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The Risks of Zoloft Addiction and Dependence

This entry was posted in Addiction and tagged on by .
Medically Reviewed Fact Checked

Last Updated on February 22, 2023 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Zoloft, generic sertraline, is a selective serotonin reuptake inhibitor (SSRI). A selective serotonin reuptake inhibitor is a type of drug often prescribed as an antidepressant. SSRIs are used to treat moderate to severe depression, and they work in the body by trapping serotonin (a natural chemical) at the nerve synapse.  Unfortunately, Zoloft addiction and dependence may develop over time.


As an SSRI, Zoloft creates an accumulation of serotonin in the brain by blocking its normal reuptake. SSRIs are marketed as generally effective long-term medications to treat depression, anxiety, and other mental health disorders. Zoloft is a medication specifically used to treat panic disorder, major depressive disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).1

Unfortunately, many patients have been prescribed Zoloft without being fully informed about the full implications of chronic use. In fact, over time, patients using Zoloft have endangered their health and negatively impacted their daily lives. Many patients who begin taking antidepressants like Zoloft find they cannot easily stop their use.2

Does Zoloft Create Brain Chemicals?

Does Zoloft Create Brain Chemicals?

Contrary to popular belief, antidepressants like Zoloft don’t actually create serotonin. Instead, they block the reuptake of serotonin, in theory, to achieve a better balance of this critical neurotransmitter in the brain. Unfortunately, the trapped serotonin held in suspension is subject to being broken down and lost. This artificial manipulation of serotonin levels can eventually create serotonin deficiency.3

These alterations of normal brain function are part of the profile of Zolof addiction and dependence that can develop over time

Another consequence (though rare) is that an overly high concentration of serotonin can lead to serotonin syndrome which is a potentially life-threatening reaction. Serotonin syndrome is discussed in more detail below.16

One study found that synaptic remodeling occurs when a patient starts taking Zoloft.4 This effect, sometimes referred to as neuroplasticity, is very similar to how cocaine affects the architecture of the brain. Users report that cocaine creates a “high,” but only for a short period. Dopamine is referred to as the “feel-good chemical” in the brain. Cocaine binds dopamine transporters, thereby trapping dopamine in abnormal concentration. When cocaine is first taken, users report feeling extremely happy, excited, and rewarded.

In this example of neuroplasticity, cocaine highjacks normal dopamine interactions, creating abnormally high levels for short periods of time. The body eventually begins to suppress creating more dopamine as a defense mechanism to mitigate this abnormally high concentration of dopamine. Dopamine suspended at the neuron synapse is subject to degradation, and in the end, the person will experience a dopamine shortage and the dips in mood that come with it.

In a similar way, Zoloft can cause synaptic remodeling as the neurons attempt to adjust to the changed brain chemistry which has become dysfunctional. This affects mood, sleep, and many more aspects of normal human health.

Risks of Zoloft Addiction and Dependence

Despite pharmaceutical ads and what you may read on some websites detailing the benefits of the drug, clinical research paints a much different picture. Users of sertraline find that long-term use of the medication can lead to Zoloft addiction and dependence. Though rare, Zoloft has developed some cases of misuse and abuse.18 Below are some signs to be aware of Zolof addiction and dependence.

What are some signs of Zoloft addiction and dependence?
  • Taking more, more often than was prescribed.
  • Pretending ailments in order to be prescribed at a higher dose or increased frequency.
  • Seeking non-prescribed sources for obtaining more of the drug.
  • Spending inordinate amounts of time and/or money on getting the drug.
  • Adverse events as the drug wears off, leading to increased frequency of dosing.

After Zoloft dependence has developed, significant symptoms develop when the medication is discontinued either abruptly or gradually. This can interrupt the patient’s life and put their health at risk.

Other manifestations can also develop. These include low libido, nausea, aggression, violence in thoughts and actions, insomnia, numbness, and irritability. Other significant effects can include worsening clinical symptoms, suicidality, risk of serotonin syndrome, hepatitis, nutrient deficiencies, and many others.5

Serotonin Syndrome

Serotonin syndrome is a severe drug reaction that happens when a prescription drug builds up high levels of serotonin in the body. This can cause physical symptoms including fever, sweating, chills, and coma, and can be fatal if not immediately treated. Serotonin syndrome is a high-risk emergency situation that requires immediate medical care. The syndrome can occur when the individual begins taking an SSRI like Zoloft for the first time, when the dosage is increased, or when Zoloft is combined with other serotonergic medications.16

Secondary Hepatitis

With the way Zoloft is metabolized in the body, elimination of the medication from the body can be hampered by liver impairment, and the drug can cause secondary hepatitis as well.6 Long-term use of the drug may magnify and worsen these side effects. The use of alcohol or other prescription medications can also worsen the effects of Zoloft on the liver.

Nutrient Deficiencies

Individuals are especially at risk for developing malnutrition-related disorders like osteoporosis, osteopenia, and more during prescription dependence and recovery. There has been a wealth of research on the effects of correcting deficient vitamins, minerals, amino acids, magnesium, and other nutrients for mental health improvements.17

Active dependency (and even depression itself) often makes it difficult to eat an appropriate amount of vitamins and nutrients, leading to deficiencies.7 This effect is worsened when combined with hormonal and other chemical changes drugs like Zoloft can create within the body, inhibiting the body’s natural ability to absorb nutrients from food. In addition, the effects of poor nutrition on the body can serve to worsen symptoms of mood disorders like depression. Reversing the effects of Zoloft dependence and addiction can see immediate improvements by correction of diet and by proper supplementation.

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Should You Stop Taking Zoloft Right Away?

If you are currently taking Zoloft to deal with depression, you may have noticed the negative side effects the medication can cause. However, stopping sertraline abruptly and even gradually can cause severe, often lingering, reactions in patients taking the medication. Sertraline withdrawal symptoms can be very intense, causing lethargy, diaphoresis, confusion, nausea, irritability, dysphoric mood, hypomania, agitation, sensory disturbances, vertigo, tremors, cephalgia, emotional lability, sleep disorders, tinnitus, and seizures.5

To mitigate 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, indicating that the effects of Zoloft cause dependency and addiction. For patients using sertraline, it is recommended to consult a doctor, addiction treatment professional, or other medical health professionals before discontinuing the drug.

Is Zoloft Habit-Forming?

It is important to note that drug companies are known to be notorious for false advertising. As a result, many clinicians that prescribe the medication claim to their patients that the drug is entirely safe, without mentioning potential Zoloft dependence or addiction.19 But the symptoms experienced by many when the drug is stopped say otherwise.

Clinical trials pre-approval were short-term and did not research the adverse effects caused by long-term use, or clearly show the outcomes when discontinuing use. The initial discontinuation symptoms were downplayed as mild or misdiagnosed as returning mental disorders, and patients reporting trouble when stopping, were often not taken seriously. Antidepressant discontinuation syndrome was virtually ignored for decades, and its impact was not examined fully.9 However, as long-term users of the medication continue to increase yearly, ignoring the possible implications of long-term use of this antidepressant medication is dangerous.

Sertraline affects the way neurons in the brain reuptake and process serotonin. This prescription drug can therefore change the brain’s chemistry, affecting natural serotonin and other neurotransmitters. Eventually, the brain relies upon the presence of the drug to function, causing issues when use is stopped.

How Does Addiction to Zoloft Develop?

Dependence and addiction to Zoloft develop when the medication is used for long-term treatment. This long-term treatment can cause the patient to feel dependent on the effects of the drug on the brain, and cessation symptoms are common when it is discontinued. This can be too much to bear for many people, and they must resume the medication to avoid further distress.

Zoloft addiction can develop if a patient relies on the medication to elevate their mood, causing a psychological dependence on the drug. Some report experiencing a feeling of euphoria after taking Zoloft, which may encourage taking the drug recreationally. Regardless of the means of addiction, patients can become dependent on the drug for their brain to function in a way that feels “normal.”

Zoloft Addiction, Half-Life, and the Euphoric Effects of the Drug

taking sertraline

Patients taking sertraline or other SSRI medications often report developing a dependency on the feeling of a Zoloft high. While official sources say the drug does not produce a sense of euphoria, the drug label lists hypomania among the many adverse effects of the medication. Hypomania is a short-lived period (often 2-3 days) of increased mood, excited state, and overactive behavior that can be euphoric to some. Zoloft addiction and hypomania can also lead to aggression towards others and even crashes that can result in suicidal ideation.

Zoloft’s addictive qualities may have to do with the drug’s half-life. The half-life is the amount of time it takes for half of the chemical to metabolize or become inactive in the body. The half-life of sertraline in the bloodstream for someone taking 50 to 200 mg daily is about 26 hours according to the FDA. The drug’s half-life extends to 50 hours if the liver is damaged. When the half-life period ends, the adverse side effects of Zoloft addiction begin. Patients can become dizzy, depressed, anxious, and irritable because they haven’t taken their medication.10,15

Patients suffering from antidepressant addiction can experience dreams or nightmares, nausea, insomnia, zapping sensations, and akathisia when Zoloft is stopped. Akathisia is a potential side effect of this drug’s use and is characterized by extreme agitation, unbearable internal and motor restlessness, and anxiousness. Akathisia is commonly thought to be a precursor to aggressive thoughts, aggressive behaviors, and suicidal thoughts or ideation. This is one of the extremely detrimental effects that can occur from SSRI drugs. Not only is akathisia a horrendous side effect, but it is often linked with suicide after a person so affected becomes desperate for relief.11 This is only one of the extreme symptoms a patient can experience when dealing with antidepressant dependence and addiction.

Zoloft Addiction Recovery

Your mental health is essential and should be a priority in any drug treatment program. If you are taking Zoloft and want to discontinue your use of the drug, it is crucial that

you take a step-by-step approach and do not abruptly or too quickly stop taking the medication. In fact, to stop taking this medication safely, it is not only essential to manage your physical symptoms, but also to ensure that you have access to the right tools to help you cope with your mental health, as well.

It’s best to create a plan with all relevant medical professionals before going off the medication, as this process can be quite lengthy and involves tapering for weeks or months. Keep in mind that the way an individual patient is helped to stop the drug depends on how long the patient has been on Zoloft, the dosage the patient was taking, the person’s general health, and the symptoms the patient has had while taking the medication. Once you and your medical team have decided to begin a taper, alternative resources can provide critical tools in successfully and safely discontinuing Zoloft use.12

Begin Therapy

Psychotherapy can help you cope with the symptoms of Zoloft addiction and the intensity of the physical and mental symptoms from stopping the use of the medication. Talk therapy, cognitive behavioral therapy, and other counseling can help you develop ways to cope with what you are feeling that do not rely on pharmaceutical drugs. In addition, if you are struggling with other substance addictions, therapy can help you learn to manage symptoms of substance use disorder (SUD).

Engage in Physical Activity

Another helpful tool for Zoloft addiction recovery is physical activity. The endorphins and chemicals released during exercise have a powerful antidepressant effect. For many people, these “feel-good chemicals” can help in drug recovery programs. Physical activity can be extremely useful during a gradual taper to zero Zoloft use. Exercise is a well-documented strategy to help recover after drug dependence and addiction, as it helps repair the mental and physical deficits that the person’s drug use induced.13

Address Your Diet

Healthy diet

Nutrition is a key factor in recovering from Zoloft dependence as well, including an improved diet and supplementation that can support the healing process. As mentioned, nutrient deficiencies are fairly common during substance dependence and can serve to make the symptoms of depression worse.

Addressing nutrition and restoring a healthy gut microbiome enables individuals to resume healthy serotonin production that can help regulate mood. Attention to a healthy diet is key to recovery both for drug dependence and mental health.14

Secure a Support System

As you recover from Zoloft use and dependence, make sure to have a proper support system in place. This includes, first and foremost, a clinician or medical professional to help guide you through the tapering process and who is familiar with and sympathetic towards the physical and emotional symptoms experienced when discontinuing the medication.

During discontinuation, consider a family member or friend to have as part of your support system to help deal with the emotional stress of stopping the medication. Finding a local recovery group or utilizing the services of an addiction recovery facility can help you connect with others who have had a similar experience.

Remain Dedicated to the Discontinuation Schedule

Lastly, the most critical part of recovery is completing the discontinuation process. When you gradually stop taking Zoloft, the dose will need to be reduced by using lower-dose pills, cutting the pills, or in some cases, converting to liquid dosing. Until you are very well stabilized, be sure to stay in close contact with a medical professional even after completely stopping the medication. This is because symptoms may persist for some time, even after your gradual discontinuation is complete. This can help ensure your discontinuation symptoms are lessening, and no depression has returned.


Treatment for Zoloft Addiction

Whether you feel dependent on Zoloft to maintain your mood or have experienced symptoms while trying to stop your use of this medication, Zoloft addiction and dependence should be taken seriously. Medical professionals can recommend a safe discontinuation schedule as well as a plan of action to help you recover from your dependence on the medication, and put strategies in place that will correctly address your original symptoms without the need to rely on prescription medications.


The Alternative to Meds Zoloft Addiction Recovery Program

Zoloft Addiction Recovery Program

We focus on discovering the medical, nutritional, and environmental causes that are contributing to an individual’s symptoms. Our addiction treatment methods address biophysical and psychological factors. We use lab tests, and other diagnostics to determine how to best design an individualized 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, orthomolecular medicine, and other holistic treatments that can combat depression and other unwanted symptoms You can view our holistic protocols in more detail on our services overview pages. Please contact us for more information on our programs to treat Zoloft addiction and dependence at Alternative to Meds Center.

Sources:


1. Singh HK, Saadabadi A. Sertraline. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/ [cited 2022 Nov 21]

2. Cartwright C, Gibson K, Read J, Cowan O, Dehar T. Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient Prefer Adherence. 2016 Jul 28;10:1401-7. doi: 10.2147/PPA.S110632. PMID: 27528803; PMCID: PMC4970636. [cited 2022 Nov 21]

3. Siesser WB, Sachs BD, Ramsey AJ, Sotnikova TD, Beaulieu JM, Zhang X, Caron MG, Gainetdinov RR. Chronic SSRI treatment exacerbates serotonin deficiency in humanized Tph2 mutant mice. ACS Chem Neurosci. 2013 Jan 16;4(1):84-8. doi: 10.1021/cn300127h. Epub 2012 Oct 1. PMID: 23336047; PMCID: PMC3547473. [cited 2022 Nov 21]

4. Schaefer, A., Burmann, I., Regenthal, R., Arélin, K., Barth, C., Pampel, A., … & Sacher, J. (2014). Serotonergic modulation of intrinsic functional connectivity. Current Biology, 24(19), 2314-2318.  [cited 2022 Nov 21]

5. Read J, Williams J. Adverse Effects of Antidepressants Reported by a Large International Cohort: Emotional Blunting, Suicidality, and Withdrawal Effects. Curr Drug Saf. 2018;13(3):176-186. doi: 10.2174/1574886313666180605095130. PMID: 29866014. [cited 2022 Nov 21]

6. Suen, C. F., Boyapati, R., Simpson, I., & Dev, A. (2013). Acute liver injury secondary to sertraline. BMJ case reports, 2013. [cited 2022 Nov 21]

7. Jeynes KD, Gibson EL. The importance of nutrition in aiding recovery from substance use disorders: A review. Drug Alcohol Depend. 2017 Oct 1;179:229-239. doi: 10.1016/j.drugalcdep.2017.07.006. Epub 2017 Aug 4. PMID: 28806640. [cited 2022 Nov 21]

8. Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019 Jun;6(6):538-546. doi: 10.1016/S2215-0366(19)30032-X. Epub 2019 Mar 5. PMID: 30850328. [cited 2022 Nov 21]

9. Wilson E, Lader M. A review of the management of antidepressant discontinuation symptoms. Ther Adv Psychopharmacol. 2015 Dec;5(6):357-68. doi: 10.1177/2045125315612334. PMID: 26834969; PMCID: PMC4722507. [cited 2022 Nov 21]

10. Mendhekar DN, Gupta D, Girotra V. Sertraline-induced hypomania: a genuine side-effect. Acta Psychiatr Scand. 2003 Jul;108(1):70-4. doi: 10.1034/j.1600-0447.2003.00080.x. Erratum in: Acta Psychiatr Scand. 2003 Dec;108(6):466. PMID: 12807380. [cited 2022 Nov 21]

11. Patel J, Marwaha R. Akathisia. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519543/ [cited 2022 Nov 21]

12. Lejoyeux M, Adès J. Antidepressant discontinuation: a review of the literature. J Clin Psychiatry. 1997;58 Suppl 7:11-5; discussion 16. PMID: 9219488. [cited 2022 Nov 21]

13. Bremner JD, Moazzami K, Wittbrodt MT, Nye JA, Lima BB, Gillespie CF, Rapaport MH, Pearce BD, Shah AJ, Vaccarino V. Diet, Stress and Mental Health. Nutrients. 2020 Aug 13;12(8):2428. doi: 10.3390/nu12082428. PMID: 32823562; PMCID: PMC7468813. [cited 2022 Nov 21]

14. Owen L, Corfe B. The role of diet and nutrition on mental health and wellbeing. Proc Nutr Soc. 2017 Nov;76(4):425-426. doi: 10.1017/S0029665117001057. Epub 2017 Jul 14. PMID: 28707609. [cited 2022 Nov 21]

15. FDA Drug label Zoloft (sertraline hydrochloride) tablets, oral solution [cited 2022 Nov 21]

16. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013 Winter;13(4):533-40. PMID: 24358002; PMCID: PMC3865832. [cited 2022 Nov 21]

17. Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008 Apr;50(2):77-82. doi: 10.4103/0019-5545.42391. PMID: 19742217; PMCID: PMC2738337. [cited 2022 Nov 21]

18. Evans EA, Sullivan MA. Abuse and misuse of antidepressants. Subst Abuse Rehabil. 2014 Aug 14;5:107-20. doi: 10.2147/SAR.S37917. PMID: 25187753; PMCID: PMC4140701. [cited 2022 Nov 21]

19. Goldman R, Montagne M. Marketing ‘mind mechanics’: decoding antidepressant drug advertisements. Soc Sci Med. 1986;22(10):1047-58. doi: 10.1016/0277-9536(86)90205-4. PMID: 2426792. [cited 2022 Nov 21]



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

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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The Risks of Zoloft Addiction and Dependence
Medical Disclaimer:
Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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