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Zoloft: Uses, Dosage, Side Effects And Warnings
Zoloft has a wide range of potential side effects. "Some side effects are short-term and resolve with time, and others are not," explains Dr. Catanzano. "Some side effects are also challenging to predict. If a patient experienced side effects with a different antidepressant or SSRI, it does not mean they will experience that side effect with Zoloft, and vice versa."
Specific side effects of Zoloft may include:
If any side effects are severe or do not go away, it's strongly recommended to speak to your doctor. Often, side effects resolve as a person adjusts to the medication. Additionally, starting on a lower dose can minimize the side effects a person experiences.
A common side effect of Zoloft that may not improve with time is sexual dysfunction, including a lower libido. "It is important for patients and providers to understand a person's sexual health at baseline and actively monitor for side effects during treatment," notes Dr. Catanzano. "It is also important to note that sexual dysfunction can also be attributed to the presence of mental health symptoms and treatment with a medication like Zoloft can help."
Beyond these more common side effects, there are also more rare and serious potential side effects of Zoloft. These can include seizures, abnormal bleeding or bruising, agitation or hallucinations, severe muscle stiffness or twitching, loss of coordination, a rash or hives, swelling and difficulty breathing.
Further, individuals taking Zoloft, particularly older women, may experience low sodium levels, notes Dr. Catanzano. Older adults who take Zoloft long term are also at risk for decreased bone mineral density, she continues.
Zoloft InteractionsZoloft may negatively interact with medications that increase levels of serotonin in the body, or directly act at serotonin receptors. This is because using these medications in conjunction with Zoloft can increase the risk of developing serotonin syndrome. "These medications can include other antidepressants, antipsychotics, certain pain medications, as well as over-the-counter medications and herbals like dextromethorphan (a common ingredient in cough and cold medicine) and St. John's Wort," says Dr. Catanzano.
Additionally, because Zoloft is primarily metabolized by the enzyme CYP3A4, medications that affect this enzyme's activity, such as calcium channel blockers, certain high cholesterol medications and glucocorticoids, can potentially interfere with the amount of Zoloft a person is exposed to, either increasing it or decreasing it. "This can result in increased risk of side effects or decreased efficacy, respectively," says Dr. Catanzano.
Further, there is also an increased risk for bleeding among those taking blood thinning medications or NSAID medications, such as Advil or Aleve, alongside Zoloft.
12 Things Doctors Always Do When They Travel To Avoid Getting Sick
When travelers return home from a vacation, they typically bring cool souvenirs, cherished memories and a broadened perspective on the world. But sometimes they also come home with a terrible cold, digestive problems or other health issues.
It's common to get sick when you travel, whether you come down with symptoms during the trip or start feeling bad after the return. But this outcome doesn't have to be inevitable.
"You can assume that travel will increase the risk of getting sick, and none of us wants to get sick while traveling, said Dr. Henry M. Wu, an associate professor at Emory University School of Medicine and director of the Emory TravelWell Center. "It makes sense to take extra precautions we don't do on a daily basis."
Below, Wu and other doctors share the things they always do when they travel to avoid getting sick.
Masking In The Airport And On The Plane
"Although COVID is no longer as large of an issue as it was, given that I am in close quarters with the same circulating air on an airplane, I still wear a mask on all flights and in the airport," said Dr. Barbara Bawer, a family medicine physician at The Ohio State University Wexner Medical Center. "Depending on where you are going, wearing a mask in crowded places is also important."
She suggested packing at least a couple of masks in case one gets soiled or ruined. High-quality masks like N95s are your best bet for reducing germ transmission in crowded indoor situations.
"I still lament the time I sat on an overnight train in France across from a couple that coughed and sneezed the entire trip — only to get a horrible cold a day later and miss the 48-hour French countryside wedding extravaganza I had traveled so far to attend," said Dr. Sarah Battistich, an emergency medicine specialist with NYU Langone Health's Virtual Urgent Care. "Now I routinely wear masks in transit, whether or not there are identifiably ill persons around me."
Face coverings can also offer protection in multiple ways.
"The mask will keep you from touching your nose and mouth with your hands," said Dr. Heather Viola, a primary care physician at Mount Sinai Doctors-Ansonia.
Frequently Washing And Sanitizing Hands
"First and foremost, I constantly wash my hands, always carrying with me hand sanitizer that contains at least 60% alcohol to prevent the spread of germs," Viola said. "Many airlines are giving out alcohol-based disinfectant wipes when you board. I use these to clean my seat, headrest, armrests, tray table, and entertainment screen — basically, anything you may touch while sitting in your seat."
Packing your own alcohol-based disinfecting wipes can also be useful.
"I am a big proponent obviously of hand washing," Battistich said. "But also trying to limit touching of shared surfaces and therefore limit the risk of coming into contact with bacteria and viruses. I make a game out of it with my daughter to not touch any surface in public bathrooms, including doors and toilet seats."
Masking and hand washing are still crucial for preventing infections.Staying Hydrated
"If I'm taking a long flight, try to start out well hydrated and avoid alcohol on the plane," Battistich said.
Maintaining a healthy water intake was a priority for all the doctors who spoke to HuffPost.
"I always travel with electrolytes ― packets of dissolvable electrolytes ― for water or vitamin water," Viola said. "This is a good way to keep hydrated with more than just water and help prevent in-flight nausea or dehydration."
Taking Immune System Boosters
Viola is also a fan of nasal mists and vitamin C tablets prior to boarding.
"The plane cabin is dry, and microorganisms are free to circulate in the air, so before I go on a plane, I take a few vitamin C tablets to boost my immune system and help give my body the ability to fight off airborne germs," she said. "Nasal saline spray or nasal mists can also help fight germs as they keep your nasal passages moist, which enhances your body's own germ-flushing activity. You can even apply a small amount of Neosporin or petroleum jelly just inside the nostrils — using a Q-tip if your hands aren't washed — to create a barrier between you and the airborne germs."
Avoiding Peak Travel Times
"If possible, try to travel during non-peak times, which often is the middle of the week and mid-morning or midday, instead of very early or in the evening," Bawer said. "This may depend on your city, though, so do some research ahead of time."
Avoiding the biggest crowds and sense of stress is a good way to cut down on your potential exposure to germs, and traveling in the middle of the day typically allows for a full night's sleep the night before or after your flight.
Prioritizing Rest
"Make sure to get adequate rest before your flight and if able, try to sleep while traveling when appropriate," Bawer said. "When returning home, give yourself some time to re-adjust back to your daily schedule and environment. Try not to return home at 11 p.M. Or midnight and then have to head straight to work the next day. Give yourself a few hours or, if able, an entire day at least to recover, get caught up on laundry or grocery shopping or other needed chores, and get plenty of rest."
Fatigue can impair your immune system, as well as decrease your endurance and negatively impact your mood.
"I'm a big fan of those flat packable travel pillows which support your neck, and I've found bringing ear plugs and an eye mask or scarf to keep out the lights is super helpful for getting that extra bit of rest — like that hour at the end of a night flight where you still want to sleep but the flight crew turns the bright overheads on," Battistich said.
Roma Black / 500px via Getty Images
Resting is a key component to a healthy immune system.Not Overscheduling
Just as you should prioritize rest to help your immune system, you should also try to reduce stress where possible.
"Don't overschedule your trip to allow time to enjoy yourself and give some flexibility in the itinerary," Bawer advised. "Stress can induce sickness, especially in a new environment."
Eating A Well-Balanced Diet
"Eat a well-balanced diet leading up to the trip to get your body and immune system ready to fight anything it comes into contact with and on the day of travel as well," Bawer said. "Most people don't eat as healthy while on vacation but try to incorporate fruits and vegetables with all meals to keep your immune system at the highest level."
She always packs healthy snacks and a refillable water bottle to ensure she gets the nutrients she needs during her travels.
"Often we don't have time to eat, especially with flights being delayed or late, and we either skip meals or grab something quick, which is rarely healthy," Bawer noted.
Researching Travel Vaccines And Medicines
"I make sure I am up-to-date on vaccines before travel," Wu said. "Flu and COVID-19 are so common among travelers, and even a mild case can ruin a trip. Also, for international travel, there are additional vaccines that might be recommended or required, or even malaria prophylaxis for some areas. I suggest travelers check the CDC [Centers for Disease Control Prevention] travel website or see a travel medicine specialist for advice."
In addition to getting the necessary travel vaccines ahead of time, you may want to procure special medications in advance.
"Consider getting a prescription for diarrhea medicine if traveling to another country where traveler's diarrhea may be an issue," Bawer advised. "If traveling to another country, avoid drinking their water — this includes anything washed with local water like salad and fruit. Focus on eating foods that have a shell and don't need washing and drink bottled water. Also, use this to brush your teeth. This can help to avoid traveler's diarrhea from developing."
Packing an over-the-counter anti-diarrheal like Imodium is another good idea, especially when traveling internationally.
"If I'm uncertain about particular meals, I try to stick to foods that have been fully cooked and are served hot, avoiding raw and undercooked foods," Viola added.
Keeping Up With Sun Protection
"Wear sunscreen daily," Bawer urged.
Whether at home or on vacation, you should apply (and reapply) a broad-spectrum sunscreen with an SPF of at least 30 every day. Keeping up with your sun protection regimen is especially important if you'll spend a lot of time outside during your travels.
"Sunburn and heat-related illnesses are some of the most easily preventable causes of a ruined vacation," Battistich said. "Don't forget sunscreen, long sleeve shirts ― linen is great for hot climates ― and hats. The bigger and more packable the hat, the better."
Buying Insect Repellent
"If it's an outdoorsy trip or I'm going to tropical areas, I make sure to pack bug repellent," Wu said. "Mosquitoes, ticks and other biting bugs can transmit many infections."
Ensure your sunscreen complies with local regulations and check the CDC's recommendations for effective products.
"It isn't always easy to find these things on the fly, so preparing in advance will eliminate the chance I am caught off guard," Wu added.
Packing Medication
"I also bring over-the-counter medications that I will have on hand in case I start to feel unwell," Viola said.
She packs acetaminophen for pain or fever, ibuprofen for pain, an antihistamine like Benadryl and Pepto-Bismol in case of stomach upset.
"My doctor's travel kit included some preventatives and some emergency rescue meds," Battistich said, listing many of the same medications, as well as anti-nausea medications and remedies like SeaBands, ginger packets, and aromatherapy sticks.
"There is evidence that taking Pepto-Bismol tablets before and during travel can help reduce in the risk of traveler's diarrhea," she added. "I also back very basic wound kits with Band-Aids, antibiotic cream, and if going to a hot and humid climate, or when hiking and backpacking, I will also often bring an antifungal cream."
How To Get Rid Of Phlegm, According To Doctors
It's never any fun feeling under the weather, but when a common cold is paired with excess phlegm, it makes matters even worse. This can lead to irritating symptoms, such as coughing, a sore throat, and breathing issues. When this happens, you're probably wondering how to get rid of phlegm as quickly as possible. In good news, there are many at-home remedies and over-the-counter medicines you can try to treat excessive phlegm.
So, why do we get phlegm in the first place? There are many reasons why you may have phlegm stuck in your throat, and most are not a reason for concern, but sometimes it can be a sign of a more serious health problem. Understanding the causes of your phlegm can help you treat it or indicate seeking medical attention.
Read on to learn more about what exactly phlegm is, its causes, and tips to get rid of it.
What is phlegm?In simple terms, phlegm is an excessive amount of mucus. Mucus is a healthy protective lining and thin liquid that covers our respiratory surfaces, gut, intestines, and even our eyes. Mucus is essential to prevent these areas from drying out, and it protects our bodies from bacteria, viruses, and environmental agents that attack our respiratory system.
We have mucus in our bodies all the time, but it becomes noticeable and irritating when our bodies produce too much. This is what we all know as phlegm, which is a thicker mucus that can cause bothersome symptoms.
Phlegm is the body's attempt at clearing irritants and infections from your lungs. "When activated fighting off an attack of outside invaders, or allergens, the amount of this healthy mucus increases and thickens," says Jacob Teitelbaum, M.D., board-certified internist and integrative physician. "Then it is called phlegm. It may also be associated with inflammation."
Typically, phlegm is somewhat clear with a cloudy or whitish tint to it. When phlegm has a yellow, green, or red color to it, it's indicating certain infections or health conditions.
If you're looking to get rid of phlegm and want to clear your sinuses, the first step is to identify what triggered your body to produce phlegm. That way, you can treat the underlying cause.
Causes of phlegmAccording to Cleveland Clinic, bodies create more, thicker mucus when the immune system is kicked into gear due to a virus, bacterial infection, or an allergen. There are some instances where phlegm can indicate a larger, underlying health issue that should be brought to the attention of your doctor, but phlegm is mostly treatable and not a reason for concern.
AllergiesSeasonal allergies are our body's response to pollen and harmless environmental substances, which are referred to as allergens. Allergies can cause a runny nose, watery eyes, difficulty breathing, sneezing, and–you guessed it–phlegm. "Allergies again cause phlegm production because your body is in an inflammatory state and producing excess amounts of mucus as a result of the response to an allergen," Dr. Campbell says.
Dry airNiket Sonpal, M.D., internist and adjunct assistant professor of clinical medicine at Touro College of Osteopathic Medicine, says phlegm can be a result of the environment you are in, such as dry air and low humidity. The lining in your nose becomes irritated if there is not enough moisture, which can cause the body to start over producing mucus. The air tends to be drier in the colder, winter months outside and inside due to heating systems in homes.
Upper respiratory tract infectionAn upper respiratory infection is caused by a virus or bacterial infection in your respiratory system. This happens when you make contact with an infected surface or person, and then spread those germs to your mouth, eyes, or nose. These infections are known as a common cold, sinusitis (sinus infection), sore throat, and laryngitis. All of these infections can cause a cough that produces phlegm.
Inflammation of the lungs (pneumonia)Peter Ashman, M.D., otolaryngologist surgeon at ENT and Allergy Associates, LLP, says phlegm is the body's way of using mucus to prevent infections. "It is your body's way of shedding dead cells/tissue and to trap bacteria and viruses to prevent them from causing an infection," Dr. Ashman says. "As such, any inflammation of the lungs or the throat will cause an increased amount of mucus and therefore phlegm."
Pneumonia is a viral or bacterial infection of the lungs that inflames the lungs' air sacs and fills it with fluids. The symptoms can include coughing up thick yellow, green, or brown phlegm. Seek medical attention if you think you have pneumonia and you are having difficulty breathing.
AsthmaAsthma is a long-term condition that causes inflammation to the airways to our lungs, making it difficult to breathe and an increase in the production of phlegm. People with asthma have certain triggers and can seek treatment plans from a doctor.
BronchitisBronchitis is an inflammation to the bronchial tubes due to bacteria or a virus. This can cause our body to create excessive mucus and cough up phlegm.
SmokingWhile there are plenty of reasons to quit smoking or vaping already, Dr. Ashman says smoking can also cause phlegm. Hot smoke is a chemical irritant, which signals danger to your body and it produces extra mucus to protect itself. Also, smokers can develop chronic bronchitis or a persistent cough, which can eventually lead to coughing up phlegm.
How to get rid of phlegmThe ideal way to get rid of phlegm is to get to the root of the problem. "Phlegm is best treated by treating the underlying cause, whether it is an infection, allergies, acid reflux, etcetera," says Dr. Ashman. If your phlegm is caused by a non-serious health issue, or a doctor recommended at-home treatments and rest to get well again, read on for methods to treat phlegm:
1. HydrateConsidering dryness can cause an overproduction of phlegm, one of the best ways to beat phlegm is drinking loads of water. "Staying hydrated is critical to loosening up the phlegm so it can be coughed out and doesn't plug up the airways," Dr. Teitelbaum says. Moisture and water will break apart dried phlegm and help it move out of your respiratory system. He recommends drinking hot teas, as hot liquids are very effective at loosening phlegm, but to avoid excess sugar because it causes mucus production.
2. Humidify the airOnce again, dry air is the villain when it comes to phlegm. Moisturizing the air can help thin the excessive, thick mucus lodged in your throat. Dr. Campbell suggests using a humidifier to help you breathe easier and loosen the phlegm.
For a quick fix, Dr. Teitelbaum says you can try taking a hot steamy shower. This will also help keep your body temperature warm, which research found is ideal when fighting off an infection or common cold.
3. Saline sprayYou can use nasal spray to relieve congestion, add moisture to the nose, clear the sinuses, and break up phlegm. "Using saline rinses, especially with a Neti pot, can help wash out the infections," Dr. Teitelbaum says. "Holistic doctors can prescribe the antifungal Diflucan for six weeks, which combined with a sinusitis nose spray made by a compounding pharmacy can often eliminate chronic sinusitis."
4. Gargle salt waterDr. Campbell also recommends gargling salt water. This can clear the phlegm in your throat and it's one of many sore throat remedies to soothe swelling, reduce inflammation, and calm irritation. To effectively use salt water to break up phlegm, dissolve half a teaspoon of salt in a glass of warm water, and gargle multiple times throughout the day.
5. BoswelliaIf you are looking for a long-term solution, Dr. Teitelbaum recommends an herbal extract called boswellia, which is made from the resin of a boswellia tree. Boswellia is used in traditional Indian medicine, and it can be taken orally in a pill, tablet, or capsule.
"For chronic increased lung phlegm in asthma or emphysema, once the person has been evaluated by their physician, the herb Boswellia (frankincense) can dramatically decrease the lung inflammation and excess phlegm production," Dr. Teitelbaum says, who gives boswellia as a long-term treatment to patients with problematic asthma or emphysema.
6. OTC medicineOver-the-counter (OTC) medicine is what most people reach for after phlegm does not go away on its own or with natural treatments. "Taking over the counter expectorants such as Mucinex can also help to thin the mucus, so it is easier to cough up," Dr. Ashman says. Robitussin is another popular OTC cough medicine that can help you get rid of phlegm.
7. Elevate head while sleepingIf you feel phlegm stuck in the back of your throat and have a persistent cough from a postnasal drip, keeping your head elevated at night can help.
Sleeping flat on your back can cause the phlegm to pool in the back of your throat. Try sleeping with your head elevated with extra pillows to drain the phlegm from your sinuses and prevent a post-nasal drip.
8. Avoid irritantsIf your phlegm is caused by allergies, try avoiding dust and pollen when possible. Clean surfaces in your home often, take allergy medications, wear a mask outside, and follow other home remedies for allergies.
Can antibiotics treat phlegm?Surprisingly, antibiotics are not always the first line of treatment for phlegm. "For chronic sinusitis, antibiotics usually make the problem worse in the long term," Dr. Teitelbaum says.
Research from the Mayo Clinic shows chronic sinusitis is triggered by fungal overgrowth. "And most women know that when you take an antibiotic, yeast/fungal overgrowth gets worse," Dr. Teitelbaum says. "So, treating sinusitis with antibiotics is what makes the sinusitis become chronic."
What does the color of my phlegm indicate?The color of your mucus can point to signs of what underlying condition is causing the phlegm. "Problems in the lungs can cause phlegm to change color," Dr. Sonpal says. "Green or yellow phlegm can occur with an infection, but brown phlegm might be a sign of bleeding. Typically, it is clear, thin, and unnoticeable. When someone has a cold or infection, the phlegm can become thickened and change color."
Dr. Teitelbaum said yellow or green mucus is considered to be a "soft sign" of bacterial overgrowth, meaning it is not 100% reliable. "Clinically it likely suggests the presence of large amounts of unhealthy bacteria that need treatment," Dr. Teitelbaum says. "Sometimes, if it is persistent for many days and comes from the lungs, accompanied by shortness of breath, it may suggest the need for treatment with an antibiotic."
When to see a doctorIn moderate amounts, phlegm can be treated with the above remedies and OTC medications. If phlegm is causing difficulty breathing, lasts for a long time, or it is recurring, call your doctor. "Having it once in a while is not a cause of concern but if it's a regular thing, the only way to treat it is to have a physician identify what is causing it and then treat," Dr. Sonpal says. "If you have tried reasonable at home remedies like salt water gargles and changing your eating patterns, allergy meds. Essentially, you have already tried the routine stuff you would find in CVS." Dr. Ashmans recommends seeing a doctor if you have a fever, shortness of breath, discolored phlegm, or a cough lasting more than two weeks.
What is the difference between phlegm and mucus?Mucus is healthy and always present in our body, while phlegm is essentially the overproduction of mucus. Our body creates excess mucus (a.K.A. Phlegm) as a response to a virus or bacterial infection.
"Mucus is a normal way for your body to coat the tissues in your throat, lungs, and gut and provide a barrier for protection against infection and irritants," Dr. Campbell says. "Phlegm is an overproduction of mucus in an effort to clear irritants from the body."
Dr. Sonpal says you can compare the difference in consistency between phlegm and mucus to the difference between pudding and custard: "Mucus is thin, while phlegm is thick," Dr. Sonpal says. "Everyone has mucus, but it turns into phlegm when something chronic is going on in the body."
Should I swallow phlegm or cough it up?Most phlegm can be coughed up or swallowed safely, so it's up to personal preference. "If it is swallowed, all of the irritants will be neutralized in the stomach due to the acidity regardless," Dr. Campbell says. "You may feel slightly nauseous after swallowing a significant amount of it, however. You can also cough it up as this is your body's way of expelling all of the irritants that are trapped in the mucus."
Dr. Teitelbaum advises spitting yellow or green phlegm out because these colors signal the mucus is infected with billions of bacteria. "Although it is okay to swallow it and let your stomach acid kill most of these bugs, when it is convenient to spit it out instead, it can take a little load off your immune system," Dr. Teitelbaum says. "This way billions of unhealthy bacteria go down the drain instead of your body having to do hand-to-hand combat with them. But go with what is easiest for you."
Editorial Assistant
Isabella Cavallo is a freelance editorial assistant at Prevention. She graduated from Binghamton University with a bachelor's degree in English: Literature & Rhetoric. Isabella gained a passion for health journalism after a rare cancer diagnosis and treatment. When she's not writing, you can find her listening to music, playing Bananagrams, or running through Central Park.
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