TC - I cannot diagnose your condition, but I can tell you about the Zoloft™ (sertraline). The side effects that you mention (headache, nausea, tiredness, and insomnia) are usually start-up side effects of Zoloft, and usually begin to go away within a month of starting the antidepressant. Unfortunately, the decrease in sexual desire and function are often long term side effects of Zoloft. The side effects that you mention could be a result of your depression, rather than the medication.

Zoloft is not addictive, nor should it be looked at as "pumping chemicals into your body". Zoloft works at the ends certain nerve cells (serotonergic axon terminals) to increase the efficiency of the electrical transmission between nerve cells containing serotonin. Depression is thought to be a breakdown of the body's response system to stress. One of the results of this breakdown is a decrease in the efficiency of passing information (in the form of electrical signals) between cetain nerve cells. These particular nerve cells use a natural body chemical (serotonin, one of 100s of neurotransmitters in the brain) to carry the electrical signal from one nerve cell to the next. In depression, the amount of serotonin produced by these cells is decreased and this results in the array of symptoms we call depression. What Zoloft does is raises the levels of serotonin between nerve cells by not allowing the nerve cell that released the serotonin to reabsorb it as readily as it would normally. In scientific lingo, it is said that Zoloft "blocks the reuptake of serotonin"; and since Zoloft is selective for blocking serotonin reuptake, it is called an SSRI (Selective Serotonin Reuptake Inhibitor). By artificially blocking serotonin reuptake, the amount of serotonin between two serotonergic nerve cells is increased and thus electrical transmission from one nerve cell to the next is enhanced. This results in the reversal of depressive symptoms and forces the body to produce more serotonin. It is hoped that by forcing the body to produce new serotonin that, in time, the body will "relearn" to produce sufficient serotonin on it's own, and the Zoloft can then be stopped.

You mentioned that you have gynecomastia. Has any doctor told you why this has happened to you? Gynecomastia is usually a result of the body producing too much of a substance called prolactin, which is an important chemical in the body's endocrine system. Secretions (including prolactin) from various endocrine glands affect various processes in the body, such as metabolism, growth, and secretions from other organs. When too much prolactin is produced, it is said that there is a malfunction (dysregulation) of a certain endocrine system. Depression can be a secondary effect of (or a result of) such a dysregulation. Has your doctor looked into the possibility of too much prolactin causing your depression?

I hope that this makes some sense. - Cam