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Zoloft (Sertraline) Side Effects, Withdrawal and FAQs

Zoloft (sertraline) is an antidepressant drug developed in the 1970’s, for which Pfizer received FDA approval in 1991.
This SSRI drug is prescribed in treating adult depressive disorders, panic disorder, OCD, social anxiety, and others. In 2013 Zoloft was the most prescribed antidepressant in the US.
Sertraline is categorized as an SSRI drug, and is considered a potent serotonin reuptake inhibitor. However, it also is sometimes called an SDRI drug, referring to the drug’s secondary (weaker) dopamine reuptake inhibiting characteristic.

It has been suggested, though not conclusively proven, that increasing dopaminergic as well as serotonergic activity may be relevant to medication-based treatment of depression. (1)

Like all SSRI drugs, Zoloft can produce certain side effects and adverse effects that may be experienced when withdrawing from the drug. Below we will present information on these topics and others that appear to be some of the most common questions and searches done on the drug.

What is Zoloft (Sertraline) Used For?

As previously mentioned, Zoloft (sertraline) is a drug used to treat adult MDD (major depressive disorder). The Black Box warning on the drug’s packaging contains warnings which indicat the drug should not be prescribed to anyone under the age of 25, due to known increase of suicidality. There is an exception for patients under the age of 25 who have been diagnosed with OCD (obsessive compulsive disorder).

There are several other adult-only uses for the drug in a clinical or treatment setting, which include:

  • PTSD: Post traumatic stress disorder
  • Panic disorder
  • Anxiety disorder, i.e., social phobias
  • OCD: Obsessive compulsive disorder
  • PMDD: Premenstrual dysphoric disorder


Zoloft (Sertraline) Alternative Names and Slang

Zoloft is a brand name for the generic drug sertraline, or sertraline hydrochloride. In the UK sertraline was sold under the trade name of “Lustral” in the 1980’s. In the US sertraline and Zoloft are available by prescription only.

Zoloft (Sertraline) Side Effects

There is a wide range of commonly experienced side effects on Zoloft. Women in particular should be aware that any drug ingested during child-bearing years may have liabilities should she become pregnant. There have been studies done to explore the risks of pregnancy which link certain birth injuries where mothers were prescribed SSRI drugs. (2) Always speak to your physician if you are or could become pregnant and are considering starting an SSRI prescription.

Zoloft was given a “C” rating, by the FDA, meaning the drug causes harm when tested on animals but no human testing has been done, so the drug remains legal to prescribe to pregnant women. In June 2015, however, the alphabet rating system was replaced by the “PLLR” rating system, or what is known as the Pregnancy and Lactation Labeling Final Rule. The FDA has been noncommittal in labeling pregnancy risks on SSRI packaging, despite studies that show increased (3-5%) risk of birth defects.

Nonetheless, there are certain adverse conditions in infants whose mothers took Zoloft which are documented and publicly available,(3) that would be recommended reading before starting or stopping a prescription to an SSRI drug while pregnant, lactating, or planning a pregnancy.  Some reported and documented birth defects and injuries include:

  • PPHN: persistent pulmonary hypertension of the newborn, a heart and lung condition which can result in respiratory failure requiring a mechanical ventilator, decreased oxygen to the brain and multiple organ injury. (3)
  • CONGENITAL HEART DEFECTS connected to Zoloft and other SSRI’s include ventricular septal defects and atrial septal defects, also referred to as “holes in the heart”, related to heart murmurs, suppressed appetite, breathing difficulties, tiredness, inadequate growth, etc. (4)
  • INCREASED RISK OF AUTISM has been reported on extensively but evidence has not yet been considered conclusive enough for regulatory bodies to ban prescribing to pregnant women. (5) (6)
  • INCREASED RISK OF CLUBFOOT connected to SSRI’s during pregnancy as reported by NIMH, where sertraline exposure had the highest increase in clubfoot of all SSRI’s. (7)
  • INCREASED RISK OF MAJOR MALFORMATIONS was reported in a Canadian study from 1998 to 2010 published in the June 2015 issue of the American Journal of Obstetrics. (8)

Generally, SSRI’s can have an emotional deadening effect, sometimes described as a “zombie-like” feeling.  Clinical studies call this as SSRI-induced-indifference. (9) While such emotional masking can provide a temporary measure of relief, there may be other drug-free treatments that may be more appropriate, less risky, and more permanent.

A person may experience no side effects at all, where another person may experience one or multiple adverse symptoms when taking sertraline. Symptoms can range from mild to moderate to severe, and the most severe may require immediate medical intervention.

Here are some of the known side effects of Zoloft (sertraline):

  • Serotonin syndrome: A life-threatening condition requiring immediate medical care in a hospital emergency clinic or ICU. Symptoms to watch for include sudden fever, losing consciousness, inability to move or speak, copious sweating, dilated pupils, chills, tremors, convulsions, diarrhea, agitation, restlessness, racing heart, etc.
  • Suicidal ideation
  • Suicide attempt
  • Hyperkinesis (muscle spasms, movement disorder)
  • Worsened depression
  • Aggression
  • Paranoia
  • Anxiety
  • Mania
  • Convulsions
  • Unconsciousness
  • Coma
  • Teeth grinding
  • Akathisia (relentless internal restlessness and discomfort marked by repeated motions, pacing, rocking, etc., can lead to suicidal ideation as a means of relief)
  • Tachycardia (racing heart, even when the body is at rest)
  • Rash
  • Itching
  • Burning, crawling feeling in the skin
  • Fever
  • Tics, sudden jerky movements
  • Emotional blunting
  • Behavioral apathy, SSRI-induced-indifference (9)
  • Pain on urination, difficulty urinating
  • Cloudy urine
  • Headache
  • Sexual impairments, i.e., anorgasma, inability to ejaculate, lowered libido
  • Mood swings
  • Pain around the eyes or eye sockets
  • Somnolence
  • Bladder pain
  • Prickling skin sensation
  • Numbness
  • Sensory disturbances
  • Insomnia
  • Depersonalization
  • Nervousness
  • Nightmares
  • Hostility
  • Nausea
  • Diarrhea

This list is not a complete list. Be sure and speak to your prescribing physician if you are experiencing any discomforts or unusual feelings while taking sertraline.

Zoloft (Sertraline) Withdrawal Symptoms

One of the most commonly reported discomforts while coming off SSRI medications is termed brain zaps, described as feelings of electric shock passing through the brain/head/neck.

Brain zaps, or shivers, can be severe, unbearably so, and come on unexpectedly and sometimes in rapid succession. It is not known exactly why they occur but is thought to be related to neurochemical changes as the body and central nervous system attempt to adjust to or compensate for, reduced levels of sertraline or other SSRI medication in the system.

It is highly likely that the body was depending on the drug’s artificial support of serotonin, and that the person may be experiencing a sudden deficit while their own natural mechanisms are attempting to come back on line to compensate.

Other withdrawal symptoms include but are not limited to:

  • Diarrhea
  • Headache
  • Mental fog, confusion
  • Hallucinations
  • Mood swings
  • Return of original symptoms, sometimes intensified
  • Crying spells
  • Tremors

Discontinuing/Quitting Zoloft (Sertraline)

Coming off Zoloft (sertraline) can take a considerable amount of time, and it is not easy to give an exact timeline as individual differences such as age, general health, dosage, length of time on the drug, and other factors all have some impact. One could expect the process to take at least some weeks, or longer.

The FDA and other regulatory bodies recommend never to abruptly stop taking an SSRI medication. The safest approach would involve a slow taper process. When slowly dropping the dosage, over time, various measures can be utilized for support such as nutrition, adequate rest, a reduced daily schedule to allow time for self-care, etc.

Some people opt for inpatient care during this sometimes difficult period of readjustment.

There is wisdom to this choice, as the withdrawal manifestations maybe not only difficult on the individual, but also challenging for the family members and friends who may misunderstand the process and convolute the situation.

Zoloft (Sertraline) FAQs

Can You Become Dependent on Zoloft (Sertraline)?

Yes. It can take a significant period of time for the central nervous system to become accustomed to sertraline and the effects that it induces on brain chemistry. The body/brain adapts to these changes, and alters its neurochemistry to align with and compensate for the drug’s effects.

Once this has occurred, the body/brain/neurochemistry will react to a withdrawal of sertraline, and the result is that withdrawal symptoms will emerge. This is drug dependence.

Sometimes called addiction or abuse, a person may crave the drug’s “feel good” effects, and may begin to take more of the drug than has been prescribed. In either case, the drug has now become entrenched into the system, and careful tapering would be the best option to extricate from this unhealthy condition.

What’s the Difference Between Zoloft and Xanax?

Zoloft is an SSRI medication, also called an antidepressant and used to treat depression and anxiety. Xanax is a benzodiazepine, also known as a tranquilizer, and is also prescribed mainly for the treatment of anxiety, but is also prescribed to treat depression.

The two drugs have different chemical components, and work differently in the brain. Xanax slows the central nervous system to reduce anxiety. Zoloft blocks reuptake of serotonin, causing an artificial calming effect.

Both drugs are prone to dependence/addiction and neither should be abruptly stopped but tapered slowly to allow the central nervous system and neurochemistry to normalize.

Is Zoloft a Controlled Substance?

No, Zoloft is not classed as a controlled substance in the US.

How Long Does Zoloft Stay in Your System?

The half-life of Zoloft is estimated at 26 hours, and after approximately 6 days the drug should be 99% out of the system. (10)

Many factors can help determine or affect metabolization of drugs, and can therefore increase or decrease the timeline for elimination.

Can You Overdose on Zoloft (Sertraline)?

Yes it is definitely possible for SSRI poisoning to occur. A Zoloft overdose requires emergency medical intervention as there is a possibility that without proper care, overdose can lead to substantive health problems or even fatality. At an ICU there are proper equipment and personnel to treat such a dire situation in a timely and effective manner.

For example, the use of intravenous benzodiazepines is sometimes required to prevent seizures and extra cooling measures must be used to reduce hyperthermia, always under the direction of EMT or other medical staff attending to the patient. (11)

Treatment for Zoloft (Sertraline) Abuse and Addiction?

Zoloft has become one of the most frequently prescribed antidepressants in the US. Of equal import, depression type disorders have become one of the most frequently diagnosed conditions.

These two facts together underscore two important steps toward improved health:

  • Providing safe tapering programs for those who have decided to stop taking Zoloft, and
  • Offering drug-free options as a means to regain natural mental health without the need for prescription medications.

The ATMC program offers a cessation or tapering program that seeks to satisfy both of these steps to better health. Using specific lab tests and other diagnostic tools, the program aims toward stabilizing neurochemistry without prescription drugs. Instead, natural substances such as pharmaceutical grade supplements, proper diet, accumulated neurotoxin removal (including environmental toxins), careful tapering, IV amino acid treatments, clay packs, low-temperature sauna, nebulized glutathione treatments, and many other forms of therapies make the tapering process gentle, mild, and as comfortable as possible.

Once the neurochemistry normalization is well in progress, other work can begin with CBT and other forms of counseling that are strongly recommended in the treatment of depression and anxiety.

The very comfortable and nurturing facility is staffed by highly qualified medical and nursing staff as well as a full range of skilled, compassionate therapists. Adjunctive therapies are also available such as therapeutic massage, Reiki, classes in yoga, trainer-led exercise and many other effective holistic therapies that can help overcome the challenges of chronic or acute depression, and accelerate recovery.

In our remarkable science-based program, drug dependence and mental health issues can both be thoroughly addressed, which can provide a very real and sustainable overall resurgence in health, predictably and naturally.

This content has been reviewed, and approved by a licensed physician.

Dr. John Motl, M.D.

Dr Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor’s of Science degree with a major in biology and minors in chemistry and philosophy. He graduated Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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