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Zoloft Withdrawal

Articles


ARTICLE SUMMARY: If you’ve been taking Zoloft daily and significantly reduce doses – or quit completely – you can expect to go through withdrawal. More on the duration of Zoloft withdrawal, possible side effects, and how to ease the discomfort here.


ESIMATED READING TIME: 10-15 minutes


TABLE OF CONTENTS


Fear of Withdrawal

Most of us feel afraid or worried when we have to discontinue a prescription medication. All kinds of questions may be racing in your head:

  • How will I live without Zoloft?
  • Is withdrawal going to be painful?
  • Am I strong enough to go through detox without relapsing?

These are all quite common.

In this article, we’ll explain the withdrawal process and let you know what happens each step of the way. Additionally we talk about the importance of seeking medical help during the process. And at the end of the article, you’ll find a list of recommendations about how to quit Zoloft safely.

Finally, we welcome all your questions in the comments section at the end. We’ll try to respond to all real life questions with a personal and prompt reply.

Definitions

Zoloft is a powerful antidepressant intended for short term use. Its main psychoactive ingredient – sertraline – affects the central nervous system through inhibition of neuronal reuptake of serotonin. And when a person has used this medication for longer than a month, dependence can develop. So, what is drug dependence? And how is it related to withdrawal?

As defined by the National Institute on Drug Abuse, dependence is a state:

“…in which the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased (withdrawal). Physical dependence can happen with the chronic use of many drugs—including many prescription drugs, even if taken as instructed.”

So, dependence and withdrawal are connected; withdrawal is an indicator of dependence.

However, drug dependence is not the same as addiction. You can be drug dependent and yet NOT addicted. The main difference is in psychological craving. So, if you quit Zoloft but CANNOT stay quit, it’s possible that you are struggling with a drug addiction.

What Causes Withdrawal?

The World Health Organization defines drug withdrawal as a:

“group of symptoms with different intensity and degree of severity which occur on cessation, or reduction of regular drug use after a prolonged period and/ or in high doses”.

Withdrawal is usually predictable in nature, and related to the drug of choice. Why does it happen? Zoloft withdrawal symptoms come as a result of chemical processes that happen in the brain.

Zoloft blocks the serotonin receptors in the brain. It basically increases the levels of serotonin (chemically). When you quit this medication, these receptors become unblocked and serotonin levels drop significantly.  Usually, the features of Zoloft withdrawal are the opposite of the effects of the medication. This is why Zoloft withdrawal syndrome is usually accompanied by signs of physical and physiological disturbance.

Symptoms

Most cases of withdrawal manifest two types of symptoms: physical and psychological.

Physical withdrawal symptoms include:

  • decreased appetite
  • diarrhea
  • dizziness
  • fatigue
  • fever
  • fly like symptoms
  • headaches
  • lightheadedness
  • memory loss
  • nausea
  • tremors
  • weakness

Psychological withdrawal symptoms include:

  • anxiety
  • confusion
  • depersonalization
  • depression
  • hallucinations
  • irritability
  • mood swings
  • panic attacks
  • poor concentration
  • suicidal thoughts
  • vivid dreams

How Long Does It Last?

Zoloft withdrawal is highly individual and depends on many factors. So, it is hard to give a precise time frame, because druation varies considerably from one person to another.

The medication itself will be out of your body in 2-4 days, but making a full recovery back to normal may take several months. The readjustment period will last at least 3 months. Still, there are some common timeframes. Acute Zoloft withdrawal peaks, on average, between 2-4 days after last dose. The average length of reported symptoms is 3 weeks.

Influencing Factors

The truth is this: while there are general symptom and guidelines that define the detoxification period, the process highly depends on the individual herself. Various factors determine the course of Zoloft withdrawal. These include:

  • the time span (how long you’ve taken your medication)
  • the dosage
  • your individual physiology
  • whether you quit cold turkey or gradually

Each of tehse factors will play a significant role in the duration and the intensity of your withdrawal journey. Consider the following factors as you plan detox off Zoloft.

1. Duration of use.

How long did you used Zoloft? Did you take it for a few weeks, months, or years? The longer you take a certain drug or a medication, the more difficult and intense withdrawal will feel. The rule applies vice versa. The shorter you took Zoloft, the easier it’s going to withdraw from it. For Zoloft, use that goes beyond 4-6 weeks is considered “long-term use”.

2. Dosage.

The amount of your daily Zoloft doses are another contributing factor to the course of withdrawal. Most people take anywhere from 50 mg (minimum) to 200 mg (maximum) dose per day of this medication. If you were on a lower dose, you should be able to come off of this drug moreeasily than someone who was taking the maximum prescribed daily dose of 200 mg. If you used larger Zoloft doses for a longer period of time, it will take more time to taper off and withdrawal discomfort may be increased.

3. Individual factors.

For some people, the withdrawal process is easier than for others. Individual drug metabolism can play arole here. Personal resilience, or the way a person responds to life challenges, can also play a role in determining how fast you recover from withdrawal. If you have a high tolerance for pain, you are also better prepared to successfully manage the pain and powerful cravings. The environment, your social support system, diet and quality of the food you eat, physical preparedness, exercise, and hydration…each of these can help you prepare for a succesful withdrawal period.

4. Method of discontinuation.

In order to facilitate safe detoxificationy, Zoloft should be withdrawn slowly and gradually using tapering protocols to help ease withdrawal symptoms. Quitting cold turkey is not advised and may end up doing more harm than good. With a powerful antidepressant such as Zoloft, it is better to use a step-by-step dosage decrease over a period of weeks and/or months so that you give some time to your system to readjust itself.

When using abrupt cessation with no taper, you can trigger a state of physical and psychological chaos. Your brain expects a daily dose of Zoloft, and when that repeated cycle of regular use is interrupted, your brain feels like “going crazy” while trying to make up for the lack of serotonin. In order to minimize the intensity of withdrawal symptoms, it is highly recommended to do a slow taper.

Zoloft Withdrawal Timeline

24 – 72 hours after discontinuation.

The initial symptoms are felt within the first 24-72 hours after cessation. Usually, the first few days without Zoloft feel intensely umcomfortable. The start of the withdrawal journey is marked by flu-like symptoms, mood swings and racing or erratic thoughts. Feelings of anxiety and strong craving tend to occupy the mind. Some people have even experienced seizures in the first few days of Zoloft withdrawal. This is another reason why all cases of drug withdrawal should be medically supervised.

Week 1 after discontinuation.

In the first week after coming off Zoloft, mood swings, fatigue, muscle tension and even feelings of dissociation (that you are disconnected from your body) may occur. This is why it’s vital that you are in the presence of medical professionals who follow your health condition and can provide either medication or psychological support. The symptoms mark their peak during the first few weeks and therefore you should try to endure the powerful cravings and find something that will occupy your time and keep your thoughts away from Zoloft.

Week 2 after discontinuation.

After a peak in symptom intensity during the first week, the second week is much easier. When you reach this period of withdrawal the physical symptoms typically subside. However, you may still struggle with insomnia or have vivid dreams or nightmares. These things will subside with time.

Week 3 and beyond.

The most common symptoms after 3 weeks include weight gain, rebound depression, and overall feelings of malaise. At this phase, the biggest challenge would be gathering your strength to carry on and live your life without the need to use Zoloft. The most critical symptom at this period is depression. Having low levels of motivation is the most common trigger for relapsing back into the old patterns of use, but you must remain strong and find the will to beat this challenge.

Side Effects

The majority of those who experience Zoloft withdrawal feel like they have the flu, or a stomach bug. They struggle with disturbing thoughts or images. And seizures have been reported in some cases. Still, there are three reasons why you SHOULD NOT consider quitting Zoloft without a prior doctor’s consultation. We review them here:

1. You can interfere with your treatment plan for depression. Stopping Zoloft can set back your treatment plan. It can prolong the time it takes to feel better, or it might actually worsen your symptoms.

2. Suicidal ideations might arise. Not being properly treated may increase your risk of suicidal thoughts. This increases the risk to act on those thoughts. According to the American Foundation for Suicide Prevention (AFSP), the most common health problem linked to suicide is depression.

3. Other symptoms can get worse. Stopping Zoloft might worsen other symptoms associated with your depression such as headaches, pain, or insomnia. Additionally, untreated depression can make it harder for you to manage other health problems.

Suggestions

If you’re thinking about stopping antidepressants, you should go step-by-step, and consider the following recommendations:

1. Do not rush, take your time.

You may be tempted to stop taking Zoloft as soon as symptoms related to depression ease, but depression can return if you quit too soon. Doctors generally recommend staying on the medication for six to nine months before quitting.

Talk to your doctor about the risks of stopping Zoloft in your particular situation, and consult them when is the best time to stop using it. Before discontinuing, you should be 100% sure that you’re functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might arise. Do not try to discontinue Zoloft while you’re under stress or undergoing a significant change in your life, such as a new job, an illness, a separation, or a major loss.

2. Make a plan.

Stopping the use of Zoloft usually involves reducing your dose gradually and slowly within the time frame of two to six weeks. Your physician should instruct you in tapering your dose and prescribe the appropriate dosage for making the change. The schedule will depend on how long you’ve been on Zoloft, your current dose, and any symptoms you had during previous medication changes.

It’s also recommended to keep a “mood calendar” on which you keep track of your mood on a scale of one to 10. This way you will have a detailed insight into the way the tapering regime affects you.

3. Consider psychotherapy.

The use of powerful antidepressants such as Zoloft makes profound changes in your mind and psyche. Some statistical records show that 20% of the people who either use or have used antidepressants undergo psychotherapy. A study done by the Harvard Medical School discovered that people who undergo psychotherapy while discontinuing an antidepressant lower their chances of relapse.

4. Engage in physical activity.

Pay attention to the things you eat, learn some stress-reduction techniques, sleep regularly and stay active as much as you can. Exercise naturally increases your body’s endorphins and improves your mood. It’s been proven that people are far less likely to relapse after recovering from depression if they exercise several times a week. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off Zoloft.

5. Seek support.

Professional support is very important as you through the process of withdrawal. You should communicate with your doctor about any physical or emotional symptoms that are related to quitting Zoloft. If the symptoms are mild, know that they are just temporary, but if the symptoms are severe, you might need to go back to a previous dose and reduce the levels more slowly. Zoloft has a short half-life, so your doctor might switch you to a longer-acting drug.

Besides the support and attention from professionals, it is also very important to have a relative or close friend that will support you during the process. When your loved ones realize that you’re discontinuing Zoloft, they should be supportive and provide you with all the love and understanding. A close friend or family member may also be able to recognize signs of recurring depression that you might not perceive. Therefore having emotional and professional support during withdrawal is essential for success.

6. Stick to your tapering schedule.

By the time you stop taking Zoloft, your dose will be very small. Some physicians prescribe a single 20-milligram tablet of a longer acting antidepressant the day after the last dose of Zoloft in order to ease its final elimination from the body. However, this this approach hasn’t been tested in a clinical trial.

7. Do regular checkups with your doctor.

Once you quit your last Zoloft dose it does not mean the work on your sobriety is over. It’s highly advised to do a follow-up appointment with your doctor. He/she will check to make sure withdrawal symptoms have eased and there are no signs of returning depression. Ongoing monthly check-ins are the best way to maintain your good health and sobriety.

Your  Questions

Building a foundation of healthy habits after living with a dependence problem is never easy. Restructuring your whole life might just take time, devotion, professional help and strong commitment. But when others have done it before, why not you?

In case you were left with any additional questions feel free to post them in the section below. Or if you have a personal experience with Zoloft discontinuation we’ll be more than happy to hear your story. It may inspire others who are struggling.

Reference Sources: NCBI: Steps Following Attainment of Remission: Discontinuation of Antidepressant Therapy
Harvard Medical School: Going off antidepressants

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