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Re: Why Is Zoloft No1

Posted by SLS on November 6, 2001, at 12:54:51

In reply to Re: Why Is Zoloft No1, posted by JahL on November 4, 2001, at 18:40:06

> > I have my beliefs as to the reasons why this may be but would like to know other people's opinions and also if people who have taken Sertraline can compare it with other SSRIs and have had better results with Sertraline. You see I only have noticed subtle differences in the effects of Paroxetine, Fluvoxamine and Sertraline.
>
> Setraline was the only SSRI (including Prozac, Paroxetine & Citalopram) that didn't briefly switch me to euthymia or hypomania. Also crashed my car on it :-(
>
> I saw the director of the Maudsley DP unit the other day & Sertraline is her favoured SSRI. She didn't give any specific reasons as to why this is (tho' I'll ask next time) other than to say that it possesses a favourable side-effect profile.
>
> My bro' has just been prescibed Sertraline as a first AD whereas 5 yrs ago I was given Paroxetine; Sertraline was 3rd & then only when I specifically asked for it. Obviously word is spreading...
>
> J.


Hi.

Sertraline (Zoloft) became the treatment of choice for most psychiatrists at least 5 years ago. I think many are now turning to citalopram (Celexa).

I know one person who is doing considerably better now on Celexa than he did on Zoloft for many years prior.

Zoloft is the least "potent" (affinity to bind to the reuptake transporter) of the SSRIs currently available. I'm not sure how important this distinction is. It just determines the dosage needed to have the desired effect.

Zoloft: 100mg - 200mg
Prozac: 20mg - 60mg
Paxil: 20mg - 50mg
Celexa: 20mg - 40mg
Luvox: 100mg - 300mg

Other things are brought into consideration when trying to explain the actions of a drug at a particular dosage or concentration. Selectivity might be more important than potency. Even here, selectivity is usually nothing more than a relative term, since it depends upon which other actions it is being compared to.

For what it's worth, Zoloft produces the most dopamine reuptake inhibition of the SSRIs, although its magnitude is considered by most as being irrelevant at therapeutic dosages. However, this always begs me to ask the question: "How does one determine the amount of anything that can be neglected?"

http://www.preskorn.com/columns/9909.html


- Scott

 

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