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Originally Posted On: https://www.alternativetomeds.com/blog/zoloft/

Zoloft Withdrawal Symptoms, Sertraline Adverse Effects, Treatment Help

Many of our Zoloft withdrawal clients have reported being prescribed Zoloft within a 30-minute doctor visit. There was no investigation into other life factors, lab testing, or any conversation about what adverse effects might present. The failings of this approach may cause quite a burden on the patient.

Depression, lack of sleep, fibromyalgia, and other symptoms that Zoloft is often prescribed for might stem from hormonal inadequacies,6 diminished vitamin/mineral levels,7 dietary concerns,8 food allergies,9 mitochondrial dysfunction,10 neurotoxic accumulation,11 and many other potential contributors.

Do Your Symptoms Require Zoloft?

Alternative to Meds has been mitigating antidepressant withdrawal within a retreat-style licensed facility for about 2 decades now. Many of our professional, licensed staff are survivors of medication debacles. Over this time we have collected outcome studies and published evidence validating that over 77% of our clients are able to come off of antidepressants using ATMC methods AND fare better symptomatically for the long term after sertraline withdrawal was correctly done.

Zoloft Withdrawal Symptoms

Up to 56% of people experience Zoloft withdrawal symptoms, as occurs with other antidepressants. Zoloft withdrawal syndrome is a cluster of symptoms also referred to as Zoloft discontinuation syndrome. Did you know that 46% of those who experience antidepressant withdrawal claim it is severe? 44

Brain zaps are one of the most commonly reported yet underappreciated symptoms experienced while coming off Zoloft. Brain zaps feel like electric shocks passing through the brain/head/neck, and are common withdrawals for most antidepressants.12,58

Brain zaps, or shivers, can be notoriously unbearable as they come on unexpectedly, and sometimes in rapid succession. Some report a frequent connection with lateral eye movements, which seem to trigger the event. Why they occur remains a mystery, but are known to be a drug-related phenomenon experienced during Zoloft withdrawal. These reactions are thought to be associated with neurochemical changes as the body and central nervous system attempt to adjust to or compensate for reduced levels of sertraline in the system during Zoloft withdrawal.1

It is highly likely that the body became dependent on the drug’s artificial support of serotonin levels, and that the person may be experiencing a sudden deficit while their own natural mechanisms are dysfunctional, though attempting to come back online to compensate.

The most common Zoloft withdrawal symptoms reported include what can be summed up in the mnemonic FINISH: Flu-like symptoms, Insomnia, Nausea, Imbalance, Sensory disturbances, and Hyperarousal.14 While some people can shake off these withdrawal symptoms over a relatively short period of weeks, others experience a protracted withdrawal that can carry on for months or even years.15,16 Many of our patients come to us to help with these Zoloft protracted withdrawal experiences as they are tremendously difficult to overcome without the correct help.3,14,17,33,58

Zoloft withdrawal symptoms can include:

• Increased suicidal ideation*
• Brain zaps, shivers, shocks that pass through the brain, head, neck
• Seizures
• Ringing in the ears
• Tremors
• Akathisia
• Diarrhea
• Nausea
• Vomiting
• Headache
• Fatigue
• Insomnia
• Mania or hypomania
• Mental fog, confusion
• Hallucinations
• Mood swings, crying spells, irritability, etc.
• Aggression, hostility
• Rebound depression
• Anxiety
• Return of original symptoms, sometimes greatly intensified

*The FDA issued a mandatory “black box warning” on SSRIs because of an increased risk of suicidality.3

How Do You Survive Zoloft Withdrawal?

This page covers Zoloft withdrawal symptoms, the most common adverse effects of taking Zoloft, information about the drug and how it may act upon neurochemistry and receptors, and answers some Zoloft FAQs. We have other pages that you might find informative and useful. One is our Zoloft alternatives page which discusses other holistic ways to treat symptoms for which Zoloft was prescribed. Another is Zoloft tapering which gives information about weaning off of Zoloft. No one should try discontinuing Zoloft without medical oversight and guidance.

Of fundamental importance, the FDA and other regulatory bodies recommend never to abruptly stop taking antidepressants.3 The best approach according to medical consensus would be a slow and gradual Zoloft withdrawal over weeks or months. By easing a reduction in dosage, over time, various other measures can be utilized for added support while coming off Zoloft. These can include natural neurochemical support, targeted nutrition, adequate rest, and a less stressful daily schedule to allow time for self-care, etc.

Inpatient Care During Zoloft Withdrawal

Inpatient care is highly recommended during this often difficult period of readjustment. There is wisdom to this choice, as the withdrawal manifestations are not only difficult on the individual but also challenging for the family members and friends who may misunderstand the process and inadvertently convolute the situation.

For many, Zoloft withdrawal symptoms can linger for a considerable amount of time, and need attentive support to manage them well. Individual differences such as age, general health, dosage, length of time on the drug, and other factors can all impact withdrawal.4

At Alternative to Meds Center, we have observed that almost all people can comfortably get off of Zoloft within a number of weeks and avoid harsh withdrawal symptoms in the process.

While some people feel that leaving loved ones at home this long can be unbearable, they often find this temporary separation preferable to the trauma that they put themselves and their family through at home while trying to do this unsupported. For others, 8 weeks may seem too abbreviated of a withdrawal period, especially with what they have already endured in possible previous at-home attempts. There is a lot that goes into our program and how we support natural neurochemistry to ease the process. Our strategies are designed to ease the process considerably. We encourage you to view our services section of the website to get an idea of the maximum support we offer.

When Do Zoloft Withdrawal Symptoms Start When Discontinuing / Quitting Zoloft?

Generally, the half-life will be a good predictor of when Zoloft withdrawal symptoms will begin to emerge.54

Zoloft is estimated to have a half-life of approximately 24 hours, although research has shown the half-life can be shorter in young males (15-22 hr) compared to females including elderly females and elderly males (32-36 hr).

For some, transitioning to a longer-acting SSRI such as fluoxetine may be helpful as a strategy to overcome impassable difficulties in Zoloft discontinuation.55

What is Zoloft?

Zoloft (sertraline) is an antidepressant medication developed in the 1970s with FDA approval granted in 1991, allowing Pfizer to bring it to market. Doctors prescribe this SSRI drug for treating adult major depressive disorder (MDD), panic disorder, obsessive compulsory disorders (OCD), social anxiety disorders (SAD), post-traumatic stress disorders (PTSD), and premenstrual dysphoric disorder (PMDD).3,18

By 2005, Zoloft topped the sales charts as the most prescribed antidepressant in the United States.19 Zoloft is categorized as an SSRI drug and is thought to act as a potent serotonin reuptake inhibitor. However, Zoloft is sometimes and perhaps more accurately referred to as an SDRI drug due to its secondary (weaker) dopamine reuptake inhibiting characteristic.20 As such, we feel that it would act as a mood elevator similar to Effexor. Effexor, a dopamine-norepinephrine-type drug, can worsen anxiety.21 It has been suggested, though not conclusively proven or even understood, that increasing dopaminergic, as well as serotonergic activity, is the basis for treating symptoms such as depression.22

Holistic, drug-free methods of treatment for anxiety and depression are under-utilized in general practice, but we are encouraged as we see the trend is gradually shifting.

The following information covers some of the most common questions asked and searches done on the drug.

Zoloft and Suicide – Risk to Adults

The Black Box warning on the drug’s packaging acknowledges that the drug should not be prescribed to anyone under the age of 25, due to the heightened risk of suicide. An exception to this for patients under the age of 25 who have been diagnosed with OCD (obsessive-compulsive disorder).3

However, more recent research has disclosed the risk of suicide in adults has been corrected and tabulated as two and a half times that of placebo. FDA data was revisited by researchers Hengartner and Ploderl in 2019. Therefore the black box warning needs revising as this risk is significant and should be clearly stated so prescribers and patients are more fully informed of this risk.61

What Is Zoloft Used For?

Zoloft (sertraline) is an antidepressant medication approved to treat adult MDD (major depressive disorder).

Adult-only approved uses for the drug provided in a clinical or treatment setting include: 3

• MDD:  Major Depressive disorder
• PTSD:  Post-traumatic stress disorder
• PD:  Panic disorder
• SAD:  Social anxiety disorder
• OCD:  Obsessive-compulsive disorder
• PMDD:  Premenstrual dysphoric disorder

Zoloft ( sertraline ) Alternative Names and Slang

Zoloft is a brand name for the generic drug sertraline hydrochloride. In the UK, sertraline was sold under the trade name “Lustral” in the 1980s. In the US, sertraline and Zoloft are available by prescription only. Coming off any brand name of sertraline will be subject to the same phenomena as Zoloft withdrawal.3,36-41,53

Zoloft Adverse Effects

The potential risk of drug-induced suicidality is associated with all SSRIs and may be a concern leading one to consider Zoloft withdrawal, which is recommended to always be done under medical or caregiver monitoring.

However, there are many other adverse reactions specifically associated with sertraline. A study published by the Journal of Pharmacoepedimiological Safety showed that 3 out of 4 patients experienced adverse events while taking sertraline. And, the study also noted an additional 100 adverse events in users of sertraline that were not mentioned on the drug’s label.60

Some of the known adverse effects of Zoloft (sertraline) include these:

• Serotonin syndrome:  A life-threatening condition requiring immediate medical care in a hospital emergency clinic or ICU. Symptoms to watch for include sudden fever, losing consciousness, inability to move or speak, copious sweating, dilated pupils, chills, tremors, convulsions, diarrhea, agitation, restlessness, racing heart, etc.
• Suicidal thoughts (common)
• Suicide attempt (common)
• Hyperkinesis (muscle spasms, movement disorder)
• Worsened depression
• Aggression
• Paranoia (rare)
• Anxiety
• Mania (common)
• Convulsions
• Unconsciousness
• Coma
• Teeth grinding
• Akathisia (relentless internal restlessness and discomfort marked by repeated motions, pacing, rocking, etc., that can lead to suicidal thoughts as a means of relief)
• Tachycardia (racing heart, even when the body is at rest)
• Rash
• Itching
• Burning, crawling feeling in the skin
• Fever
• Tics, sudden jerky movements, myoclonus
• Emotional blunting
• Behavioral apathy, SSRI-induced indifference
• Painful urination or difficulty urinating
• Cloudy urine
• Headache
• Sexual impairments such as anorgasmia, inability to ejaculate, lowered libido
• Mood swings
• Pain around the eyes or eye sockets
• Sleepiness
• Bladder pain
• Prickling skin sensation
• Numbness
• Sensory disturbances
• Insomnia
• Depersonalization (common)
• Nervousness
• Nightmares
• Hostility
• Nausea
• Diarrhea
• Weight gain

The list noted above is not a complete list. Be sure and speak to your prescribing physician if you are experiencing any discomfort or unusual feelings while taking sertraline.

A Note on Uncommon Zoloft Adverse Effects

At Alternative to Meds Center, we have certainly seen some rather bizarre symptoms over the years. After all, each person is a completely unique expression of life.

Not uncommonly, before coming to Alternative to Meds Center, some people have gone to all sorts of specialists, gastroenterologists, neurologists, etc., to try to get an understanding of what they are going through.

In the end, it is not at all uncommon for us to find that medication was the culprit or was at the very least a significant contributing factor, requiring a more nuanced set of treatments to generate the healing processes.

Sertraline and Emotions

Generally, SSRIs can have an emotional numbing or deadening effect, sometimes described as a “zombie-like” feeling. Clinical studies call this an SSRI-induced indifference.35 While such emotional masking can provide a temporary measure of relief to an individual, there may be other drug-free treatments that may be more appropriate, less risky, and more permanent.

One person may experience no reactions at all, and another person may experience one or multiple adverse symptoms when taking sertraline. Symptoms can range from mild to moderate to severe, with the most severe potentially requiring immediate medical intervention.

Of Interest to Women of Child-bearing Age

Patients can experience a wide range of commonly experienced reactions to Zoloft. Women, in particular, should be aware that any drug ingested during child-bearing years may come with liabilities should they become pregnant.3

Though limited in number, there have been studies done to explore the risks of pregnancy that link certain birth injuries to mothers who were prescribed SSRI drugs.23 Women of childbearing age are advised to speak to their prescriber before starting an SSRI prescription.

Zoloft was given a “C” rating by the FDA, meaning the drug was shown to cause harm to pregnant animals when tested, but for ethical reasons, little to no human testing has been done on pregnant women.24-26 Still, the drug remains legal to prescribe to women of childbearing age, and even those who are pregnant. In June 2015, the alphabet rating system was replaced by the “PLLR” rating system, known as the Pregnancy and Lactation Labeling Final Rule. Despite studies that show sertraline (Zoloft) shows up in breast milk, long-term effects have not been adequately evaluated.27

More studies need to be done, but what has been reported should be seriously considered for anyone of child-bearing age.

The FDA drug label for Zoloft mentions infants born to mothers taking Zoloft may suffer damage to the lungs and the infant may experience withdrawal symptoms at birth. Important data was reported in a 2015 study out of Quebec that followed hundreds of pregnancies where the mother took sertraline during pregnancy. The authors of the study found an increase in major malformations in these newborns including craniosynostosis (malformation of the skull) and heart defects. Other birth defects associated with Zoloft are described in more detail below, with their respective clinical reports cited at the end of this article.3,6,23-32,34

Other reported and documented birth defects and injuries include:

• PPHN or persistent pulmonary hypertension of the newborn is a heart and lung condition which can result in respiratory failure, decreased oxygen to the brain, and multiple organ injuries.29
• Congenital heart defects connected to Zoloft and other SSRIs include ventricular septal defects and atrial septal defects, also referred to as “holes in the heart”. These defects are associated with heart murmurs, suppressed appetite, breathing difficulties, tiredness, inadequate growth, and other effects.30
• Increased Risk of Autism has been extensively reported but evidence has not yet been considered conclusive enough for regulatory bodies to ban prescribing to pregnant women.31
• Increased Risk of Clubfoot connected to SSRIs during pregnancy was reported by NIMH. Sertraline exposure caused the highest incidence of clubfoot of all SSRIs.32
• Increased risk of atrial/ventricular defects and craniosynostosis was reported in a Canadian study from 1998 to 2010 and published in the June 2015 issue of the American Journal of Gynecology & Obstetrics.33

Can Zoloft Make Depression Worse?

A study published in July 2011 in the Frontiers of Psychology journal revealed that antidepressant users with major depression are far more likely to have subsequent reoccurrences of major depression than those who avoid antidepressants. This case review study was headed up by McMaster University evolutionary psychologist Dr. Paul Andrews and his colleagues. They reviewed 46 studies carefully selected for reliability and high standards to compare outcomes for patients who used antidepressants versus those given placebos. They concluded that antidepressant users experience a depressive relapse at 42% compared to 25% in the placebo group.36,37 This would suggest that there is a possibility that in some cases, antidepressants like Zoloft can make the cycle of depression harder to resolve.

Zoloft Aggression in Children

Previous studies have also indicated a link between SSRIs and violent behavior. Diagnosticians call it antidepressant disinhibition, or antidepressant-induced activation. Antidepressant disinhibition affects 10-20% of children taking SSRI antidepressants.42,43 In two clinical trials performed by Pfizer, clinicians listed aggression as the most common reason for Zoloft discontinuation in children studied. More clinical studies are needed on the topic of Zoloft and aggression in adults.38,39

Zoloft FAQs

Can You Get Addicted to Zoloft?

Yes. Studies on the subject point to neuroadaptation as a causal factor. It can take a significant period of time for the central nervous system to become accustomed to the presence of sertraline and the effects that it induces on brain chemistry. This will also be true about the readjustment period after discontinuing Zoloft. The body/brain adapts to these changes and alters its neurochemistry to compensate for the drug’s effects.

If one misses taking a dose after the drug dependence has developed, the person will experience withdrawal.14,44 In a 2020 article published in the Journal of Addictive Behaviors the authors reported that 61% of people stopping an antidepressant drug experienced withdrawal manifestations, with 44% of those indicating that the withdrawal symptoms were severe. 40% claimed that they felt addicted, with 39% labeling the addiction as severe. Curiously, only 0.7% of those studied could recall that their prescriber had told them about the possibility of antidepressant dependency, or addiction.45

Some Zoloft users report the drug has become habit-forming, or they have experienced a pattern of abuse. For example, a person may crave the drug’s “feel good” effects and may begin to take more of the drug than has been prescribed. In either case, the body and CNS have neuroadapted, so the drug has entrenched itself in the system. Careful gradual cessation provides the best option to resolve this unhealthy condition.

What’s the Difference Between Zoloft and Xanax?

Zoloft is an SSRI medication, an antidepressant, used to treat depression and anxiety. Regulators class Xanax as a benzodiazepine, often referred to as a tranquilizer. Xanax is prescribed mainly for the treatment of anxiety and panic disorders but is also prescribed off-label to treat depression.56,57

These two drugs each combine different chemical components and work on different brain receptors and neurotransmitters. However, some of their effects overlap. Unlike Zoloft, Xanax mainly affects GABA transmission, which can slow or quieten the central nervous system to reduce anxiety.46

In contrast, Zoloft is designed to block the reuptake of serotonin, in the main, and to a lesser degree, dopamine.

Both drugs carry a significant risk of becoming habit-forming and developing dependence. However, in a small double-blind study, it was found that Zoloft produced more unpleasant sensations and reactions and less pleasant sensations like euphoria than Xanax.59

If comparing the two drugs, they cause similar withdrawal symptoms. However, the body clears each drug along different timelines, resulting in different half-lives.  Zoloft’s half-life runs at about 22-36 hours, and the half-life of Xanax takes about 11 hours. Xanax can generally cause more severe complications if abruptly stopped, including seizures.47 For safe Xanax or Zoloft withdrawal, the reduction in dosage must be slowly administered over time to allow the central nervous system and neurochemistry to safely normalize.2,5

Is Zoloft a Controlled Substance?

No, Zoloft is not classed as a controlled substance in the US and is not a DEA-scheduled narcotic.48

How Long Does Zoloft Stay in Your System After Zoloft Withdrawal?

Generally, the literature estimates the half-life of Zoloft at between 15-26 hours. However, clearing half of the drug in some persons may extend out to 33 or 36 hours. This occurs in some populations, particularly in the elderly, and in females (any age). After approximately a week the system will have cleared about 99 percent of the drug.49

Many factors can help determine or affect how a drug metabolizes, thereby increasing or decreasing the actual timeline for partial and complete elimination.

Can You Overdose on Zoloft ( sertraline )?

Yes, it is definitely possible for SSRI poisoning to occur. A substantial Zoloft overdose requires emergency medical intervention to prevent major health problems. We could not find any recorded instances of fatal Zoloft overdose, though certainly there are cases where an overdose required urgent medical attention. One example, Zoloft-induced serotonin syndrome, is best treated in an ICU.50 At an ICU, the proper equipment and personnel ensure patient care is given in a timely and effective manner.

According to the National Institute of Health (NIH), intravenous benzodiazepines are sometimes initiated during an overdose of Zoloft to prevent seizures. Extra cooling measures must be used to reduce hyperthermia, always under the direction of an EMT or other medical staff attending to the patient.51

Treatment for Zoloft Withdrawal

Zoloft has become one of the most frequently prescribed antidepressants in the US. At the same time, statistics show that depressive disorders have become one of the most frequently diagnosed conditions. These two facts clearly show that the use of prescription drugs to treat mental illness is a losing battle.

But here are two important and often overlooked points:

• Safe treatment should be available for those who have decided on Zoloft withdrawal, and
• Drug-free options to regain natural mental health should be used more widely, even preferring these approaches over medications as a first-line approach to treatment.

Zoloft Withdrawal Treatment at Alternative to Meds Center

The ATMC program offers a Zoloft withdrawal program that combines Zoloft discontinuation and holistic recovery steps and therapies to satisfy both of these steps to better health. Using specific lab tests and other diagnostic tools, the program aims to stabilize neurochemistry without prescription drugs. Natural substances are utilized such as pharmaceutical-grade supplements, blended with a corrected diet based on orthomolecular principles, neurotoxin removal (including environmental toxins),  IV treatments, clay packs, therapeutic massage, spa services, biotransformative sauna, nebulized glutathione treatments, plus many other therapies that are designed to make discontinuing Zoloft gentle, mild, and as comfortable as possible.

Once the neurochemistry normalization is well in progress, other work can begin with CBT and other forms of counseling, which are strongly recommended for the treatment of
An incredible team of highly qualified medical and nursing practitioners staff our comfortable and nurturing facility flanked by a full range of skilled, compassionate therapists. The team delivers adjunctive therapies during Zoloft withdrawal such as lab testing, neurotoxin removal, colon hydrotherapy, therapeutic massage, cranial-sacral massage, Qi Gong classes, Reiki, yoga,52 trainer-led exercises, equine-assisted therapy, art therapy, IV therapy, nebulized glutathione treatments, holistic pain management, and many other effective holistic therapies. These therapies can help overcome the challenges of chronic or acute depression while accelerating recovery. The level of care given to our clients provides the very best inpatient treatment possible for overcoming Zoloft withdrawal and achieving the recovery of drug-free natural mental health.

1 (888) 907-7075 for Zoloft Withdrawal Help

Sources:

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Originally Published Sep 13, 2018 by Diane Ridaeus