— During the admission period, you must drive carefully and engage in potentially dangerous types of work.
- 18% of patients experience drowsiness, 15% dry mouth, 5% weight loss. Other side effects occur in 1-3% of cases.
5. Paroxetine
Belongs to the SSRI group, is used most often for severe anxiety, panic, social phobia, nightmares, stress after trauma. Paroxetine can resolve the problems of anxious depression, anxiety-phobic disorders. Take once a day at a dose of 20 mg.
Pros
+ The most powerful stimulant among SSRIs.
+ Anxiety and insomnia pass quickly.
+ Minimal side effects in the form of vomiting, diarrhea.
+ Suitable for patients with cardiovascular problems.
Cons
— Not suitable for patients with severe motor, mental inhibition.
- Reduces libido.
- Harmful to the fetus when taken during pregnancy.
6. Fluoxetine
One of the most widely used antidepressants in the SSRI group. Known as Prozac. Fluoxetine is also known as a good mood stimulant. Patients have a feeling of fear, tension, anxiety, gloomy dislike for others. Depending on the indications, the average daily dose is 20-60 mg.
Pluses
+ There is practically no effect on the work of the heart.
+ Does not cause sedation.
+ Effective for patients with motor retardation and excessive daytime sleepiness.
Cons
- May cause weight loss.
— Hypoglycemia is possible in diabetes mellitus.
- Contraindicated in severe renal impairment.
7. Fluvoxamine
Another SSRI drug.
Fluvoxamine is similar to Prozac Fluoxetine but is fast acting and may cost cheaper. The effect is in a more active slowing down of the reuptake of serotonin by neurons. It is indicated for depression of various origins, as well as obsessive-compulsive disorders. The average daily dose is 100 mg.
Pros
+ Lower price than traditional Prozac.
+ Faster action than him.
+ Relatively minor side effects (diarrhea, dry mouth, drowsiness).
Cons
- Contraindicated in diabetes.
- Pregnant women - with caution, lactation - prohibited.
- Causes nausea in some patients.
8. Sertraline
One of the widely used and universal drugs of the SSRI group. They treat almost any depressive condition, panic disorder, social phobia. However, in severe clinical cases, sertraline may not be effective enough. The standard dose is 50 mg/day.
Pros
+ No cardiotoxicity.
+ The patient's psychomotor activity does not change.
+ Does not increase body weight.
+ Combines well with other groups of antidepressants.
Cons
— In the first 2 weeks there may be problems with sleep, diarrhea.
- Side effects of a sexual nature.
- Contraindicated in pregnant women.
9. Escitalopram
The drug is classified as an SSRI. Its difference is in its effectiveness in depression, which is accompanied by involuntary movements (tic, tremor, chewing, smacking). Escitalopram is prescribed to patients with panic, anxiety, phobias, obsessive thoughts or actions. The daily dose is 20 mg.
Pluses
+ Effective in tardive dyskinesia.
+ One of the most powerful SSRIs.
+ More pronounced thymoleptic effect (improvement of mood) compared to many antidepressants of the same group.
Cons
- In some patients, anxiety increases within 2 weeks after starting treatment.
- Gastrointestinal disorders, insomnia, agitation are possible.
