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Tapering Off Zoloft, Discontinuation Symptoms and Side Effects

Zoloft (sertraline) is an antidepressant medication developed in the 1970s with FDA-approval granted in 1991, allowing Pfizer to bring it to market.

This SSRI drug is prescribed in treating adult depressive disorders, panic disorder, OCD, social anxiety, and others. By 2013, Zoloft was the most prescribed antidepressant in the United States.

Sertraline is categorized as an SSRI drug, and is considered a potent serotonin reuptake inhibitor. However, it also is referred to as an SDRI drug due to its 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.

Like all SSRI drugs, Zoloft can produce certain side effects that present when withdrawing from the drug, also known as discontinuation symptoms. The following information covers some of the most common questions asked and searches done on the drug.

What is Zoloft (Sertraline) Used For?

Anti-DepressantZoloft (sertraline) is an antidepressant medication used to treat adult MDD (major depressive disorder). The Black Box warning on the drug’s packaging mentions that the drug should not be prescribed to anyone under the age of 25, due to a known increase in suicidal thoughts. There is an exception for patients under the age of 25 who have been diagnosed with OCD (obsessive compulsive disorder).

Other adult-only uses for the drug provided in a clinical or treatment setting 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 1980s. In the US, sertraline and Zoloft are available by prescription only.

 

Zoloft (Sertraline) Side Effects

There is a wide range of side effects commonly experienced by patients taking Zoloft. Women, in particular, should be aware that any drug ingested during child-bearing years may come with liabilities should she become pregnant. There have been studies done to explore the risks of pregnancy which link certain birth injuries to mothers who were prescribed SSRI drugs. 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 was shown to cause harm on animals when tested, but no human testing has been done. Still, the drug remains legal to prescribe to pregnant women. In June 2015, however, the alphabet rating system was replaced by the “PLLR” rating system, known as the Pregnancy and Lactation Labeling Final Rule. Despite studies that show increased risk (three to five percent) of birth defects, the FDA has been noncommittal in labeling pregnancy risks on SSRI packaging.

Nonetheless, there are certain adverse conditions in infants whose mothers took Zoloft. Many have been documented, are publicly available, and should 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 or persistent pulmonary hypertension of the newborn, a heart and lung condition which can result in respiratory failure, decreased oxygen to the brain, and multiple organ injury.
  • Congenital Heart Defects connected to Zoloft and other SSRIs 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. 
  • Increased Risk of Autism has been extensively reported but evidence has not yet been considered conclusive enough for regulatory bodies to ban prescribing to pregnant women.
  • Increased Risk of Clubfoot connected to SSRIs during pregnancy as reported by NIMH, where sertraline exposure had the highest increase in clubfoot of all SSRIs. 
  • Increased Risk of Major Malformations was reported in a Canadian study from 1998 to 2010 and published in the June 2015 issue of the American Journal of Gynecology & Obstetrics.

Generally, SSRIs can have an emotional deadening effect, sometimes described as a “zombie-like” feeling.  Clinical studies call this as SSRI-induced-indifference. While such emotional masking can provide a temporary measure of relief to an individual, 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, with the most severe potentially requiring 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 thoughts
  • 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 thoughts 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
  • Pain on urination or difficulty urinating
  • Cloudy urine
  • Headache
  • Sexual impairments, i.e., anorgasma, inability to ejaculate, lowered libido
  • Mood swings
  • Pain around the eyes or eye sockets
  • Sleepiness
  • Bladder pain
  • Prickling skin sensation
  • Numbness
  • Sensory disturbances
  • Insomnia
  • Depersonalization
  • Nervousness
  • Nightmares
  • Hostility
  • Nausea
  • Diarrhea

The list noted above 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 Withdrawal Symptoms

One of the most commonly reported symptoms experienced 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—sometimes in rapid succession. Why they occur remains a mystery but 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 levels, 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 Zoloft discontinuation 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. Individual differences such as age, general health, dosage, length of time on the drug, and other factors all have some impact on withdrawal. One could expect the process to take at least some weeks or longer.

The FDA and other regulatory bodies recommend never abruptly stop taking antidepressants. Rather, the safest approach would involve a slow taper process. By easing a reduction in dosage, over time, various other measures can be utilized for added support while tapering off Zoloft such as nutrition, adequate rest, and a less stressful daily schedule to allow time for self-care, etc.

Some people opt for inpatient care during this often difficult period of readjustment. There is wisdom to this choice, as the withdrawal manifestations are 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, resulting in the emergence of withdrawal symptoms. 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 remove this unhealthy condition.

What’s the Difference Between Zoloft and Xanax?

Zoloft Xanax DifferencesZoloft is an SSRI medication, an antidepressant, 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 slowly tapered 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?

In 2018, Harvard Medical School updated its 2010 article about anti-depressant withdrawal, noting that the half-life of Zoloft is estimated at 26 hours and after approximately six days the drug should be 99 percent out of the system.

Many factors can help determine or affect how a drug metabolizes, thereby increasing or decreasing 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 it 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.

According to the National Institute of Health (NIH), the use of intravenous benzodiazepines is sometimes required during Zoloft overdose to prevent seizures. Extra cooling measures must be used to reduce hyperthermia, always under the direction of EMT or other medical staff attending to the patient.

Treatment for Zoloft (Sertraline) Abuse and Addiction?

Zoloft has become one of the most frequently prescribed antidepressants in the US. Of equal importance is that depressive 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 to stabilize neurochemistry without prescription drugs. Instead, natural substances such as pharmaceutical grade supplements, proper diet, accumulated neurotoxin removal (including environmental toxins), careful tapering, I-V 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, strongly recommended in the treatment of depression and anxiety.

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

In our remarkable science-based program, drug dependence and mental health issues can both be thoroughly addressed, providing a very real and sustainable overall resurgence toward better 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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