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Zoloft Tapering

This entry was posted in Antidepressant on by .
Medically Reviewed Fact Checked

Last Updated on August 3, 2022 by Carol Gillette

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

It is critical to know that the same strategies that ease Zoloft tapering and titration also support natural mental health. This provides the great advantage of significantly reducing or eliminating unwanted reactions to weaning Zoloft altogether.

If you have found SSRI treatment less than satisfactory, or drug-based treatment didn’t meet your expected goals, you may want to consider the option of Zoloft tapering, and a transition to drug-free protocols for true symptoms relief.

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Alternative to Meds has been an antidepressant tapering and titration help authority for more than 17 years. We have published evidence regarding our success. Even if the person had what might be considered the most off-the-wall symptoms, these same symptoms are much more common than what is being admitted to. Not only do we specialize in these symptoms, but many of us have also had to endure them ourselves in order to become the teachers that we are.
Does it seem that you have been through the drug treatment mill so many times, or for so long that you cannot be helped? Are you afraid that you’ve tried everything and that this is your life from now on? The woman in this video was on antidepressants and benzodiazepines for decades. She suffered very serious side effects. She eventually reached out to Alternative to Meds for help. After successfully completing the program, she turned her life around. Her story is riveting. We encourage you to watch so that you can gain hope for your situation.

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Safe Zoloft Tapering

Withdrawal from Zoloft merits careful preparation and realistic goals, and knowledgeable guidance along the way. it is possible to learn how to get off Zoloft using trusted and proven methods to reduce the discomforts that could otherwise make Zoloft cessation intolerable. This guidance is provided at Alternative to Meds Center in its inpatient programs for clients trying to quit Zoloft or other medications.

FDA WARNING:   It bears repeating that the FDA warns against abruptly stopping Zoloft. To do so can be injurious to health. Tapering Zoloft gradually can make the process more tolerable, and can actually prevent much of the harsh discomfort associated with trying to quit Zoloft or similar medications too quickly.4

Does Zoloft Create Dopamine or Serotonin?

No, Zoloft does not create new serotonin or dopamine. Zoloft is an SSRI type of medication that is designed to have some effects on serotonin in the body. Whether starting on or stopping Zoloft, the way serotonin is distributed in the body will be affected. SSRI drugs accelerate how quickly any available serotonin gets used up. The accelerated purge of serotonin is what is believed to create a lift in tone, hence the term “antidepressants.” But this process is also likely to ultimately leave a deficit of your body’s natural neurochemicals in its wake. This could be likened to the way alcohol impairs the uptake and metabolism of certain nutrients. Zoloft also affects other types of natural chemicals in similar ways, such as norepinephrine and dopamine, these are targeted to a lesser extent. The next day, these impairments and created deficits contribute to the misery that is most often referred to as a “hangover.” 9,20

zoloft's effect on dopamineAs stated above, Zoloft does not create dopamine but is thought to affect dopamine, sometimes called the pleasure or “reward” hormone. Along with a surge of serotonin, Zoloft is designed to trigger a surge of dopamine to be released, stimulating the pleasure centers in the brain. Sertraline also affects norepinephrine, a natural stimulant. Increasing the availability of these neurochemicals is thought to cause an enhanced lift in mood. Of all of the SSRIs, sertraline (Zoloft) was the only one found to increase extracellular dopamine amounts in the nucleus accumbens and striatum (dopamine receptor sites in the brain) of rats.7,21,22

Over time, however, these natural neurochemicals — which are blocked from reabsorption by the drug — will be lost, mainly through enzymic decomposition.19 This exhausts or inactivates these suspended molecules in the body. At this point, a person may begin to notice that the Zoloft “isn’t working anymore.” This may lead to considering alternative treatments or seeking help with getting off Zoloft altogether. However, it is advisable that one first learns as much as possible about Zoloft tapering before embarking on the process. Zoloft cessation may be made more difficult than it has to be; in fact, the process could be disastrous if one goes at it too fast and without proper guidelines and preparation.

Zoloft Discontinuation Syndrome

effexor discontinuation syndromeZoloft discontinuation syndrome has been studied relatively minimally by the majority of healthcare professionals, especially in light of the fact that SSRI medications are so widely prescribed. Outside of limited clinical trials and a prevalence of anecdotal reporting, very little research has been done on the problems encountered with Zoloft tapering or weaning off antidepressants generally.10 However, there is some consensus that withdrawals can be intense and long-lasting, and are sometimes misdiagnosed as a relapse.11 This can, in turn, lead to further mismanagement of the condition.

At Alternative to Meds, we find very often that clients were never fully briefed by their prescribing physicians about the potential challenges of Zoloft tapering or information on how to get through it successfully. Indeed, their physicians may not have known themselves.16 The subject is not covered in medical school. Many of our clients have said that had they known how hard it would be to stop, they would have never opted for taking antidepressants in the first place, but would have sought non-drug-based treatments. Quite a significant number of clients have been referred to us by their prescriber, knowing that a residential treatment center would be much more able to assist than struggling with Zoloft tapering without a high level of attentive care.

Zoloft Tapering Guidelines

Always seek medical oversight and guidance before beginning to taper Zoloft. Each person is unique and will need personal guidance. Having a well-informed support team of family or friends to assist you is a good strategy, so let them know how they can best support you in the process.

Have your prescribing physician help in prescribing lower dosage sizes, whether in pill or liquid form, and in the actual cutting of pills if that is required. In the case of Zoloft, the lowest pill dosage is 25mg.

Zoloft Tapering Guidelines Include:
  • zoloft tapering guidelinesThe FDA recommendation is to gradually reduce dosage, not to stop abruptly.4
  • Get the smallest dose pill available. Your physician can assist in cutting the pill if needed. For Zoloft, the smallest dosage pill is 25mg. A liquid form may also be available.
  • Inform your prescriber of any sensitivity issues or reactions you may experience during Zoloft tapering. The dosage may need to be adjusted to compensate. Emerging suicidality should be reported to your prescriber without delay.
  • A slow rate of reduction (10-25% adjusted as needed) per 1, 2, or more weeks.12
  • Expect withdrawal symptoms to emerge around the drug’s half-life range. (1 day) 13
  • Your prescribing physician will want to allow some time to settle things out after each reduction, before recommending further adjustments to dosage.
  • It is not uncommon to see an increased challenge toward the end of the Zoloft taper – your prescriber may advise you to slow the pace at that point. Stay in close contact with your prescribing physician.

Your doctor may advise you of the possibility of a protracted withdrawal which may make continuing on your own impassable. Alternative to Meds Center specializes in this phenomenon and we can help.

Are Brain Zaps Always Part of Withdrawal From Zoloft?

While brain zaps are commonly reported during Zoloft cessation, a proper Zoloft tapering regimen can tend to lessen or even eliminate these reactions entirely. There are ways to support the withdrawal by bolstering the neurochemistry with naturally occurring substances that will tend to combat the deficiency of serotonin and other natural neurotransmitters during the withdrawal, and this can reduce any likelihood of brain zaps during Zoloft withdrawal.

Zoloft Tapering and Pregnancy

Zoloft increases birth defects and stillbirths in animals, according to clinical trials discussed in the FDA drug labeling information.4 It is something of a tragedy that Zoloft is still legal for prescribing to women whether the woman is pregnant or not. However, a woman taking Zoloft who is planning on becoming pregnant may opt for trying to quit Zoloft as a self-directed precaution. before getting pregnant.

WARNING:  Both the FDA and the CDC caution against Zoloft use during pregnancy, due to potential birth defects that the drug may cause.6,18,23

drugs pregnancyWomen who are considering starting Zoloft or other SSRI-type medication may not always be informed of the 3-5% increased risk of birth defects compared to placebo according to trials that have been done.1 An infant born to a mother taking Zoloft may suffer profound withdrawals in addition to the risks of various birth defects.17 Again, to avoid these complications and risks, seriously consider Zoloft tapering before one becomes pregnant, both for the future health of the baby and the health of the mother.

Pharmaceutical companies are not required by law to do human clinical trials on SSRI drugs on pregnant women. Some research may have been done on animals but their results may not have been vigorously disseminated to prescribing doctors or the public at large. Women and all parents-to-be would be well-advised to do their own careful research before continuing SSRI medications especially if they are planning a pregnancy.

Please note that NIMH has published findings regarding increased instances of infants with clubfoot born to mothers taking Zoloft, which may be of particular interest to researchers on the subject of women’s health.2,4,6,23

Again, we stress for the sake of an unborn child’s health, women are advised to do their own research to make the best decisions concerning health and pregnancy. Speak to your doctor before getting pregnant if you are taking Zoloft.

Long-Term Zoloft Use and Neuroadaptation

zoloft zombie SSRIs like Zoloft (sertraline) are endocrine disruptive as demonstrated in rat studies.14 These effects are thought to explain the sexual dysfunction linked to such medications. The neuroadaptive capabilities of the CNS are geared to attempt to normalize despite the drug-induced flooding of serotonin into the nervous system. Antidepressant patients can develop chronic apathy and worsened depression after long-term use of SSRIs. This is not a mental illness returning; this is the possible effect that serotonergic medications have upon the human body. This antidepressant-induced apathy creates “zombie-like” or deadened feelings. Clinicians sometimes refer to the effect as “SSRI-induced indifference” or “SSRI-induced apathy.” 15 Elderly patients with dementia are particularly susceptible to antidepressant-induced chronic apathy.3

A person may wish to avoid these potential risks and can do so by initiating gradual withdrawal from Zoloft and also by not staying on an antidepressant for very long. A person suffering from this chronic apathy may require some help in the form of encouragement from family members or others who can support their loved one through the process of Zoloft tapering.

Zoloft Adverse Reactions and Side Effects

A person taking antidepressant medication may be subject to various adverse reactions, generally referred to as side effects, despite the fact that these are DIRECTLY INDUCED drug effects that can dominate one’s overall health.

Zoloft Side-effects include:
  • Suicidality
  • Paranoia
  • Anxiety
  • Convulsions
  • Spams of muscles, movement disorder
  • Akathisia
  • Grinding of the teeth
  • Racing heartbeat
  • Difficulty breathing
  • Rash (can be severe enough to warrant emergency/hospital care)
  • Sexual dysfunction

And many, many others.

Each person is a distinct and unique expression and therefore can often react to medications in unpredicted or surprising ways. This unpredictability and the severity of certain side effects may present other reasons a person may consider getting off Zoloft to make improvements to health.

Alternative to Meds Inpatient Zoloft Tapering Support

Our Zoloft tapering programs are designed to mitigate or completely eliminate the most difficult of outcomes you may be experiencing, or that you are worried may occur. There are many actions that we deliver to prepare such as lab testing before the medically supervised tapering process actually begins as well as during the process so that your Zoloft taper is the smoothest and most problem-free experience possible.

The extensive use of Zoloft alternatives makes Zoloft tapering much easier to tolerate, including the use of neurotoxin removal, neurotransmitter rehabilitation, environmental medicine, acupuncture, correction of diet including prescribed supplementation, therapeutic massage, nebulized glutathione, yoga, equine-assisted therapy, CBT and other counseling, peer support programs, co-occurring disorders holistic treatment, holistic pain management, Qi Gong, colon hydrotherapy, and many, many other adjunct services and proven strategies for improvements in overall health and well-being.

Contact Alternative to Meds Center

The Alternative to Meds Center programs for stopping Zoloft and other medications seek to prepare a person in several fundamental ways before the process of Zoloft tapering even begins. It can seem a particularly daunting task to withdraw from Zoloft, especially getting off Zoloft or any prescription drug all on your own. We have helped many thousands of clients and we would like to be able to assist you or your loved one as well

Please contact Alternative to Meds Center for more information on our safe and gradual Zoloft tapering program, delivered in a luxurious, warm, and nurturing inpatient setting and always with 24/7 oversight and care.

1. Jefferies A L “Selective serotonin reuptake inhibitors in pregnancy and infant outcomes.” Canadian Paediatric Society [INTERNET] 2011 Nov 11 reaffirmed 2018 Feb 18 [cited 2022 July 6]

2. Yazdy MM, Mitchell AA, Louik C, Werler MM. Use of selective serotonin-reuptake inhibitors during pregnancy and the risk of clubfoot. Epidemiology. 2014 Nov;25(6):859-65. doi: 10.1097/EDE.0000000000000157. PMID: 25171134; PMCID: PMC4180776. [cited 2022 July 6]

3. MDs Wamsley, Byerley, McConnell, Dawson, Grosser “Receptor Alterations Associated With Serotonergic Agents: An Autoradiographic Analysis” Clinical Journal of Psychiatry, 1987 [cited 2022 July 6]

4. FDA Zoloft label [approval 1991] [cited 2022 July 6]

5. “Pregnant or Thinking of Getting Pregnant?” CDC Pregnancy Homepage (N.D.) [INTERNET] [cited 2022 July 6]

6. FDA Drug Safety Communication, Zoloft [INTERNET] [cited 2022 July 6]

7. Kitaichi Y et al “Sertraline increases extracellular levels not only of serotonin, but also of dopamine in the nucleus accumbens and striatum of rats” PubMed, [INTERNET] 2010 Nov 10 [cited 2022 July 6]

8. EMC Patient Leafleft Setraline [cited 2022 July 6]

9. Ryle PR, Thomson AD. Nutrition and vitamins in alcoholism. Contemp Issues Clin Biochem. 1984;1:188-224. PMID: 6400499. [cited 2022 July 6]

10. Haddad PM. Antidepressant discontinuation syndromes. Drug Saf. 2001;24(3):183-97. doi: 10.2165/00002018-200124030-00003. PMID: 11347722. [cited 2022 July 6]

11. Haddad P. Newer antidepressants and the discontinuation syndrome. J Clin Psychiatry. 1997;58 Suppl 7:17-21; discussion 22. PMID: 9219489. [cited 2022 July 6]

12. Glenmullen J, “The Antidepressant Solution- A Step-by-step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “addiction’” [book] published 2005 by Simon and Schuster ISBN 0743269721, 9780743269728 [cited 2022 July 6]

13. DeVane CL, Liston HL, Markowitz JS. Clinical pharmacokinetics of sertraline. Clin Pharmacokinet. 2002;41(15):1247-66. doi: 10.2165/00003088-200241150-00002. PMID: 12452737. [cited 2022 July 6]

14. Cecilie Hurup Munkboel, Lizette Weber Larsen, Johan Juhl Weisser, David Møbjerg Kristensen, Bjarne Styrishave, Sertraline Suppresses Testis and Adrenal Steroid Production and Steroidogenic Gene Expression While Increasing LH in Plasma of Male Rats Resulting in Compensatory Hypogonadism, Toxicological Sciences, Volume 163, Issue 2, June 2018, Pages 609–619, [cited 2022 July 6]

15. Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004 May;10(3):196-9. doi: 10.1097/00131746-200405000-00010. PMID: 15330228. [cited 2022 July 6]

16. Informed Consent AMA Principles of Medical Ethics: I, II, V, VIII [cited 2022 July 6]

17. Levinson-Castiel, R., Merlob, P., Linder, N., Sirota, L. & Klinger, G. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch. pediatrics Adolesc. Med. 160, 173–176, (2006). [cited 2022 July 6]

18. Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA, and the National Birth Defects Prevention Study. Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. BMJ. 2015 published online CDC Key Findings – A Closer Look at the Link Between Specific SSRIs and Birth Defects [cited 2022 July 6]

19. Prah A, Purg M, Stare J, Vianello R, Mavri J. How Monoamine Oxidase A Decomposes Serotonin: An Empirical Valence Bond Simulation of the Reactive Step. J Phys Chem B. 2020;124(38):8259-8265. doi:10.1021/acs.jpcb.0c06502 [cited 2022 July 6]

20. Singh HK, Saadabadi A. Sertraline. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: [cited 2022 July 6]

21. Schmitt JA, Ramaekers JG, Kruizinga MJ, van Boxtel MP, Vuurman EF, Riedel WJ. Additional dopamine reuptake inhibition attenuates vigilance impairment induced by serotonin reuptake inhibition in man. J Psychopharmacol. 2002 Sep;16(3):207-14. doi: 10.1177/026988110201600303. PMID: 12236626. [cited 2022 July 6]

22. Ahrold TK, Meston CM. Effects of SNS activation on SSRI-induced sexual side effects differ by SSRI. J Sex Marital Ther. 2009;35(4):311-9. doi: 10.1080/00926230902851322. PMID: 19466669; PMCID: PMC4426856. [cited 2022 July 6]

23. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S, and the National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol. 2011;205(1):51.e1-8. [cited 2022 July 6]

Originally Published Nov 3, 2019 by Lyle Murphy

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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Zoloft Tapering
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