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The Risks of Zoloft Addiction and Dependence

Last Updated on February 15, 2025 by Carol Gillette

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

Zoloft addiction is more commonly referred to as Zoloft dependence. Zoloft is one of the most prescribed SSRIs — but what if it didn’t work for you? What if your SSRI made things worse? And what if you find yourself trapped in dependence?

Abrupt withdrawal of Zoloft, like all SSRIs, typically results in ruinous withdrawals, especially after long-term use or if dosages were high. We offer specialized help for resolving addiction and dependence, as well as thoroughly addressing those factors which precipitated taking an SSRI in the first place.1,2


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Signs of Zoloft Addiction, Dependence, Tolerance

Users of sertraline commonly find that the drug becomes ineffectual after a time.14 A prescriber will typically increase the dose or frequency, and this may occur multiple times. This phenomenon is termed tolerance. But if the drug is stopped, withdrawal symptoms occur. This is what happens when the body becomes drug-dependent. It is a vicious circle that often ends in hopelessness and despair.

Though rare, clinical literature has cited some cases of what could be called Zoloft addiction, and recreational misuse and abuse.18 However, the vast majority of sufferers are not “abusers” but have been placed in a kind of limbo of being drug-dependent, still suffering from unwanted symptoms, and additionally at risk of debilitating withdrawal symptoms if they try to stop the drug. Below are some signs to be aware of that may help detect Zoloft dependence, tolerance, and addiction issues.

What are some manifestations of Zoloft addiction, dependence, and tolerance?
  • symptoms of zoloft tolerance and dependenceThe drug stops working at the usual dose or frequency. This is called tolerance.
  • Tolerance leads to taking more, or more often than was prescribed.
  • Return of symptoms can be intensified, and misdiagnosed as relapse, leading to being prescribed at a higher dose or increased frequency.
  • Drug side effects and drug withdrawals being misdiagnosed as “newly emerging disorders” and being prescribed additional drugs to numb the cascade of drug-induced adverse effects.
  • The person who takes Zoloft recreationally will notice the same pattern as the above, as tolerance creates an on-going need to increase dosage to get the same desired effects.

Tolerance can develop over as little as a week or two. But historically, people are prescribed far longer. And Zoloft addiction, though rare, can also persist over long periods of time. Overall, tolerance and developing dependence is not at all rare. What IS rare is finding a prescriber who understands these mechanics and has the tools to help their patients recover.

Despite past decades of medical mis-education or perhaps fact-blindness, it is now broadly known that the more abrupt the discontinuation, the more harsh and long-lasting the withdrawal symptoms will result, i.e., very often NOT mild, NOT short-lived, and NOT self-limiting, as much of the drug company-financed clinical trials have continued to insist is the case despite all the evidence that contradicts their statements.20,21

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?

Does Zoloft Create Brain Chemicals?

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

holistic treatment for zoloft addiction sedona drug rehab

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.

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

6. Suen, C. F., Boyapati, R., Simpson, I., & Dev, A. (2013). Acute liver injury secondary to sertraline. BMJ case reports, 2013. [cited 2025 Feb 14]

7. Koliscak LP, Makela EH. Selective serotonin reuptake inhibitor-induced akathisia. J Am Pharm Assoc (2003). 2009 Mar-Apr;49(2):e28-36; quiz e37-8. doi: 10.1331/JAPhA.2009.08083. PMID: 19289334. [cited 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

13. Hengartner MP, Schulthess L, Sorensen A, Framer A. Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum. Ther Adv Psychopharmacol. 2020 Dec 24;10:2045125320980573. doi: 10.1177/2045125320980573. PMID: 33489088; PMCID: PMC7768871. [cited 2025 Feb 14]

14. Pietrzykowski AZ, Treistman SN. The molecular basis of tolerance. Alcohol Res Health. 2008;31(4):298-309. PMID: 23584007; PMCID: PMC3860466. [cited 2025 Feb 14]

15. FDA Drug label Zoloft (sertraline hydrochloride) tablets, oral solution [cited 2025 Feb 14]

16. Volpi-Abadie J, Kaye AM, Kaye AD. Serotonin syndrome. Ochsner J. 2013 Winter;13(4):533-40. PMID: 24358002; PMCID: PMC3865832. [cited 2025 Feb 14]

17. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant Withdrawal and Rebound Phenomena. Dtsch Arztebl Int. 2019 May 17;116(20):355-361. doi: 10.3238/arztebl.2019.0355. PMID: 31288917; PMCID: PMC6637660. [cited 2025 Feb 14]

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 2025 Feb 14]

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 2025 Feb 14]

20. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017 May 29;189(21):E747. doi: 10.1503/cmaj.160991. PMID: 28554948; PMCID: PMC5449237. [cited 2025 Feb 14]

21. Guy A, Brown M, Lewis S, Horowitz M. The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition. Ther Adv Psychopharmacol. 2020 Nov 9;10:2045125320967183. doi: 10.1177/2045125320967183. PMID: 33224468; PMCID: PMC7659022. [cited 2025 Feb 14]

22. Perrine SA, Ghoddoussi F, Michaels MS, Hyde EM, Kuhn DM, Galloway MP. MDMA administration decreases serotonin but not N-acetylaspartate in the rat brain. Neurotoxicology. 2010 Dec;31(6):654-61. doi: 10.1016/j.neuro.2010.08.005. Epub 2010 Aug 26. PMID: 20800616; PMCID: PMC2974051. [cited 2025 Feb 14]

23. Kvam TM, Goksøyr IW, Stewart LH, Repantis D, Røssberg JI, Andreassen OA. Study protocol for “MDMA-assisted therapy as a treatment for major depressive disorder: A proof of principle study”. Front Psychiatry. 2022 Oct 26;13:954388. doi: 10.3389/fpsyt.2022.954388. PMID: 36386973; PMCID: PMC9645093. [cited 2025 Feb 14]


Revised February 14, 2025 by Diane Ridaeus


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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