Sertraline (Zoloft) versus ...
Sertraline vs. Amitriptyline
Major depressive disorder
Sertraline and amitriptyline have comparable antidepressant efficacy in the treatment of major depression. Sertraline
has been shown a tendency to produce greater improvements on quality
of life measures 23, 24.
Side effects and tolerability
Sertraline has more favorable safety profile and is better tolerated than amitriptyline.
Sertraline produces higher rate of gastrointestinal complaints and sexual dysfunction
than the amitriptyline. Amitriptyline produces a higher rate of dizziness, anticholinergic, sedative, autonomic
and circulatory side effects compared with sertraline25. Sertraline
has a considerably less detrimental effect on psychomotor performance and may have a
slight activating effect not found with amitriptyline 26.
Amitriptyline therapy is associated
with significantly more discontinuations due to treatment-related
adverse events, in comparison to sertraline 23, 24.
Sertraline vs. Imipramine
Depression, panic disorder
Both sertraline and imipramine are highly effective treatments for major depressive disorder and panic disorder
Sertraline has more favorable side effect profile than Imipramine. Sertraline is significantly better tolerated
with significantly fewer discontinuations due to adverse events
Onset of action
The improvement begins more rapid with Imipramine than with Sertraline. But no enduring differences
beyond week 8 of treatments 1.
Sertraline vs. Nortriptyline
Sertraline and nortriptyline are equally effective in the treatment of late-life major depression, including
those patients presenting with severe depression. However, secondary
efficacy (posttreatment measures of cognitive function, memory, and
quality of life) may be significantly higher with sertraline treatment.
Nortriptyline treatment may be associated with a mildly negative effect
on cognition. Sertraline-treated patients may have greater improvement
in energy and in most quality-of-life measures. Both drugs have similarly
beneficial effects on anxiety and sleep 2.
Nortriptyline is associated with a significant
higher rate of increase in pulse rate 2.
Onset of action
The time course of antidepressant
response is comparable for sertraline and nortriptyline 2.
Sertraline vs. Paroxetine (Paxil)
Both sertraline and paroxetine are equally effective in panic disorder. However, sertraline is associated with
significantly less clinical worsening during taper period than paroxetine
Generalized anxiety disorder
Both paroxetine and sertraline appear similarly effective for the treatment of generalized anxiety
Sertraline is significantly better tolerated. Paroxetine has a higher rate of treatment discontinuation due to adverse
Paroxetine has a significantly higher rate of weight gain 4. Also,
paroxetine is associated with higher incidence of sexual side-effects
like delay of orgasm or ejaculation and impotence 19.
Paroxetine discontinuation is associated with the higher degree of emergence of new somatic and
psychological symptoms in patients than sertraline 15.
Sertraline may have advantages paroxetine in elderly patients because of the comparatively low potential
for drug interactions.
Sertraline vs. Bupropion (Wellbutrin)
Bupropion SR and sertraline are similarly well tolerated 16.
Nausea, diarrhea, insomnia, and somnolence occurs significantly more with sertraline treatment than with bupropion
SR. Dry mouth occurs more frequently with bupropion SR than with sertraline.
Both medications are associated with similar decreases in body weight.
Sertraline treatment is more often associated with sexual dysfunction compared with bupropion
SR 16, 21. Bupropion SR may be a more appropriate
antidepressant choice than sertraline in patients for whom sexual dysfunction is a concern.
Bupropion SR and sertraline are similarly effective in the treatment
of depression 16, 21.
|Results of double-blind comparison of bupropion SR and sertraline in depression 21.
|Orgasm dysfunction, nausea, diarrhea, somnolence, and sweating
|Results of placebo-controlled comparison of bupropion SR and sertraline 16.
||significantly more patients
|Decrease in mean body weight
|Results of retrospective cohort study of bupropion versus sertraline in depressive patients with binge eating disorder 3.
|Effectiveness in reducing weight and improving sexual performances
| Effectiveness in reducing anxious-depressive symptoms and binge frequency
Anxiety in major depressive disorder
Bupropion SR and sertraline have comparable antidepressant and anxiolytic effects and an equally
rapid onset of clinically significant anxiolytic activity 22.
|Results of retrospective analysis of the effects of bupropion SR and sertraline on anxiety in patients with recurrent major depressive disorder 22.
|Effectiveness in reducing depressive symptoms
|Effect on anxiety symptoms
|Median time to reach a clinically significant anxiolytic effect
Sertraline vs. Trazodone (Desyrel)
Trazodone and sertraline are equally effective in reducing depressive symptoms and promoting remission, and have
similar onset times. Trazodone may be a therapeutic option in the
treatment of patients with major depression showing prevalent sleep
Adverse drug reactions associated with trazodone are mostly of mild intensity and mainly of the nervous system.
Most common side effects with sertraline are gastrointestinal (nausea, diarrhea).
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Published: March 31, 2008
Last updated: July 28, 2014