Comparison of the effectiveness of Zoloft and Cipralex
The effectiveness of Zoloft is quite similar to Cipralex - this means that the ability of the drug substance to provide the maximum possible effect is similar.
For example, if the therapeutic effect of Zoloft is more pronounced, then using Cipralex even in large doses will not achieve this effect.
Also, the speed of therapy - an indicator of the speed of therapeutic action - is approximately the same for Zoloft and Cipralex. And bioavailability, that is, the amount of a drug reaching its site of action in the body, is similar. The higher the bioavailability, the less it will be lost during absorption and use by the body.
Comparing the safety of Zoloft and Cipralex
The safety of a drug includes many factors.
At the same time, it is higher for Cipralex than for Zoloft. It is important where the drug is metabolized: drugs are excreted from the body either unchanged or in the form of products of their biochemical transformations. Metabolism occurs spontaneously, but most often involves major organs such as the liver, kidneys, lungs, skin, brain and others. When assessing the metabolism of Cipralex, as well as Zoloft, we look at which organ is the metabolizing organ and how critical the effect on it is.
The risk-benefit ratio is when the prescription of a drug is undesirable, but justified under certain conditions and circumstances, with the obligatory observance of caution in use. At the same time, Cipralex has fewer risks when used than Zoloft.
Also, when calculating safety, it is taken into account whether only allergic reactions occur or possible dysfunction of the main organs. In other matters, as well as the reversibility of the consequences of using Cipralex and Zoloft.
Zoloft®
Sertraline should not be co-administered with an MAOI, or within 14 days of stopping treatment with an MAOI. Similarly, after discontinuation of sertraline, no MAOIs are prescribed for 14 days.
Serotonin syndrome and neuroleptic malignant syndrome
When using selective serotonin reuptake inhibitors (SSRIs), cases of the development of serotonin syndrome (SS) and neuroleptic malignant syndrome (NMS) have been described, the risk of which increases when combining SSRIs with other serotonergic drugs (including triptans), as well as drugs that affect metabolism serotonin (including monoamine oxidase inhibitors), antipsychotics and other dopamine receptor antagonists. Manifestations of SS may include changes in mental status (in particular, agitation, hallucinations, coma), autonomic lability (tachycardia, blood pressure fluctuations, hyperthermia), changes in neuromuscular transmission (hyperreflexia, impaired motor coordination) and/or gastrointestinal disorders (nausea, vomiting and diarrhea). Some manifestations of SS, including hyperthermia, muscle rigidity, autonomic lability with the possibility of rapid fluctuations in vital function parameters, as well as changes in mental status, may resemble symptoms that develop in NMS. It is necessary to monitor patients for the development of clinical manifestations of SS and NMS.
Other serotonergic agents
- Caution must be exercised when concomitantly prescribing sertraline with other drugs that enhance serotonergic neurotransmission, such as tryptophan, fenfluramine or 5-HT agonists. Such co-administration should be avoided if possible, given the potential for pharmacodynamic interactions.
Switching from other selective serotonin reuptake inhibitors (SSRIs), antidepressants or anti-obsessive medications
The experience of clinical studies aimed at determining the optimal time required to transfer patients from taking other antidepressant and antiobsessive drugs to sertraline is limited. Caution must be used when switching, especially from long-acting drugs such as fluoxetine.
The required interval between stopping one selective serotonin reuptake inhibitor and starting another similar drug has not been established.
It should be noted that there is no sufficient experience with the use of sertraline in patients undergoing electroconvulsive therapy.
The possible success or risk of this combination treatment has not been studied. There is no experience with the use of sertraline in patients with seizure disorders, so its use should be avoided in patients with unstable epilepsy, and patients with controlled epilepsy should be carefully monitored during treatment. If seizures occur, the drug should be discontinued.
Patients suffering from depression are at risk for suicide attempts. This danger persists until remission develops. Therefore, from the start of treatment until the optimal clinical effect is achieved, patients should be under constant medical supervision.
Activation of mania/hypomania
During clinical studies prior to the marketing of sertraline, hypomania and mania were observed in approximately 0.4% of patients receiving sertraline. Cases of activation of mania/hypomania have also been described in a small proportion of patients with manic-depressive psychosis who received other antidepressant or antiobsessive drugs.
Use for liver failure
Sertraline is actively biotransformed in the liver. According to a pharmacokinetic study, with repeated administration of sertraline in patients with stable mild liver cirrhosis, an increase in the half-life of the drug and an almost threefold increase in AUC (area under the concentration/time curve) and maximum concentration of the drug were observed compared with those in healthy people. There were no significant differences in plasma protein binding between the two groups.
Sertraline should be used with caution in patients with liver disease. When prescribing the drug to a patient with impaired liver function, it is necessary to discuss the advisability of reducing the dose or increasing the interval between taking the drug.
Use for renal failure
Sertraline undergoes active biotransformation, therefore, unchanged in the urine, it is excreted in small quantities. In patients with mild and moderate renal failure (creatinine clearance 30-60 ml/min) and patients with moderate or severe renal failure (creatinine clearance 10-29 ml/min), the pharmacokinetic parameters (AUC0-24 and Cmax) of sertraline with repeated taking it did not differ significantly from the control group. In all groups, the half-life of the drug was the same, and there were no differences in plasma protein binding. The results of this study suggest that, as expected given the low renal excretion of sertraline, no dosage adjustment is required based on the severity of renal impairment.
Pathological bleeding/hemorrhage
It is recommended to exercise caution when prescribing selective serotonin reuptake inhibitors in combination with drugs that have an established ability to alter platelet function, as well as in patients with a history of hemorrhagic diseases.
Hyponatremia
Transient hyponatremia may occur during treatment with sertraline. This develops more often in older patients, as well as when taking diuretics or a number of other drugs. This side effect is associated with the syndrome of inappropriate secretion of antidiuretic hormone. If symptomatic hyponatremia develops, sertraline should be discontinued and adequate therapy aimed at correcting sodium levels in the blood should be prescribed.
Signs and symptoms of hyponatremia include headache, difficulty concentrating, memory loss, weakness and unsteadiness, which can lead to falls. In more severe cases, hallucinations, fainting, seizures, coma, respiratory arrest, and death may occur.
Comparison of addiction between Zoloft and Cipralex
Like safety, addiction also involves many factors that must be considered when evaluating a drug.
So, the totality of the values of such parameters as “o syndrome” in Zoloft is quite similar to the similar values in Cipralex. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, Zoloft has a fairly low incidence of “syndrome”, just like Cipralex.
Contraindications
Zoloft is not prescribed to patients with hypersensitivity to the components of the drug.
The combination of Zoloft with monoamine oxidase inhibitors and pimozide is strictly contraindicated. Admission is not recommended for women during gestation and lactation, as well as for children under 6 years of age. Such recommendations are due to the lack of clinical studies in these patient groups. The antidepressant is used with extreme caution in patients with a history of:
- organic brain pathologies
- epilepsy
- mental retardation
- renal dysfunction
- liver failure
- physical exhaustion with weight loss
Comparison of side effects of Zoloft and Cipralex
Side effects or adverse events are any adverse medical event that occurs in a subject after administration of a drug.
Zoloft has more adverse effects than Cipralex. This implies that the incidence is low with Zoloft and low with Cipralex. Frequency of manifestation is an indicator of how many cases of an undesirable effect from treatment are possible and registered. The undesirable effect on the body, the strength of influence and the toxic effect of drugs are different: how quickly the body recovers after taking it and whether it recovers at all. When using Zoloft, the body's ability to recover faster is higher than that of Cipralex.
Side effects
Most often, Zoloft causes disorders of the digestive tract, which are accompanied by bloating, diarrhea, constipation, abdominal pain, and dry mouth. Less commonly, the drug may cause pancreatitis.
On the part of the central nervous system, Zoloft can provoke extrapyramidal disorders, convulsions, fainting, drowsiness, tremors of the limbs, sleep disturbances, anxiety, and headache. In severe cases, when an incorrect dosage is prescribed, the drug causes mania, hallucinations, feelings of euphoria, nightmares, psychosis, suicidal thoughts, and coma.
Zoloft may also cause the following problems:
- increased heart rate and increased blood pressure
- bronchospasm
- diuretic disorders
- dysfunction of the reproductive system
- liver failure
- visual impairment
- weight loss
- tinnitus
- general weakness
- allergic reactions with itching, rashes, burning, redness of the skin
- Quincke's edema in severe cases
Comparison of ease of use of Zoloft and Cipralex
This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.
The ease of use of Zoloft is approximately the same as Cipralex. However, they are not convenient enough to use.
The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.
Last update date: 2020-12-13 10:32:12
