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Kevlar for the Mind: Antidepressant works on chemical in brain

Apr. 18, 2014 - 12:40PM   |  
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Q. I was recently prescribed the medication Zoloft by my doctor. He said it was for my depression and post-traumatic stress disorder. How does this medication work? What are the side effects? Does it work?

A. Zoloft is a trade name of the medication sertraline. Itís classified as an antidepressant, although itís used to treat not only depression but also PTSD and several other anxiety disorders.

Sertraline belongs to a class of medications called selective serotonin reuptake inhibitors ó generally referred to as SSRIs. Other medications in this class include Paxil, Celexa, Lexapro and the well-known Prozac.

The medication works primarily by increasing the availability of the neurochemical serotonin in the brain. Serotonin is known to play a role in both depression and anxiety. It also increases dopamine in the brain, which is another important chemical related to mood.

There are several common side effects associated with this medication, which can range from mild to severe. These include irritability, insomnia, stomach discomfort and sexual dysfunction. Most of the side effects are temporary, although the sexual problems may persist for as long as you are on the medication.

Sertraline is generally considered to be moderately effective for depression and anxiety. For some, a complete recovery occurs. For others, there is improvement, but some symptoms remain. For the rest, it doesnít help. Only you and your doctor can decide which group you belong to.

Q. I started taking Ambien to help me sleep. I stopped because I was having periods of time when I couldnít remember things. Is this normal?

A. Ambien-related memory problems are not common, but they do occur. There are a number of well-documented cases in which people ó after taking the medication ó drove a car, had a late-night snack, went for a walk and even had sex without remembering it.

The reason for such memory lapses is not fully known, but the suspicion is that itís related to similar processes associated with memory loss after heavy alcohol use. In fact, Ambien affects the same brain receptors as alcohol. This is also part of the reason why Ambien makes you drowsy and can cause that ďdrunkĒ feeling if you take it and donít go to sleep right away.

Memory impairment following Ambien use should be taken seriously. If it occurs, talk with your doctor right away. The good news is that this side effect is temporary and resolves once you stop taking the medication.

Bret A. Moore is a clinical psychologist who served in Iraq. Email kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.

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