Pros vs. Cons of Long-Term Antidepressant Use
Although short-term use of antidepressants is advertised to be helpful in alleviating symptoms, there is little scientific evidence to demonstrate its efficacy in reducing symptoms of depression or anxiety, according to the National Institute for Health Research.17 Worse, when used long-term, antidepressants can have severely damaging effects on your health for years to come. When it comes to Zoloft, it is important to look at the pros and cons of this treatment plan before considering an antidepressant prescription.
Drug-based treatment attempts to use prescription antidepressants, and mood stabilizers, to chemically treat mental illness.
However, some research suggests staying on antidepressants for life or even using them long-term, can be harmful to your mind and body. In many instances, extended use can leave you worse off than before. Like all SSRIs, the FDA requires a suicide warning for people under the age of 25 on the package label.1 Fortunately, there are other holistic treatment plans that can effectively help treat your mental illness without the possible adverse long-term side effects of Zoloft.
Limited Potential for Reduction in Symptoms
Zoloft is prescribed to improve mood and mitigate symptoms. As hopeful as this theory seems, over time, most patients find they need to continue to increase their Zoloft dosage to attain even minor results. Some research has shown that such results results may be mostly attributed to the placebo effect.18 Zoloft’s adverse side effects may eventually outweigh any positive changes experienced.
Disadvantages of antidepressant use include the following:
- Serotonin syndrome
- Worsening of symptoms
- Harmful drug interactions
- Zoloft dependence and withdrawal
Serotonin Syndrome
Taking an SSRI causes an artificial accumulation of serotonin. Too much active serotonin can result in serotonin syndrome. While serotonin is naturally present in your body, unnaturally high levels of this neurotransmitter can cause serious health complications. Ranging from mild symptoms such as chills and gastrointestinal issues to seizures and even death, excess serotonin buildup from sertraline use can be life-threatening.3
Worsening of Symptoms
No SSRI can be expected to fully relieve any mental illness. However, prescription drug companies often infer such. For that reason, patients often experience disappointment during their attempts to find an antidepressant that addresses their symptoms. While trying different prescriptions, the severity of your symptoms can be dramatically worsened due to adverse reactions to medications, leaving you in a more vulnerable position than you were previously. In the time it takes for you to begin an antidepressant regime, realize the medication is incompatible with you, and start another medication, your symptoms could grow increasingly worse than before you started taking SSRIs.
Harmful Drug Interactions
As with any new prescriptions, potential interactions with your current medications are a known potential risk. An example of an adverse drug interaction is Zoloft and aspirin, which can cause increased, heavy bleeding in patients taking both. It’s also dangerous to mix Zoloft with St. John’s Wort or with MAOIS medications (monoamine oxidase inhibitors). In fact, there are so many possible adverse drug interactions with SSRIs that often it is left up to the pharmacist to determine the risks for patients, as doctors are largely under-educated in the subject.4,8,9
Zoloft Dependence and Withdrawal
Since Zoloft blocks the natural reuptake of serotonin by the nervous system and forces unnatural levels of the hormone to accumulate, your body can become dependent on its effects to sustain a feeling of normalcy. Zoloft is a mind-altering chemical and can cause you to feel withdrawals when you abruptly or even gradually discontinue its use—even if you’ve done so to avoid the negative side effects of long-term use listed above. For this reason, it is critical to consult with a healthcare provider who has familiarity with the subject to gradually taper your use of Zoloft to zero. Doing a controlled, gradual taper can reduce the withdrawals you feel when ceasing your use of the drug.
As you can see, the various drug interactions, harmful side effects, and life-threatening conditions tied to prolonged use of antidepressants like Zoloft outweigh the minimal benefits. As with any condition, there are numerous alternative treatment plans available for depression and other mental health conditions Zoloft was approved to treat. These offer a safer, more holistic option for addressing your mental health.
How Long Does It Take for Zoloft Side Effects to Go Away?
A person taking Zoloft for a very short time may be able to stop taking it with mild withdrawal symptoms or may experience none at all. For example, women may be prescribed low-dose sertraline (100-150 mg) for premenstrual issues. For PMDD, Zoloft is to be taken for 14 days until the start of their period, and then the drug is discontinued. No long-term trials have ever been done specifically on whether drug withdrawals occurred after intermittent use. We do know that Zoloft discontinuation syndrome was not reported in association with several 2-week and 6-week trials of using Zoloft and other SSRIs intermittently for PMDD. Drug side effects were reported, however, and were generally observed to quickly fade as the drug is excreted from the system, over a few days. In a short-term trial published in the Journal Obstet Gynecol, 8% of PMDD participants dropped out because of adverse effects. In a similar clinical trial, the most common adverse effects were nausea, loss of libido, sweating, and tiredness.10-13
Dosage, Dependence, Withdrawals
As with any psychoactive drug, the severity of the side effects associated with Zoloft use can vary based on your body’s unique interactions with the drug, dosage, as well as length of use. Dose-related adverse effects of Zoloft have been reported, such as the emergence of hypomania at 300 mg/day, which was reversed once the dosage was lowered to 200 mg/day.14 The FDA suggests that if a patient does not improve after 24 continuous weeks of Zoloft treatment, the dose be titrated upwards to see if the patient will see improvement at a higher dose.6 This practice may lead to dependence. Once dependence develops, withdrawal symptoms will occur if a dose is missed or delayed, or the drug is abruptly discontinued. Zoloft withdrawals may emerge within a day or two due to the drug’s short half-life (22-36 hr).19 The long list of Zoloft withdrawal symptoms is collectively referred to as Zoloft discontinuation syndrome. Zoloft withdrawals can be ongoing, resembling severe, flu-like symptoms and insomnia, and a wide range of psychiatric and other symptoms which may persist for days, weeks, months, or even years. Improperly managed withdrawal after long-term Zoloft use can keep a person locked in a vicious cycle of lingering Zoloft side effects and discontinuation syndrome for a very long time.5
Serotonin is a critical chemical messenger created by and in the body, that helps regulate mood, the sleep-wake cycle, and countless other functions, and is most often associated with feeling well. Drugmakers and regulators do not know exactly how SSRIs work, but claim the drug increases active serotonin in certain areas of the brain. This is a popular half truth. No drug creates serotonin. What antidepressants like sertraline do is cause existing serotonin to linger at the synapse, instead of continuing along nerve channels as usual. The theory is that this pooling effect can lead to positive effects on mood. Unfortunately, these trapped molecules eventually break down and become lost as waste material, leaving a potential deficiency over time. This is, at least in part, why long-term use of SSRIs like Zoloft can be harmful and can worsen already hard-to-manage symptoms of depression and anxiety.
