How Does Zoloft Addiction or Dependence Develop?
Clinical research has found that synaptic remodeling occurs when a patient starts taking Zoloft.4,14
This mechanism informs many of the difficulties of Zoloft addiction, dependence and tolerance. Synaptic remodeling, or neuro-adaptation means the neurons and other systems attempt to adjust to the presence of the drug. This can affect a very wide range of normal functions, including sleep, digestion, sexual function, the heart and circulatory system, hormones and their interactions, and hundreds of additional aspects of normal physiological health. The body will adapt to the presence of disrupters to protect and enable normal functions to continue to work, even if a degree of disabling has started to occur. Then if the drug is abruptly stopped, there will be a cascade of shocks to the system, all of which need adequate time to re-balance and heal. Reinstating the drug may or may not provide relief.
Psychological aspects of Zoloft addiction can develop as well. If a patient relies on the medication to elevate their mood, this may cause a psychological dependence on the drug. Some report experiencing a feeling of euphoria after taking Zoloft, which is why some people might begin taking the drug recreationally. Regardless of the pathways of dependence or addiction, patients can come to rely on the drug for their neurochemistry to function in a way that feels “normal.” But mechanically, and neurologically, Zoloft addiction or dependence is far from normal.
What About the Chemical Imbalance Theory?
The way serotonergic medications work is commonly misunderstood. Contrary to “popular belief,” antidepressants like Zoloft don’t actually create serotonin. Instead, they SPEND it. The drug blocks the normal reuptake of serotonin, causing a temporary increase in availability. Unfortunately, the trapped serotonin held in suspension is subject to being broken down by enzymes and is then lost. Studies have found that this artificial manipulation of serotonin levels in chronic use of SSRI medications may actually create a serotonin deficiency over time.3,4
Such alterations of normal brain function may in fact be fundamental to the mechanics of Zoloft addiction and dependence that can develop over time.
Taking a broader view, the theory of serotonin deficiency causing depression was based on more supposition than actual proof. Whether or not someone had a serotonin deficiency before antidepressants like Zoloft, they will be more likely to have a deficiency after a course of SSRI treatment. This was demonstrated in a study on the serotonergic drug MDMA. The study found serotonin levels significantly decreased 7 days after the drug was administered in both human and rat studies.22 And, not to further depress the reader, some psychiatrists want to use MDMA and other serotonergic psychedelics for therapy in major depression. This is an example of how desperate drug companies must be to find “something” that works! As a note, the psychedelic drugs were found equally effective (over a short time only) as Celexa (escitalopram), another SSRI drug.23 The truth is that neither drug can be recommended, due to the consequential depletion effect on natural neurotransmitters.
Safest Ways to Discontinue Zoloft
Abruptly stopping Zoloft is NOT recommended. One exception, a very rare phenomenon, is a person having too much serotonin activated, called serotonin syndrome.7,15,16 This is a life-threatening condition that can happen in overdose, or when multiple serotonergic drugs or substances are consumed. Too much serotonin activated can overwhelm the many systems that keep a person physically functioning and alive. Only in this case would immediate cessation be called for and the safest way would be in an emergency hospital setting where life signs can be monitored carefully.
More generally, the safest way to come off Zoloft would be v e r y gradually. Alternative to Meds Center has found a number of methods for Zoloft withdrawal that are designed to provide the right kind of approach for each individual.
What is Protracted Withdrawal?
Zoloft withdrawals that last for 6 weeks are called ‘acute withdrawals.” Beyond that time frame, lingering or newly developed withdrawals are called “protracted withdrawal” or “post-withdrawal” symptoms. Stopping sertraline abruptly or faster than the body can tolerate can cause these severe and persistent adverse reactions. Sertraline withdrawal symptoms can be very intense and can linger for many years if not properly treated. 5-7,9-13,17,20,21
Symptoms of Protracted Withdrawal can include:
- Lethargy
- Anxiety
- Depression
- Suicidality
- Aggression
- Agitation, outbursts of anger, crying spells, panic attacks
- Brain zaps, body zaps
- Visual and auditory hallucinations
- Chills, flushing, dysregulated temperature, diaphoresis (excessive perspiration)
- Sexual dysfunction, genital hypersensitivity
- Cognitive impairments, amnesia
- Nausea, vomiting, abdominal pain
- Muscle aches
- Impaired balance, ataxia (loss of muscle control)
- Akathisia (intense, unrelenting inner restlessness, unease, compulsive rocking, pacing or other repetitive movements)
- Dysphoric mood, emotional lability
- Mania, hypomania (episodic)
- Agitation
- Sensory disturbances, blurred vision, altered taste
- Vertigo, dizziness
- Tremors
- Headache, cephalgia (frequent headaches severe enough to disrupt daily life)
- Insomnia, disturbed sleep
- Seizures
- Tinnitus
- Diarrhea
- Anorexia
- Itching
- burning, prickling or other painful sensations
To soften harsh symptoms, the medication is gradually tapered down to zero to soften these symptoms.8 However, tapering safely and effectively can take time — it can take months to wean off Zoloft use after Zoloft addiction, dependence and tolerance have developed. For patients using sertraline, it is recommended to consult a doctor, addiction treatment professional, or other medical health professionals who are familiar with the challenges of coming off SSRI drugs and can guide you properly. If your physician/prescriber is not sympathetic or seems to not understand the depth of the difficulty, look for one who is properly informed and who is willing to help you. Thankfully, it seems more medical practitioners are becoming better equipped and educated in this often neglected and misunderstood field of medicine.19
Treatment for Zoloft Addiction & Dependence at ATMC
We use lab tests, and other diagnostics to design an individual’s program for recovery.
Based on orthomolecular medicine, we use natural substances for neurochemistry stabilization, removal of neurotoxins that have accumulated, gradual medication cessation techniques, amino acid therapy and other nutritional therapies, personal counseling, lifestyle management coaching, yoga, massage, peer support, sound therapy, trainer-led exercise, Qigong, cold-plunge therapy, and other holistic treatments that can combat depression and other unwanted symptoms You can view a much more in-depth description of the many holistic protocols available inpatient on our services overview pages. We understand that not everyone is able to attend an inpatient treatment center. We may be able to refer you to a caregiver who will understand the seriousness of your situation and this may be a valuable resource for you. Please contact us for more information on our programs to safely and effectively treat Zoloft addiction and dependence and related issues at Alternative to Meds Center.
The drug stops working at the usual dose or frequency. This is called tolerance.
