Sertraline (Zoloft) versus ...
- Sertraline vs Fluoxetine
- Sertraline vs Amitriptyline
- Sertraline vs Imipramine
- Sertraline vs Nortriptyline
- Sertraline vs Venlafaxine
- Sertraline vs Paroxetine
- Sertraline vs Bupropion
- Sertraline vs Trazodone
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.
Depression, panic disorder
Both sertraline and imipramine are highly effective treatments for major depressive disorder and panic disorder 27.
Onset of action
The improvement begins more rapid with Imipramine than with Sertraline. But no enduring differences beyond week 8 of treatments 1.
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.
Both sertraline and paroxetine are equally effective in panic disorder. However, sertraline is associated with significantly less clinical worsening during taper period than paroxetine 4.
Generalized anxiety disorder
Both paroxetine and sertraline appear similarly effective for the treatment of generalized anxiety disorder 14.
Sertraline is significantly better tolerated. Paroxetine has a higher rate of treatment discontinuation due to adverse events 4.
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.
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.
|Results of double-blind comparison of bupropion SR and sertraline in depression 21.||Bupropion SR||Sertraline|
|Orgasm dysfunction, nausea, diarrhea, somnolence, and sweating||more frequently|
|Results of placebo-controlled comparison of bupropion SR and sertraline 16.||Bupropion SR||Sertraline|
|Orgasm dysfunction||significantly more patients|
|Decrease in mean body weight||-1.06 kg||-1.06 kg|
|Results of retrospective cohort study of bupropion versus sertraline in depressive patients with binge eating disorder 3.||Bupropion||Sertraline|
|Effectiveness in reducing weight and improving sexual performances||more effective|
|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.||Bupropion SR||Sertraline|
|Effectiveness in reducing depressive symptoms||
|Effect on anxiety symptoms||
|Median time to reach a clinically significant anxiolytic effect||4 weeks||4 weeks|
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 with prevalent sleep disturbances 5.
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: August 09, 2014