Increased dosage of zoloft

When Should You Increase Your Zoloft Dosage To Treat Anxiety?

  • Overview
  • What is Zoloft?
  • What is the proper Zoloft dosage for anxiety?
  • When to increase your Zoloft dose for anxiety?
  • Talk to your doctor first
  • Factors that could impact whether you need a higher dose
  • Zoloft’s effects on anxiety
  • The lowdown

If you’ve been prescribed Zoloft to treat your anxiety, but it’s not quite doing the job, you might find it tempting to increase your dosage. 

However, Zoloft is a psychiatric medicine, so it’s crucial you don’t take more or less than the dosage prescribed. However, your doctor may be able to prescribe a stronger dose if needed, if they determine that this is the right course of action.

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Zoloft, or sertraline as it is known under its generic name, is a psychiatric medicine used largely in the treatment of depression and anxiety. 

Taken orally, Zoloft belongs to a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. SSRIs are a commonly prescribed antidepressant that improves mood by blocking the mechanisms that absorb serotonin, allowing it to be available to the brain for longer. 

This is important because serotonin is known for its ability to induce feelings of happiness. In fact, serotonin is often referred to as the “happy hormone.” 

Starting Zoloft

The appropriate dosage of Zoloft will be determined by a doctor and is likely to differ depending on the patient and their individual needs. 

Typically, 50 milligrams once a day is a standard starting dosage for adults with depression, obsessive-compulsive disorder, and premenstrual dysphoric disorder. Some conditions tend to start with a lower dose of 25 milligrams once a day, like panic disorder.  

Maximum dose

Your Zoloft dose must stay within a safe range, so you’re unlikely to be prescribed anything higher than 150-200 milligrams per day. In the end, your dosage will depend on the condition being treated and your individual needs. 


Children can also benefit from Zoloft but will follow a different dosage regimen. This dose will be at the discretion of your doctor and is based on your child’s age, size, and therapeutic need. For instance, for children aged 6 to 12 years of age with obsessive-compulsive disorder, a standard starting dose is 25 milligrams once a day. 

If you have concerns or questions about your dosing, make sure to discuss it with your doctor before making any changes to your medication regimen. 

If you’re taking Zoloft, but aren’t feeling any improvement in your anxiety levels, it can be tempting to simply up your dose – but it’s important not to. 

Zoloft is not an instant relief medication. SSRIs do not exert instant effects like, pain relief does. Zoloft (and other SSRIs) is a little more complicated and it takes longer for its full effects to be felt. 

These medications take time for their effectiveness to peak. Zoloft works by blocking the reuptake of serotonin and it takes repetitive dosing and time for the medication to be able to exert its effects on your system. It can take around two to six weeks before you start to experience a reduction in your anxiety symptoms. 

If after this period you still haven’t seen any benefits then you may want to talk to your doctor about altering your Zoloft dose. 

While Zoloft can have a positive impact on anxiety, it can also come with some minor side effects. Zoloft can also increase your risk of serious side effects if you have an existing medical condition or are taking other medication. 

Therefore, increasing your Zoloft dose without approval from your doctor should not be done under any circumstances. This can have serious detrimental effects on your health and wellbeing and can result in coma and seizures.

Zoloft side effects and drug interactions 

The following side effects¹ and potential drug interactions² highlight why it’s important to follow your Zoloft prescription and avoid increasing your dosage without your doctor's approval.

Potential side effects of Zoloft include:

  • Nausea 

  • Loss of appetite or indigestion 

  • Diarrhea

  • Excessive sweating 

  • Tiredness or fatigue 

  • Sexual performance issues, e.g. reduced sex drive, failure to ejaculate 

  • Sleep disturbances, e.g. sleepiness or insomnia 

  • Shaking hands

  • Increased agitation and irritability

  • Suicidal ideations 

  • Impulsive and dangerous behavior 

  • Worsening of depression and/or anxiety symptoms

  • Violent behavior 

  • Seizures 

  • Manic behavior, e.g. fast-paced and racing thoughts, extreme high and low emotions, excessive energy, and talking grandiose thinking.

  • An allergic reaction (typical symptoms include trouble breathing, a rash or hives, and swelling).

  • Eye problems, e.g. blurred vision, red eyes, pain in the eyes.

  • Serotonin syndrome includes symptoms such as hallucinations, agitated behavior, loss of consciousness/coma, increased heart rate, vomiting, and rigid muscles

There are also specific side effects that can affect children taking Zoloft:

  • Nose bleeds

  • Urine problems, e.g. frequently needing to urinate or leaking urine 

  • Changes to menstruation, specifically heavier periods 

  • Agitation or fidgeting 

  • Aggressive or irritable behavior that is out of the norm 

  • Changes to physical development. You may see your child’s growth rate start to slow down and/or weight gain.

 Conditions that can increase your risk of Zoloft side effects:

  • Glaucoma: People with glaucoma can experience an increase in glaucoma attacks if they take Zoloft and should therefore talk to their doctor to determine if the SSRI is appropriate.  

  • Seizure conditions: Since seizures are already a potential side effect of Zoloft, the medication should be considered carefully in people with a seizure condition lest it increases their frequency or severity³. 

  • Liver issues: Patients with liver problems should take care when starting Zoloft as they can experience stronger effects than normal, due to their liver’s inability to break down the medication. 

  • Bipolar disorder: Bipolar disorder is a possible contraindication for Zoloft as you may experience a higher risk of manic symptoms. 

  • Kidney issues: Much like the liver, if your kidneys aren’t functioning well then you may not be able to filter medications properly, resulting in higher levels of Zoloft in your system. 

Side effects that can occur when Zoloft is taken alongside certain medications: 

  • Increased risk of serotonin syndrome can occur when Zoloft is taken with monoamine oxidase inhibitors, linezolid, intravenous methylene blue, triptans, lithium, fentanyl, tramadol, and St John’s wort.

  • Heart problems can occur when Zoloft is taken with pimozide.

  • Bruising and bleeding can occur when taken with nonsteroidal anti-inflammatory medications, e.g. aspirin.

  • A build-up of medications (including Zoloft) can occur in your system when taken with cimetidine, tricyclic antidepressants.

While it’s important to stick to the dose recommended by your doctor, there are legitimate and safe reasons why your doctor may increase your Zoloft dose. 

For instance, your doctor may increase your Zoloft dose if you aren’t seeing a significant reduction in your anxiety symptoms, so long as it is safe. 

The risks of altering your Zoloft dosage without medical approval are substantial. However, with a prescribed dosage and professional advice, Zoloft can have a positive impact on your anxiety and improve your quality of life. 

Research tells us that Zoloft can effectively reduce anxiety scores. One study⁴ found that Zoloft managed to significantly improve anxiety, worry, and depressive symptoms in patients (60 years and older), with an anxiety diagnosis (generalized anxiety disorder, panic disorder, agoraphobia, or social phobia). 

Zoloft is also an effective treatment option for children suffering from anxiety. A 2018 study found that SSRIs significantly reduced anxiety symptoms⁵ in children. The study also found that a combination of Zoloft and cognitive behavioral therapy was a particularly effective treatment option. 

What To Expect When You Take Anxiety Medication

Zoloft is an effective treatment for managing anxiety. Your doctor will prescribe Zoloft if they believe it is a good fit, and may gradually increase your dose until you start to see results or reach a maximum dose. 

However, since Zoloft can have some serious side effects and can interact negatively with other drugs, do not increase your dosage until you have consulted a medical professional.

Zoloft (sertraline) dosing, indications, interactions, adverse effects, and more

Patient Education
sertraline oral




WARNING: Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

USES: Sertraline is used to treat depression, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, social anxiety disorder (social phobia), and a severe form of premenstrual syndrome (premenstrual dysphoric disorder).This medication may improve your mood, sleep, appetite, and energy level and may help restore your interest in daily living. It may decrease fear, anxiety, unwanted thoughts, and the number of panic attacks. It may also reduce the urge to perform repeated tasks (compulsions such as hand-washing, counting, and checking) that interfere with daily living. Sertraline is known as a selective serotonin reuptake inhibitor (SSRI). It works by helping to restore the balance of a certain natural substance (serotonin) in the brain.

HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start using sertraline and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually once daily either in the morning or evening. The tablet or liquid form of this medication may be taken with or without food.The 25 milligrams, 50 milligrams, and 100 milligrams capsule is usually taken with food. The 150 milligrams and 200 milligrams capsule may be taken with or without food. Swallow the capsules whole. Do not crush or chew the capsules. If you have any questions about how to take the capsule form of this medication, ask your doctor or pharmacist.The liquid form of this medication must be mixed with another liquid before use. Just before taking, carefully measure the dose using the medicine dropper provided. Do not use a household spoon because you may not get the correct dose. Mix the dose with a half cup (4 ounces/120 milliliters) of water, ginger ale, lemon-lime soda, lemonade, or orange juice. Do not use other liquids to mix this drug. The mixture may appear cloudy, which is normal and harmless. Drink all of the mixture right away. Do not prepare a supply in advance.If you are taking this medication for premenstrual problems, your doctor may direct you to take this drug every day of the month or for only the 2 weeks before your period until the start of your period.The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Keep taking this medication even if you feel well. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as mood swings, headache, tiredness, sleep changes, and brief feelings similar to electric shock. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Report any new or worsening symptoms right away.Tell your doctor if your condition lasts or gets worse.

SIDE EFFECTS: See also Warning section.Nausea, dizziness, drowsiness, dry mouth, loss of appetite, increased sweating, diarrhea, upset stomach, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: easy bleeding/bruising, decreased interest in sex, changes in sexual ability, muscle cramps/weakness, shaking (tremor), unusual weight loss.Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, fainting, black stools, vomit that looks like coffee grounds, eye pain/swelling/redness, widened pupils, vision changes (such as seeing rainbows around lights at night, blurred vision). This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking sertraline, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as latex found in the medicine dropper, tartrazine found in some brands), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, bleeding problems, liver disease, seizure disorder, thyroid disease, personal or family history of glaucoma (angle-closure type). Sertraline may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using sertraline, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using sertraline safely. This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).The liquid form of this medication contains alcohol. Caution is advised if you have diabetes, alcohol dependence, or liver disease. Some medications (such as metronidazole, disulfiram) can cause a serious reaction when combined with alcohol. Ask your doctor or pharmacist about using this product safely.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially bleeding, loss of coordination, or QT prolongation (see above). Loss of coordination can increase the risk of falling. Older adults may also be more likely to develop a type of salt imbalance (hyponatremia), especially if they are taking "water pills" (diuretics). Children may be more sensitive to the side effects of the drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.Since untreated mental/mood problems (such as depression, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder) can be a serious condition, do not stop taking this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, discuss with your doctor right away the benefits and risks of using this medication during pregnancy.This drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: See also Precautions section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: pimozide, other drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as dabigatran/warfarin).Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before and after treatment with this medication. Ask your doctor when to start or stop taking this medication.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including other SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as alcohol, marijuana (cannabis), antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain or cough relievers (such as codeine, hydrocodone).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Aspirin can increase the risk of bleeding when used with this medication. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.This medication may interfere with certain medical/lab tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

NOTES: Do not share this medication with others.Keep all regular medical and psychiatric appointments.

MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised May 2022. Copyright(c) 2022 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.


Reception of Amitriptyline is possible not earlier than 14 days after discontinuation of MAO inhibitors.

Warnings and precautions

Talk to your doctor or pharmacist before using Amitriptyline.

Arrhythmias and hypotension may occur with high doses of amitriptyline. This can also occur at regular doses if you suffer from heart disease.

QT prolongation

Cardiac abnormalities called “QT prolongation” (as seen on an electrocardiogram, ECG) and arrhythmia (rapid or irregular heartbeat) have been observed with Amitriptyline. Tell your doctor if:

  • you have a slow heartbeat,
  • you have or have had problems where your heart is not able to supply the body with the blood it needs (a condition called heart failure),
  • are taking other medicines that can cause heart problems, or
  • have a disorder that results in low levels of potassium or magnesium or high levels of potassium in the blood
  • if you are preparing for surgery, as it may be necessary to stop taking amitriptyline before administering anesthetics. In case of emergency surgery, the anesthesiologist should be informed about the treatment with amitriptyline.
  • have an overactive thyroid or are taking thyroid medication. nine0022

Suicidal thoughts and worsening of your depressive disorder

If you are depressed, you may sometimes have suicidal thoughts and desire to hurt yourself. These may be increased the first time antidepressants are used, as these drugs take time to develop an effect, about 2 weeks or more.

This is especially observed in the following categories of patients:

  • if you have had suicidal thoughts and desire to hurt yourself in the past,
  • if you are young. Data from clinical studies have shown that an increased risk of suicidal tendencies occurs in people under the age of 25 with psychiatric disorders treated with antidepressants.

If you have suicidal thoughts and want to hurt yourself, call your doctor or go to the hospital right away.

It may be helpful to tell a relative or close friend that you are depressed and ask them to read this leaflet. You can ask them to tell you if they think your depression or anxiety is getting worse, or if they are worried about changes in your behavior. nine0003

Manic episode

Some patients with manic-depressive illness may enter a manic phase. It is characterized by exuberant and rapidly changing ideas, hyperthymia (persistent high spirits), and excessive physical activity.

Tell your doctor if you have or have recently had health problems, especially if you have

  • narrow angle glaucoma (loss of vision due to an abnormal increase in intraocular pressure)
  • epilepsy, history of convulsions or seizures
  • difficulty urinating
  • prostate enlargement
  • diseases of the thyroid gland
  • bipolar disorder
  • schizophrenia
  • acute liver diseases
  • severe heart disease
  • pyloric stenosis (narrowing of the opening at the outlet of the stomach) and paralytic ileus (intestinal obstruction)
  • diabetes, because you may need to adjust the dose of your diabetes medicine. nine0022

If you are using antidepressants such as selective serotonin reuptake inhibitors (SSRIs), your doctor may consider changing the dose of your medicine (see section Other drugs and Amitriptyline and section How to take Amitriptyline).

Older people are more likely to experience certain side effects, such as dizziness with orthostatic hypotension (see section Possible side effects).

Children and adolescents

Depression, neuropathic pain, chronic tension headache and migraine prophylaxis

Amitriptyline should not be used in children and adolescents under 18 years of age as safety and efficacy have not been established in this age group.


  • ECG should be performed before initiation of amitriptyline therapy to rule out long QT syndrome
  • Medicines in this group should not be taken concomitantly with anticholinergics (see also section Other medicines and Amitriptyline)
  • Suicidal thoughts and behavior may also develop during early antidepressant treatment for disorders other than depression; in the treatment of patients with bedwetting, the same precautions should be observed as in the treatment of patients with depression.

Other medicines and Amitriptyline

Some medicines can affect the way other medicines work and this can sometimes cause serious side effects.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines such as: (used to treat Parkinson's disease). They should not be taken during a course of treatment with amitriptyline (see section Do not take amitriptyline)

  • epinephrine, ephedrine, isoprenaline, norepinephrine, phenylephrine and phenylpropanolamine (they may be present in cough or cold mixtures and in some combination anesthetics)
  • high blood pressure medication, such as calcium channel blockers (eg diltiazem and verapamil), guanethidine, betanidine, clonidine, reserpine and methyldopa
  • Anticholinergics, eg certain drugs for Parkinson's disease and gastrointestinal disorders
  • thioridazine (used to treat schizophrenia)
  • tramadol (painkiller), nefopam or opioid analgesics
  • medicines for the treatment of fungal infections (including fluconazole, terbinafine, ketoconazole and itraconazole)
  • sedatives (including barbiturates)
  • antidepressants (including SSRIs (fluoxetine, paroxetine, fluvoxamine and bupropion)
  • medicines for the treatment of certain heart conditions (including antiarrhythmic drugs, beta-blockers such as amiodarone, disopyramide, propafenone)
  • cimetidine (used to treat stomach ulcers)
  • methylphenidate (used to treat ADHD)
  • ritonavir (used to treat HIV)
  • oral contraceptives
  • rifampicin (used to treat infection)
  • phenytoin and carbamazepine (used to treat epilepsy)
  • St. John's wort - herbal remedy for depression
  • thyroid hormone preparations
  • apraclonidine and brimonidine (used to treat glaucoma)
  • altretamine (used in the treatment of certain types of cancer)
  • disulfiram (used to treat alcohol dependence)
  • baclofen (muscle relaxant)
  • drugs for the treatment of angina pectoris of the inhalation or sublingual type (including nitroglycerin, isosorbide dinitrate)
  • sibutramine (appetite suppressant)
  • valproic acid.
  • Also tell your doctor if you are taking, have recently taken or may be taking medicines that can affect your heart rate, including:

    • medicines for the treatment of palpitations (including quinidine and sotalol)
    • astemizole and terfenadine (used to treat allergic reactions and hay fever)
    • medicines used to treat certain mental illnesses (including pimozide and sertindole)
    • cisapride (used to treat certain types of indigestion)
    • halofantrine (used to treat malaria)
    • methadone (used for pain management and drug detox)
    • diuretics (including furosemide).

    If you are having surgery with general or local anesthetics, you must tell your doctor that you are taking this drug.

    You must also tell your dentist that you are taking this drug before you use a local anesthetic.

    Amitriptyline with alcohol

    It is not recommended to drink alcohol during treatment with this medicine, as this may increase the sedative effect. nine0003

    Pregnancy and lactation

    If you are pregnant or breastfeeding, think you may be pregnant or are planning to become pregnant, please consult your healthcare professional.

    Amitriptyline is not recommended during pregnancy unless you and your doctor have discussed the risks and benefits of using the drug.

    If you are taking this drug during the last trimester of pregnancy, you should know that your newborn baby may have the following side effects such as irritability, increased muscle tension, tremors, irregular breathing, reluctance to drink fluids, loud crying, urinary retention and constipation. nine0003

    Your doctor will tell you to start/continue/stop breastfeeding or stop using this drug based on the benefits of breastfeeding for your baby and the benefits of therapy for you.

    Influence on the ability to drive and use mechanisms

    The drug may cause drowsiness, dizziness, especially at the beginning of treatment. It is unacceptable to drive or work with mechanisms if it negatively affects you. nine0003

    Important information about the ingredients of Amitriptyline tablets

    Amitriptyline tablets contain lactose medicine.

    How to take Amitriptyline

    Amitriptyline should be taken exactly as directed by your doctor. If you have any doubts, you should consult your doctor or pharmacist. nine0003

    Not all dosage regimens are possible with different dosage forms and doses of the drug.

    The appropriate dosage form and dosage must be selected for starting 3 and subsequent increasing doses.


    Adults :

    The recommended starting dose is 25 mg twice a day. Depending on the clinical effect, the dose may be increased up to 150 mg/day divided into two doses. nine0003

    Elderly patients (over 65 years of age) and patients with cardiovascular disease

    The recommended starting dose is 10-25 mg per day. Depending on the clinical effect, the dose may be increased to 100 mg / day, divided into two doses. If you are taking 100mg to 150mg of the drug, you may need to see your doctor more often.

    Use in children and adolescents

    Amitriptyline is not recommended for children and adolescents to treat depression. See section 2 for more information.

    Neuropathic pain, chronic headaches tension-type headaches and migraine prophylaxis

    Your doctor will adjust the dose to your treatment according to your symptoms and your response to your symptoms.

    Adults :

    The recommended starting dose is 10-25 mg in the evening.

    The recommended daily dose is 25-75 mg.

    Depending on the clinical effect, the dose may be gradually increased. If you are taking more than 100mg/day, you may need to see your doctor more often. Take the drug once a day or divide the dose into two doses, your doctor will tell you.

    Elderly patients (over 65 years of age) and patients with cardiovascular disease

    The recommended starting dose is 10-25 mg in the evening.

    Depending on the clinical effect of the drug, the dose may be gradually increased.

    If you are taking more than 75 mg/day, you may need to see your doctor more often.

    Use in children and adolescents

    Amitriptyline is not recommended for use in children and adolescents for the treatment of neuropathic pain, chronic tension headache and migraine prophylaxis. For more information, see What you need to know before you use Amitriptyline.


    Use in children and adolescents


  • Children 6 to 10 years of age: 10-20 mg daily. In this age group, appropriate release forms are used.
  • Children 11 years of age and older: 25-50 mg.
  • The dose should be increased gradually.

    Should be taken 1 to 1.5 hours before bedtime.

    Before starting treatment, your healthcare provider should perform an ECG to check for signs of a palpitations.

    Your doctor will re-evaluate your condition after 3 months of treatment and, if necessary, perform a repeat ECG. nine0003

    Do not stop taking this medicine without your doctor's advice.

    Special patient populations

    Patients with liver disease or known to be "slow metabolizers" are usually given lower doses.

    Your doctor may take blood samples to check your amitriptyline level (see What you need to know before you use amitriptyline).

    How and when to take Amitriptyline

    The drug should be taken during or after a meal.

    Tablets should be swallowed whole with water. Tablets should not be chewed.

    Treatment period

    Do not change the dose of the drug or stop taking the drug without consulting a doctor.


    As with other drugs used to treat depression, this too can take several weeks before you feel any improvement in your condition. nine0003

    In the treatment of depression, the duration of treatment is individual and is usually at least 6 months. The duration of treatment is determined by your doctor.

    Continue taking Amitriptyline for as long as your doctor tells you to. The disease may persist for a long time. If you stop treatment too soon, the symptoms of the disease may recur.

    Neuropathic pain, chronic headaches tension type and migraine prevention

    It may take a few weeks for your condition to improve.

    Talk to your doctor about the duration of treatment and continue taking the drug until the doctor stops it.


    Your doctor will determine if you need to continue treatment after 3 months of taking the drug.

    If you have taken more Amitriptyline than recommended

    If you have taken more Amitriptyline than prescribed by your doctor, contact your doctor or the nearest hospital emergency department immediately, even if you do not experience any discomfort or symptoms of poisoning . Take the medicine package with you if you go to the doctor or hospital.

    Overdose symptoms include:

    • dilated pupils
    • rapid or irregular heartbeat
    • difficulty urinating
    • Dry mouth or tongue
    • intestinal obstruction
    • seizures
    • fever
    • anxiety
    • confusion
    • hallucinations
    • involuntary movements
    • low blood pressure, weak pulse, pallor
    • shortness of breath
    • cyanosis of the skin
    • Decreased heart rate
    • drowsiness
    • loss of consciousness
    • coma
    • various heart diseases such as cardiac conduction block, heart failure, hypotension, cardiogenic shock, metabolic acidosis, hypokalemia.

    If you forget to take Amitriptyline

    Take your next dose at the usual time. Do not take a double dose to make up for a missed one. nine0003

    If you stop taking Amitriptyline

    Your healthcare provider will decide when and how to stop treatment in order to avoid unwanted symptoms that may occur when stopping the drug suddenly (for example, headache, feeling unwell, insomnia and irritability).

    If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

    Russia again suspended the supply of the antidepressant "Zoloft" - RBC

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    Due to production problems, the Zoloft antidepressant (active ingredient sertraline) is temporarily not supplied to Russia. This is not the first time that the supply of this drug has been interrupted: at the beginning of the year, it was not available in pharmacies

    Photo: Konstantin Kokoshkin / Global look Press

    technical problems in production, RIA Novosti was told in the press service of the Russian division of the American company Viatris. nine0003

    “Due to technical problems at the production site of a third-party manufacturer of the finished product, supplies of the Zoloft drug to the Russian Federation have been temporarily suspended,” they said, noting that problems arose with the supply of the drug in packages of 28 tablets with a dosage of 100 mg and in packs of 14 or 28 tablets with a dosage of 50 mg.

    “The reason for the temporary suspension of supplies is not related to the quality, safety or effectiveness of the finished product,” RBC was told in the press service of the Russian representative office of Viatris. nine0003

    The company is currently evaluating the timing of the suspension of supplies and recommends that patients who are prescribed Zoloft consult with their doctor to find a possible replacement for the drug.

    Zoloft is an antidepressant, a selective serotonin reuptake inhibitor. The active substance sertraline is included in the list of vital and essential drugs (VED).

    The drug is popular and widely used by psychiatrists and psychotherapists due to the minimal number of side effects. It has analogues, but the replacement of the drug is very difficult for patients. nine0003

    Roszdravnadzor notes that since last year in Russia the number of drugs with the active ingredient sertraline has increased by 30%: since the beginning of the year, more than 2 million packages of five trade names have been put on sale, including over 958 thousand packages of Zoloft. Thus, the agency points out, there is no shortage of medicines on the Russian market. “The temporary lack of the drug in some pharmacies in the regions is associated with a rush demand,” Roszdravnadzor believes.

    This is not the first time that Zoloft supply problems have arisen. Thus, Russian pharmacy chains noted a shortage of the drug last January. Roszdravnadzor clarified that the antidepressant had not been on sale since January 1, and expected supplies to resume in the second quarter of this year.

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