Sertraline HCL is the active ingredient in the brand-name antidepressant medication Zoloft. Nearly two dozen generic products that have the same effect as Zoloft have entered the U.S. market over the past 2 years, and those generics are sold only as sertraline HCL, with the "HCL" standing for "hydrochloride." Each sertraline product and similar antidepressant may increase young users' risk for suicide, so watching for this effect is essential.
The U.S. Food and Drug Administration has approved sertraline HCL for treating depression, obsessive-compulsive disorder, panic attacks, post-traumatic stress disorder and social anxiety disorder. Physicians may also prescribe sertraline HCL to treat headaches, premenstrual dysphoric disorder and sexual dysfunction. In addition to Zoloft from Pfizer, sertraline HCL is available in nonbranded versions from Actavis, Apotex, Aurobindo, Cobalt, Dr. Reddy's Laboratories, Genpharm, Ivax, Ivagen, Lupin, Matrix, Mutual, Mylan, Pliva, Ranbaxy, Roxane, Sandoz, Sun, Teva, Torrent, Watson, Wockhardt and Zydus.
Adults start therapy with a single 50-mg sertraline HCL tablet or a prescribed amount of sertraline HCL oral concentrate mixed with 4 oz. (1/2 cup) of ginger ale, lemonade, lemon/lime soda, orange juice or water once a day. Physicians and patients work together to find a maintenance dose of between 50 mg and 200 mg of sertraline HCL that controls symptoms without causing too many unwanted side effects. Children between the ages of 6 and 12 years of age begin therapy with a once-daily dose of 25 mg, and older children begin therapy with a once-daily sertraline HCL dose of 50 mg.
A Medication Guide distributed with each sertraline HCL prescription states, "Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment." The warning specifically applies to patients younger than 24 years of age, and the guide advises all patients to seek help if they become more depressed or manic, become more irritable, become violent, become more anxious, have trouble sleeping, or have thoughts about dying or killing themselves.
Sertraline HCL can cause changes in sex drive, constipation, diarrhea, drowsiness, headaches, loss of appetite, nausea, nervousness, shakiness, sweating and weight changes. Contact your physician if you begin experiencing abnormal bleeding or bruising, blurred vision, confusion, fever, hallucinations, irregular heartbeat or seizures.
Sertraline HCL works by increasing the amount of serotonin circulating in the user's body. The other medications in what is known as the selective serotonin reuptake inhibitor, or SSRI, class are citalopram (e.g., Celexa from Forest), escitalopram (e.g., Lexapro from Forest), fluoxetine (e.g., Prozac from Lilly) and paroxetine (e.g., Paxil from GlaxoSmithKline). An April 15, 2009, "Cochrane Review" analysis of 59 clinical studies that compared sertraline HCL with other SSRIs and other types of antidepressants revealed that sertraline HCL may be the best first option for treating depressive episodes. As the authors of the analysis report wrote, "Evidence favoring sertraline over some other antidepressants for the acute phase of major depression was found, either in terms of efficacy ... or acceptability/tolerability."