How Do You Survive Zoloft Withdrawal?
This page covers Zoloft withdrawal symptoms, the most common adverse effects of taking Zoloft, information about the drug and how it may act upon neurochemistry and receptors, and answers some Zoloft FAQs. We have other pages that you might find informative and useful. One is our Zoloft alternatives page which discusses other holistic ways to treat symptoms for which Zoloft was prescribed. Another is Zoloft tapering which gives information about weaning off of Zoloft. No one should try discontinuing Zoloft without medical oversight and guidance.
Of fundamental importance, the FDA and other regulatory bodies recommend never to abruptly stop taking antidepressants.3 The best approach according to medical consensus would be a slow and gradual Zoloft withdrawal over weeks or months. By easing a reduction in dosage, over time, various other measures can be utilized for added support while coming off Zoloft. These can include natural neurochemical support, targeted nutrition, adequate rest, and a less stressful daily schedule to allow time for self-care, etc.
Inpatient Care During Zoloft Withdrawal
Inpatient care is highly recommended 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 inadvertently convolute the situation.
For many, Zoloft withdrawal symptoms can linger for a considerable amount of time, and need attentive support to manage them well. Individual differences such as age, general health, dosage, length of time on the drug, and other factors can all impact withdrawal.4
At Alternative to Meds Center, we have observed that almost all people can comfortably get off of Zoloft within a number of weeks and avoid harsh withdrawal symptoms in the process.
While some people feel that leaving loved ones at home this long can be unbearable, they often find this temporary separation preferable to the trauma that they put themselves and their family through at home while trying to do this unsupported. For others, 8 weeks may seem too abbreviated of a withdrawal period, especially with what they have already endured in possible previous at-home attempts. There is a lot that goes into our program and how we support natural neurochemistry to ease the process. Our strategies are designed to ease the process considerably. We encourage you to view our services section of the website to get an idea of the maximum support we offer.
When Do Zoloft Withdrawal Symptoms Start When Discontinuing / Quitting Zoloft?
Generally, the half-life will be a good predictor of when Zoloft withdrawal symptoms will begin to emerge.54
Zoloft is estimated to have a half-life of approximately 24 hours, although research has shown the half-life can be shorter in young males (15-22 hr) compared to females including elderly females and elderly males (32-36 hr).
For some, transitioning to a longer-acting SSRI such as fluoxetine may be helpful as a strategy to overcome impassable difficulties in Zoloft discontinuation.55
What is Zoloft?
Zoloft (sertraline) is an antidepressant medication developed in the 1970s with FDA approval granted in 1991, allowing Pfizer to bring it to market. Doctors prescribe this SSRI drug for treating adult major depressive disorder (MDD), panic disorder, obsessive compulsory disorders (OCD), social anxiety disorders (SAD), post-traumatic stress disorders (PTSD), and premenstrual dysphoric disorder (PMDD).3,18
By 2005, Zoloft topped the sales charts as the most prescribed antidepressant in the United States.19 Zoloft is categorized as an SSRI drug and is thought to act as a potent serotonin reuptake inhibitor. However, Zoloft is sometimes and perhaps more accurately referred to as an SDRI drug due to its secondary (weaker) dopamine reuptake inhibiting characteristic.20 As such, we feel that it would act as a mood elevator similar to Effexor. Effexor, a dopamine-norepinephrine-type drug, can worsen anxiety.21 It has been suggested, though not conclusively proven or even understood, that increasing dopaminergic, as well as serotonergic activity, is the basis for treating symptoms such as depression.22
Holistic, drug-free methods of treatment for anxiety and depression are under-utilized in general practice, but we are encouraged as we see the trend is gradually shifting.
The following information covers some of the most common questions asked and searches done on the drug.
What Is Zoloft Used For?
Zoloft (sertraline) is an antidepressant medication approved 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 the heightened risk of suicide. There is an exception to this for patients under the age of 25 who have been diagnosed with OCD (obsessive-compulsive disorder).3
Adult-only approved uses for the drug provided in a clinical or treatment setting include: 3
- MDD: Major Depressive disorder
- PTSD: Post-traumatic stress disorder
- PD: Panic disorder
- SAD: Social anxiety disorder
- OCD: Obsessive-compulsive disorder
- PMDD: Premenstrual dysphoric disorder
Zoloft ( sertraline ) Alternative Names and Slang
Zoloft is a brand name for the generic drug sertraline hydrochloride. In the UK, sertraline was sold under the trade name “Lustral” in the 1980s. In the US, sertraline and Zoloft are available by prescription only. Coming off any brand name of sertraline will be subject to the same phenomena as Zoloft withdrawal.3,36-41,53
Zoloft Adverse Effects
The potential risk of drug-induced suicidality is associated with all SSRIs and may be a concern leading one to consider Zoloft withdrawal, which is recommended to always be done under medical or caregiver monitoring.
However, there are many other adverse reactions specifically associated with sertraline. A study published by the Journal of Pharmacoepedimiological Safety showed that 3 out of 4 patients experienced adverse events while taking sertraline. And, the study also noted an additional 100 adverse events in users of sertraline that were not mentioned on the drug’s label.60
Some of the known adverse effects of Zoloft (sertraline) include these:
- 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 (common)
- Suicide attempt (common)
- Hyperkinesis (muscle spasms, movement disorder)
- Worsened depression
- Aggression
- Paranoia (rare)
- Anxiety
- Mania (common)
- Convulsions
- Unconsciousness
- Coma
- Teeth grinding
- Akathisia (relentless internal restlessness and discomfort marked by repeated motions, pacing, rocking, etc., that 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, myoclonus
- Emotional blunting
- Behavioral apathy, SSRI-induced indifference
- Painful urination or difficulty urinating
- Cloudy urine
- Headache
- Sexual impairments such as anorgasmia, 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 (common)
- Nervousness
- Nightmares
- Hostility
- Nausea
- Diarrhea
- Weight gain
The list noted above is not a complete list. Be sure and speak to your prescribing physician if you are experiencing any discomfort or unusual feelings while taking sertraline.
A Note on Uncommon Zoloft Adverse Effects
At Alternative to Meds Center, we have certainly seen some rather bizarre symptoms over the years. After all, each person is a completely unique expression of life.
Not uncommonly, before coming to Alternative to Meds Center, some people have gone to all sorts of specialists, gastroenterologists, neurologists, etc., to try to get an understanding of what they are going through.
In the end, it is not at all uncommon for us to find that medication was the culprit or was at the very least a significant contributing factor, requiring a more nuanced set of treatments to generate the healing processes.
Sertraline and Emotions
Generally, SSRIs can have an emotional numbing or deadening effect, sometimes described as a “zombie-like” feeling. Clinical studies call this an SSRI-induced indifference.35 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.
One person may experience no reactions at all, and 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.
Of Interest to Women of Child-bearing Age
Patients can experience a wide range of commonly experienced reactions to Zoloft. Women, in particular, should be aware that any drug ingested during child-bearing years may come with liabilities should they become pregnant.3
Though limited in number, there have been studies done to explore the risks of pregnancy that link certain birth injuries to mothers who were prescribed SSRI drugs.23 Women of childbearing age are advised to speak to their prescriber before starting an SSRI prescription.
Zoloft was given a “C” rating by the FDA, meaning the drug was shown to cause harm to pregnant animals when tested, but for ethical reasons, little to no human testing has been done on pregnant women.24-26 Still, the drug remains legal to prescribe to women of childbearing age, and even those who are pregnant. In June 2015, the alphabet rating system was replaced by the “PLLR” rating system, known as the Pregnancy and Lactation Labeling Final Rule. Despite studies that show sertraline (Zoloft) shows up in breast milk, long-term effects have not been adequately evaluated.27
More studies need to be done, but what has been reported should be seriously considered for anyone of child-bearing age.
The FDA drug label for Zoloft mentions infants born to mothers taking Zoloft may suffer damage to the lungs and the infant may experience withdrawal symptoms at birth. Important data was reported in a 2015 study out of Quebec that followed hundreds of pregnancies where the mother took sertraline during pregnancy. The authors of the study found an increase in major malformations in these newborns including craniosynostosis (malformation of the skull) and heart defects. Other birth defects associated with Zoloft are described in more detail below, with their respective clinical reports cited at the end of this article.3,6,23-32,34
Other reported and documented birth defects and injuries include:
- PPHN or persistent pulmonary hypertension of the newborn is a heart and lung condition which can result in respiratory failure, decreased oxygen to the brain, and multiple organ injuries.29
- 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”. These defects are associated with heart murmurs, suppressed appetite, breathing difficulties, tiredness, inadequate growth, and other effects.30
- 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.31
- Increased Risk of Clubfoot connected to SSRIs during pregnancy was reported by NIMH. Sertraline exposure caused the highest incidence of clubfoot of all SSRIs.32
- Increased risk of atrial/ventricular defects and craniosynostosis was reported in a Canadian study from 1998 to 2010 and published in the June 2015 issue of the American Journal of Gynecology & Obstetrics.33
Can Zoloft Make Depression Worse?
A study published in July 2011 in the Frontiers of Psychology journal revealed that antidepressant users with major depression are far more likely to have subsequent reoccurrences of major depression than those who avoid antidepressants. This case review study was headed up by McMaster University evolutionary psychologist Dr. Paul Andrews and his colleagues. They reviewed 46 studies carefully selected for reliability and high standards to compare outcomes for patients who used antidepressants versus those given placebos. They concluded that antidepressant users experience a depressive relapse at 42% compared to 25% in the placebo group.36,37 This would suggest that there is a possibility that in some cases, antidepressants like Zoloft can make the cycle of depression harder to resolve.
Zoloft Aggression in Children
Previous studies have also indicated a link between SSRIs and violent behavior. Diagnosticians call it antidepressant disinhibition, or antidepressant-induced activation. Antidepressant disinhibition affects 10-20% of children taking SSRI antidepressants.42,43 In two clinical trials performed by Pfizer, clinicians listed aggression as the most common reason for Zoloft discontinuation in children studied. More clinical studies are needed on the topic of Zoloft and aggression in adults.38,39