tjm5711 asked
Can Zoloft (sertraline) be taken with oxycodone safely?
Answer
There is a moderate interaction between oxycodone and Zoloft (sertraline hydrochloride) and caution is advised when used together. The combined use of the oxycodone and Zoloft increases the risk of additive serotonin-related side effects and serotonin syndrome.
Taking Zoloft With Oxycodone
Zoloft (sertraline) is classified as a SSRI (selective serotonin re-uptake inhibitor). SSRI drugs are used for a variety of indications including depression, anxiety and bipolar disorder. They work by increasing the neurotransmitter serotonin in the brain.
Oxycodone is an opioid analgesic. While opioids don't directly affect serotonin, recent evidence suggests that there are certain "serotonergic opioids" which can indirectly increase serotonin levels via multiple mechanisms.
Serotonin syndrome is a rare, but serious condition that can occur when high levels of serotonin build up in the brain, causing toxicity. Symptoms of serotonin syndrome include:
- Agitation
- Visual disturbances
- Elevated heart rate
- Fever
- Sweating
- Spams
- Shivering
- Stiffness
While the incidence rate of serotonin syndrome in those taking SSRI antidepressants and opioids appears to be low, the risk is nonetheless there. Several studies have been published that detail serotonin syndrome cases in individuals using the combination.
In fact, the FDA released a safety announcement regarding the risk of combining antidepressants that affect serotonin and opioid medications.
While the potential interaction between Zoloft and oxycodone doesn't contraindicate their use together, it is important to be aware of the risks and potential symptoms of serotonin syndrome. In addition, it would be prudent to avoid combining additional medications that could potentially increase serotonin levels.
