Sertraline (Zoloft) is a commonly prescribed antidepressant. It belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It is used to treat major depression, anxiety disorders, post-traumatic stress disorder (PTSD), panic disorder, and eating disorders.
It is also used to treat severe premenstrual symptoms caused by premenstrual dysphoria (PMDD) and obsessive-compulsive disorder (OCD)...
overview
More than half (56%) of people who stop antidepressant medication experience withdrawal symptoms..The experience is different for everyone, with some people having mild symptoms while others having symptoms severe enough to affect daily life.
Sertraline has a relatively short half-life compared to other SSRIs – around one day. This means that within a few days you will have very little sertraline in your bloodstream. Short-acting antidepressants such as sertraline can cause withdrawal symptoms because your body is essentially “shocked” by the lack of the drug and your body adapts to changes in serotonin levels...
It is important to know that stopping your antidepressant medication can cause your original symptoms to relapse and even thoughts of suicide may occur...
How long do withdrawal symptoms last?
The symptoms of sertraline withdrawal may persist for a few days to a few weeks after your last dose. The most common symptoms are flu-like symptoms, dizziness, irritability, nausea, headache, insomnia, and sensory disorders.
Signs and symptoms
Sertraline prevents the reabsorption (re-absorption) of serotonin and thereby increases the serotonin level available between the nerve cells in the brain. Serotonin, a neurotransmitter, plays an important role in your moods and emotions.
If you stop or reduce your dose of sertraline, these serotonin levels will decrease and eventually reach the pre-treatment levels. Withdrawal symptoms occur when your mind and body adjust to this change...
The most common symptoms that occur during sertraline withdrawal are:
- Flu-like symptoms
- insomnia
- nausea
- Imbalance
- Sensory disorders
- Fear or excitement
While these can be the most common symptoms, SSRI withdrawal has been known to affect many systems in the body. The full spectrum of possible withdrawal symptoms includes:
- Digestive. You may experience nausea, vomiting, cramps, diarrhea, or loss of appetite.
- Balance. You may feel dizzy or light-headed, which can sometimes make walking difficult.
- Sleep disorder. You may have nightmares, unusual dreams, excessive / vivid dreams, or insomnia.
- All in all. You may have flu-like symptoms such as headache, muscle aches, weakness, and tiredness.
- Mood. You may have anxiety, restlessness, panic, thoughts of suicide, depression, irritability, anger, mania, or mood swings.
- Bizarre sensations. You may experience brain zaps (such as an electric shock or a chill in your brain), pins and needles, ringing in the ears, strange tastes, or being overly sensitive to noise.
- Heat tolerance. You may have excessive sweating, flushing, or an intolerance to high temperatures.
- Engine control. You may have tremors, muscle tension, restless legs, an unsteady gait, or difficulty controlling your speech and chewing movements...
Most people will begin withdrawal from sertraline within three to four days of your last dose. The duration of SSRI withdrawal can vary, but you can expect it to last a few days to a few weeks. However, sometimes it can take much longer...
Withdrawal symptoms vary from person to person. Some people have no symptoms at all while others have symptoms that are severe enough to interfere with their typical tasks at home, work, or school...
If you have severe withdrawal symptoms, it does not mean that you are dependent on sertraline. Addiction is characterized by the pattern of substance use in the face of adverse consequences. Withdrawal can happen to anyone who has been taking sertraline for a few months or more...
Overall, research shows that approximately half (46%) of people who go through SSRI withdrawal rate their symptoms as severe...
To get a better idea of the range of symptoms and the severity of symptoms, consider the Discontinuation-Emergent Signs and Symptoms Scale (DESS), which is sometimes used by doctors to assess the severity of SSRI withdrawal symptoms measure up.
Coping & Relief
One method that people use to stop SSRIs is through drug rejuvenation. If you were to reduce sertraline, you would gradually reduce your dose over several weeks or months.
While this is an option, some doctors prefer to switch their patients to a longer-acting SSRI before starting rejuvenation. Because sertraline has such a short half-life, the amount of the drug in your system can drop quickly. Switching to a longer-acting SSRI like Prozac can help you avoid those unnecessary peaks and valleys...
In the past, doctors have been unsure whether tapered SSRIs are an effective treatment for withdrawal. However, new research suggests that slow rejuvenation spanning several months may be more effective than traditional rejuvenation plans.
Researchers recommend continuing tapering until your dose is close to zero – well beyond therapeutic levels. This means that at the end of the rejuvenation, you may break pills into tiny pieces or switch to a liquid dose...
If you are still experiencing withdrawal symptoms, consider the following measures:
psychotherapy
Psychotherapy can improve mood, reduce anxiety, and help you better manage your symptoms.
OTC drugs
You can manage pain or flu-like symptoms with over-the-counter pain relievers and nausea medications.
lifestyle
There are also things you can do to reduce your withdrawal symptoms, or at least make treatment easier. These include:
- Exercise. Getting around 45 minutes of moderate activity three times a week can improve mood and reduce stress.
- Sleep. Make sure you get adequate rest every night. Focus on going to bed and waking up at the same time each day.
- Diet. Eat nutritious meals regularly and make sure that you stay hydrated. Avoid foods that can increase your anxiety, such as caffeinated drinks.
Natural remedies
Vitamins, minerals, and herbal supplements can help. However, you should always discuss this with your doctor before taking any natural supplements or home remedies.
social care
One of the most important factors in SSRI withdrawal management is having a social support system in place. Having people around you who can help and support you through a difficult time can reduce stress and anxiety, which can make withdrawal symptoms worse.
When your friends and family understand that you are in retreat, they will be more likely to forgive irritability and mood swings. By preventing interpersonal conflict at home, you avoid some of the negative social effects of withdrawal.
Warnings
Sertraline, like other SSRIs, warns the FDA of the potential for an increase in suicidal ideation and behavior in children and young adults, particularly when medication is instituted or dosage is changed.
Recognizing the signs of suicidal thoughts in yourself or someone else can help save your life or that of a loved one. Call for help right away if you or a loved one has any of the following symptoms:
- Plan how you would commit suicide if you did this
- Talking or thinking about suicide more than normal, for example, “I wish I were dead.”
- Gathering the funds to commit suicide, such as bullets or pills
- Feeling hopeless or trapped
- Intense mood swings
- Risky or self-destructive activities like drunk driving
- Be preoccupied with death, dying, or violence
- Create order or give things away
- Saying goodbye to people like it’s the last time
If you have thoughts of suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for the support and assistance of a trained advisor. If you or a loved one is in imminent danger, call 911.
Additional mental health resources can be found in our National Helpline Database.
If you are pregnant or planning to become pregnant, you should speak to your gynecologist or psychiatrist about the risks and benefits of continuing and stopping sertraline. There is a small risk of premature birth if you are taking antidepressants during the second and third trimesters. On the other hand, if you stop taking sertraline during pregnancy, it is more likely to relapse...
Long-term treatment
You may need additional treatment after the withdrawal period has expired. If you are still suffering from psychological symptoms such as depression or anxiety, you may need further care. Approximately 50% of people who recover from depression will experience another depressive episode in their life...
Some people choose to take antidepressants indefinitely to prevent such a result. Other people choose other treatment modalities such as psychotherapy. Researchers at Harvard Medical School and other universities found that psychotherapy reduced the risk of relapse in people who stop taking antidepressants...
resources
The National Suicide Prevention Lifeline connects you with staff or volunteers at a crisis center near you. The people on the other end of the line can help you calm down and figure out what to do next. It is available around the clock, 365 days a year. If you are hesitant to call, you may prefer to speak to a counselor. The chat services are also open around the clock.
If you have health insurance, you can also browse the list of local company providers who will accept your insurance. Most insurance companies have at least some mental health coverage, including state and federal plans.
If you need to find a psychiatrist, psychologist, or therapist in your area, there are several ways to find one. The Drug Abuse and Mental Health Authority (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357) and a knowledgeable agent will look for you.
A word from Verywell
Antidepressant drug withdrawal isn’t getting the attention it should have. Sertraline withdrawal is a real thing, and quitting is a real challenge for many people. Don’t hesitate to speak to your doctor or other members of your support system about how this is affecting your life. And remember: your symptoms are only temporary. You’ll stop sooner or later.
