One of my primary-care patients was recently taken off sertraline (Zoloft) by her pulmonologist. She was told that the medication was not good for her respiratory status. Is sertraline contraindicated in patients with asthma or chronic obstructive pulmonary disease (COPD)? — SUSAN SOLOMON-GRIMES, ARNP, Boynton Beach, Fla.

Dyspnea, especially that experienced daily by COPD patients, can increase anxiety and risk of panic attacks. A literature search shows that two studies, conducted in 1995 and 2003, demonstrated decreased anxiety once COPD patients were started on sertraline. With regard to asthma, there was one death reported in 2000 of a young woman found dead in her home, and autopsy demonstrated an overdose of sertraline as well as a severe asthma exacerbation. The specific circumstances of the situation were unknown. The Physicians’ Desk Reference lists no respiratory cautions, contraindications, or adverse effects associated with sertraline. — Rebecca H. Bryan, APRN, CNP (152-01)