Zoloft, otherwise known as 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 forcing levels of serotonin to accumulate in areas of the brain. Serotonin is a natural hormone that regulates mood, emotions, appetite, digestion, sleep cycles, and many other healthy body functions.
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 are prescribed Zoloft without being fully informed about the full implications of using them long term. In fact, long-term usage has led to side effects and withdrawal symptoms in patients using Zoloft that have endangered their health and 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?
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.3 Unfortunately, artificial manipulation of serotonin levels can eventually create serotonin deficiency or even too much serotonin (serotonin syndrome) with continued use of the medication.
One study even found that synaptic remodeling occurs when a patient starts taking Zoloft.4 This effect is very similar to how cocaine users report that cocaine helped relieve depression, but only for a short period. Dopamine is referred to as the “feel-good chemical” in the brain, and cocaine interacts with dopamine receptors. When cocaine is first taken, users report feeling happy, excited, and rewarded.
However, in this example, cocaine takes the place of normal dopamine interactions, so that the body neither responds to dopamine in the same way and also begins to suppress creating more dopamine. In the end, the person will experience a dopamine shortage and the dips in mood that come with it.
In a similar way, using Zoloft to prevent reuptake of serotonin can cause synaptic remodeling as the neurons attempt to adjust to the new brain chemistry. The synaptic connections between neurons can become dysfunctional This interferes with the body’s ability to access serotonin, affecting mood, sleep, and more.
Risks of Zoloft Addiction and Dependence
Despite pharmaceutical ads and what you may read on some websites detailing the benefits of the drug, actual Zoloft research paints a much different picture. Users of sertraline find that long-term use of the medication can lead to psychological Zoloft dependence. Significant withdrawal symptoms develop when the medication is discontinued either abruptly or gradually. This causes physical symptoms that can interrupt the patient’s life and put their health at risk.
Aside from withdrawal, other side effects come with the medication as well. These include low libido, nausea, aggression, violence in thoughts and actions, insomnia, numbness, and irritability.5 Man other significant effects of Zoloft long term use, addiction, and dependence include suicidality, risk of serotonin syndrome, hepatitis, nutrient deficiencies, and many others.
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, coma, and can be fatal if not immediately treated. Often, serotonin syndrome occurs when the individual begins taking an SSRI like Zoloft for the first time, or when the dosage is increased.
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. Use of alcohol or other prescription medications can also worsen the effects of Zoloft on the liver.
Individuals are especially at risk for developing malnutrition-related disorders like osteoporosis, osteopenia, and more during prescription dependence and recovery. Active dependency (and even depression itself) often makes it difficult to eat an appropriate amount of several 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. In this way, dependence on Zoloft can enhance the symptoms of the very disorder it is advertised to treat.
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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.
To mitigate harsh symptoms, the medication is gradually tapered down to zero to soften these withdrawal 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 the company that creates Zoloft does not claim that sertraline is addictive. In fact, many advertisements from the company have recently re-affirmed that sertraline is not a habit-forming substance. As a result, many clinicians that prescribe the medication claim to their patients that the drug is entirely safe, but the withdrawal symptoms for many say otherwise.
Clinical trials pre-approval were short-term and did not research the side effects caused by long-term use, or determine the outcomes when discontinuing use. The initial withdrawal symptoms were downplayed as mild or misdiagnosed as returning mental disorders, and patients reporting adverse withdrawals 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 and affect how it responds to 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?
Addiction to Zoloft often develops 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 withdrawal symptoms are common when it is discontinued. Withdrawal symptoms are too much to bear for many people, and they may resume use of the medication to avoid further symptoms.
Another way Zoloft addiction can develop is through a patient relying on the medication to elevate their mood. This can also cause a psychological dependence on the drug. Still others report experiencing a feeling of euphoria after taking Zoloft, which may encourage taking the drug recreationally. Regardless of the means of addiction, withdrawal symptoms develop because Zoloft has an effect on neurons that process serotonin, and 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
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 as a side effect of the medication.10 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.15 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.
Patients suffering from antidepressant addiction can experience dreams or nightmares, nausea, insomnia, zapping sensations, and akathisia during Zoloft withdrawal periods. 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 addiction.
Zoloft Addiction Recovery
Your mental health is essential and should be a priority in any withdrawal or addiction 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 tapered off the drug depends on how long the patient has been on Zoloft, the dosage the patient was taking, the person’s general health, the symptoms the patient has had while taking the medication, and the unique withdrawal symptoms that may appear. 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
Psychotherapy can help you cope with the symptoms of Zoloft addiction and the intensity of the physical and mental symptoms from ceasing 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 combat withdrawal symptoms. 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
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 Tapering Process
Lastly, the most critical part of recovery is completing the tapering 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 taper is complete. This can help ensure your withdrawal symptoms are lessening, and no depression has returned.
Treatment for Zoloft Addiction
Whether you feel dependent on Zoloft to maintain mood or have experienced withdrawal symptoms while trying to cease your use of this medication, Zoloft addiction and dependence should be taken seriously. Medical professionals can recommend a safe taper to avoid the side effects of withdrawals 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
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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 May 2]
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. https://doi.org/10.1016/j.drugalcdep.2017.07.006
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. https://doi.org/10.1016/s2215-0366(19)30032-x
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. Retrieved April 2, 2022, from https://pubmed.ncbi.nlm.nih.gov/9219488/
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 May 2]
14. Firth, J., Gangwisch, J. E., Borsini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: how do diet and nutrition affect mental wellbeing? Bmj, 369. https://doi.org/10.1136/bmj.m2382
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.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
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.