Sertraline (Zoloft) versus Other
Sertraline (Zoloft) vs. Amitriptyline
- Efficacy: 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 is associated with a lower frequency of somnolence, dry
mouth, constipation, ataxia, and pain and a higher frequency of nausea,
anorexia, diarrhea, and insomnia. So, anticholinergic and sedative
side effects are less common and gastrointestinal effects are more
common with sertraline than with amitriptyline 25.
The authors conclude that sertraline has a considerably less detrimental
effect on psychomotor performance and may have a slight activating
effect not found with amitriptyline 26.
- Discontinuation rates: Amitriptyline therapy is associated
with significantly more discontinuations due to treatment-related
adverse events, in comparison to sertraline 23, 24.
Sertraline (Zoloft) vs. Imiprmaine
- Efficacy: Both sertraline and imipramine are highly
effective treatments for major depressive disorder and panic disorder
- Side effects: 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 (Zoloft) vs. Nortriptyline
- Efficacy: 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.
- Side effects: 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 (Zoloft) vs. Venlafaxine (Effexor)
- Efficacy: Response rate is higher with Venlafaxine
than with Sertraline in the major depressive disorder. The remission
rate with venlafaxine (67%) is significanly higher than with sertraline
(36%) 3, 13.
- Side effects: Most common adverse events with venlafaxine
are nausea, headache, and sweating and with sertraline are nausea,
headache, and diarrhea 3. Venlafaxine is associated with the risk
of blood pressure increase 9. Antidepressant-induced sexual dysfunction
occurs more frequently with sertraline, than with venlafaxine 17.
- Discontinuation syndrome: Sertraline may be associated
with a lower symptom burden during treatment discontinuation 9.
Sertraline (Zoloft) vs. Paroxetine (Paxil)
Panic disorder. 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
- Tolerability: Sertraline is significantly better tolerated.
Paroxetine has a higher rate of treatment discontinuation due to adverse
- Side effects: 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.
- Discontinuation syndrome: Paroxetine discontinuation
is accosiated with the higher degree of emergence of new somatic and
psychological symptoms in patients than sertraline 15.
- Drug interactions: Sertraline may have advantages
paroxetine in elderly patients because of the comparatively low potential
for drug interactions.
Sertraline (Zoloft) vs. Fluoxetine (Prozac)
Major depression. Sertraline and fluoxetine have comparable
antidepressant efficacy in the treatment of Major depression. However,
sertraline has advantages over fluoxetine in those patients with severe
depression and low anxiety in the melancholia 5,
Obsessive-compulsive disorder. Both medications have significant
efficacy in the treatment of moderate to severe OCD. However, patients
treated with sertraline have a greater likelihood of remission as
well as an earlier improvement 8.
- Tolerability: Sertraline is considered to be better
tolerated than fluoxetine 7.
- Side effects: Sertraline has advantages over fluoxetine
on parameters such as sleep and weight disturbance in severely depressed
patients, and sleep disturbance, weight, cognitive disturbance and
retardation in melancholic patients 6.
Fluoxetine treatment is associated with a higher incidence of agitation,
anxiety and insomnia than sertraline 7.
- Discontinuation syndrome: Fluoxetine has fewer discontinuation-emergent
events than sertraline 15.
- Drug interactions: Sertraline may have advantages
fluoxetine in elderly patients because of the comparatively low potential
for drug interactions.
Sertraline (Zoloft) vs. Escitalopram (Lexapro)
- Efficacy: Sertraline and escitaloptam have comparable
antidepressant efficacy in the treatment of major depressive disorder
- Tolerability: Both medications are generally well
Sertraline (Zoloft) vs. Citalopram (Celexa)
- Efficacy: Sertraline and citaloptam have similar
efficacy in the treatment of major depression. However, citalopram
has more pronounced antianxiety effects 11, 12.
- Side effects: Sertraline treatment is associated higher
rate of gastrointestinal side effects 12. Sertraline is associated
with lower incidence of weight gain and sexual side effects than citalopram
Sertraline (Zoloft) vs. Bupropion (Wellbutrin)
Depression: Bupropion SR and sertraline are similarly effective
in the treatment of depression 16, 21.
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.
- Tolerability: Bupropion SR and sertraline are similarly
well tolerated 16.
- Side effects: Nausea, diarrhea, insomnia, and somnolence
occurs significantly more wirh 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.
Sertraline (Zoloft) vs. Trazodone (Desyrel)
- Efficacy: 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
- Side effects: 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,
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Published: March 31, 2008
Last updated: April 25, 2011