How Long Until Zoloft Side Effects Go Away?
Medically reviewed by Femi Aremu, PharmD
Zoloft (sertraline) is an orally administered Food and Drug Administration (FDA)-approved prescription medication used to treat major depressive disorder (MDD) as well as several other mood disorders, including post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), social anxiety disorder (SAD), and panic disorder (PD).
Zoloft is a member of a drug class called selective serotonin reuptake inhibitors (SSRIs) and is administered as a swallowable tablet or oral solution.
Zoloft is generally used with other measures, such as mental health counseling specific to the treatment type.
Although it is generally viewed as safe and effective, Zoloft, like any medication, can cause side effects. Most mild Zoloft side effects will dissipate within a few weeks as your body adjusts to the medication.
However, severe or persistent side effects, such as suicidal thoughts and serotonin syndrome (SS), will require intervention by a healthcare provider.
This article will provide an in-depth analysis of the use of Zoloft for various mood disorders, with particular emphasis on its potential for side effects.
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What Are Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are a popular prescription drug option for the treatment of depression and other mood disorders.
Serotonin is a neurotransmitter (chemical messenger in the brain) that helps with body functions, including mood, appetite, and sleep.
SSRI antidepressants work by increasing serotonin levels.
Commonly Used SSRIs
In addition to Zoloft, examples of other commonly administered SSRIs include:
Shared SSRI Side Effects
Side effects will vary by individual drug; however, some common SSRI side effects may include:
Stomach problems, such as nausea and diarrhea
Muscle and joint pain
Weight gain
What Is Zoloft?
Zoloft is an orally administered brand-name SSRI containing the active ingredient sertraline. For its FDA-approved uses, this medication is only permissible in adults.
Zoloft is also available in generic form and is commonly administered as a swallowable capsule.
We will refer to Zoloft and sertraline interchangeably here.
Uses
Brand-name Zoloft is taken as a tablet or oral solution (liquid).
Its FDA-approved uses include:
MDD: Clinically diagnosed depression
Obsessive-compulsive disorder (OCD; a mental health condition that causes obsessive thoughts and compulsive behaviors)
PD: Recurrent panic attacks of fear and anxiety, along with avoiding triggers
PTSD: A mental health condition associated with memories of trauma
SAD: A chronic fear or dread of interacting with other people
PMDD: A severe form of premenstrual syndrome (PMS) that includes physical symptoms like breast discomfort and bloating, as well as behavioral symptoms such as extreme sadness and irritability
Off-Label Uses
Some healthcare providers prescribe sertraline off-label (prescribing a medication for a use that it has not been FDA-approved to treat) in children and teenagers (6-17 years old) for other uses, such as MDD or OCD.
This would be considered an off-label use because Zoloft is FDA-approved for use in non-adults.
Other examples of off-label uses of sertraline include:
Generalized anxiety disorder (GAD, persistent anxiety that interferes with everyday life)
Separation anxiety (when a child has extreme anxiety about being separated from parents)
Reducing hot flashes in females
How It Works
Like other SSRIs, Zoloft works by increasing serotonin levels in the brain. Usually, cells in the nervous system are called neurons that reabsorb serotonin.
This helps improve symptoms of depression or other mental health conditions.
Dosing Guidelines
Healthcare providers will start the sertraline dose on the lower end. They will closely monitor for improvement of symptoms and side effects.
If needed, they can gradually increase the dose to an effective dose with the most minor side effects.
The usual dose of sertraline is 50 to 200 milligrams (mg) daily. It is usually taken once daily in the morning or evening.
Examples of standard dosing guidelines include:
For OCD in adults and adolescents 13 years and older with MDD, the starting dose is generally 50 milligrams (mg) by mouth once daily.
For all other uses, including OCD in children 6 years and older, the starting dose is generally 25 mg by mouth once daily.
Carefully follow your healthcare provider's instructions for dosing. If needed, the dose may be gradually increased. Do not take more medication than your healthcare provider recommends.
If you stop taking Zoloft, your healthcare professional will provide you with a tapering schedule so that you can stop taking the medication safely and gradually.
This helps avoid withdrawal symptoms, such as sweating, agitation, dizziness, electric shock sensations, confusion, tinnitus (ringing in the ears), and seizures.
How Long Until Zoloft Side Effects Go Away?
Most mild Zoloft side effects will lessen and eventually disappear within a few weeks as your body adjusts to the medication.
Ask your healthcare provider for medical advice for mild/common side effects that persist or are bothersome.
However, severe side effects, such as increased risk of bleeding, suicidal thoughts, or SS, will require intervention by a healthcare provider.
Specifically, they may lessen your dosage or stop the prescription regimen entirely.
Common Side Effects
Stomach issues: Stomach problems are a common side effect of sertraline. In clinical studies, 26% of people who took Zoloft experienced nausea.
If you experience nausea, you can try things to settle your stomach, such as:
Eating bland foods and avoiding foods that are fatty, spicy, and/or greasy
Eating smaller meals less often
Avoiding strong smells
Staying hydrated by drinking plenty of fluids and/or sucking on ice chips
Other stomach-related side effects may occur, such as diarrhea, in up to 20% of people in clinical studies.
Other stomach issues like vomiting, constipation, or indigestion may occur less commonly.
Dry mouth: About 14% of clinical study participants experienced a dry mouth.
Some things you can try to do as your body adjusts to the medication include:
Drinking plenty of water
Eating foods with a high water content, such as watermelon, cucumbers, and celery
Avoiding foods that are salty or spicy
Avoiding caffeine, alcohol, and tobacco
Chewing sugar-free gum or sucking on sugar-free hard candy
Using a cool-mist humidifier while you sleep
Gargling with a mouthwash that is formulated for dry mouth
Sexual problems: Sexual problems are a common side effect of SSRIs.
Males may experience problems such as delayed ejaculation, decreased sex drive, and problems achieving and/or maintaining an erection.
Women may experience decreased sex drive, delayed orgasm, or inability to have an orgasm.
If you experience sexual problems associated with Zoloft, talk to your healthcare provider regarding options for treatment or possibly switching to a different medication that is less likely to cause sexual problems.
Sleep issues: While taking sertraline, you may experience insomnia when you have trouble falling asleep and/or staying asleep.
About 20% of people experienced insomnia in clinical studies. On the other hand, about 12% experienced excess sleepiness.
If Zoloft affects your sleep, you can ask your healthcare provider when to take your medication.
If sleep issues persist, you may want to discuss a change in medication with your healthcare provider.
Severe Side Effects
Zoloft safety warning:
Every antidepressant, including Zoloft, has a boxed warning. This is the most severe warning required by the FDA.
The warning states that antidepressants have been found to cause suicidal thoughts (thinking about suicide) and behaviors (any action that could cause death), generally in children, adolescents, and young adults.
However, people of any age who take an antidepressant should be closely monitored by family, close friends, and caregivers for any changes in mood and/or behavior.
This profound side effect is more likely to occur when starting Zoloft or during dosage changes. Any changes in mood or behavior should be reported to the healthcare provider.
People who experience suicidal thoughts and behaviors may need to stop taking Zoloft and switch to another medication.
The healthcare provider will determine the best treatment based on the individual.
In addition to the boxed warning, other severe side effects may occur, which require medical attention:
Allergic reactions: An allergic reaction can be life-threatening. Symptoms may include hives, difficulty breathing or swallowing, or swelling of the face, lips, tongue, or throat. If these symptoms occur, get emergency medical help.
Abnormal bleeding or bruising: Be alert to signs of bleeding, such as bleeding gums, a bloody nose, or blood in the stool, and report any problems to your healthcare provider.
You will also want to avoid certain medications that increase the risk of bleeding when taken with sertraline, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Low sodium levels: Symptoms may include headache, weakness, balance problems, confusion, and problems with thinking and memory. Balance problems can also lead to falls.
Severe cases of low sodium levels can lead to death, so if you have any of the symptoms listed, you should get medical help right away.
SS: This is a life-threatening medical emergency and is caused by the build-up of serotonin. Symptoms may include agitation, hallucinations, fever, sweating or shivering, a fast heart rate, stiff muscles, twitching, incoordination, and stomach problems like nausea, vomiting, or diarrhea.
Certain drugs, when taken in combination with Zoloft, can increase the risk of serotonin syndrome (see more information in the interaction section). If you have any symptoms of serotonin syndrome, get emergency medical help.
Seizures: Before taking Zoloft, let your healthcare provider know if you have a history of seizures. While taking Zoloft, if you have a seizure, notify your provider right away.
Glaucoma: Certain antidepressants, including sertraline, can cause angle-closure glaucoma, an eye emergency caused by a rapid and dangerous increase in eye pressure.
Get emergency medical help immediately if you have eye pain, vision changes, or redness or swelling in or around the eye. Your healthcare provider may also screen you before taking Zoloft to see if you are at risk for this condition.
Manic episodes: If you have symptoms of mania, such as feeling the mind racing, having intensely high energy, feeling extremely happy, irritable, overly talkative, or engaging in unusual risky behavior, you should notify your healthcare provider.
Before taking Zoloft, you should talk about potential side effects with your healthcare provider and ensure you understand the benefits and risks of this medication.
Safely Taking Zoloft
Here are some tips for safe use of Zoloft:
Before taking Zoloft, tell your healthcare provider about your medical conditions. Carefully read your prescription label, information leaflet, and Medication Guide. Consult your healthcare provider if you have any questions or concerns.
Always take Zoloft as prescribed. Follow your healthcare provider's directions for use. They may direct you to gradually increase the dose, taking note of your symptoms and any side effects.
You can take Zoloft with or without food.
Zoloft can make you tired and impair your reactions. Do not drink alcohol while taking Zoloft. Do not drive or operate machinery until you know how Zoloft affects you.
If using Zoloft oral solution, it must be diluted before use. You can use water, ginger ale, lemon-lime soda, lemonade, or orange juice. Do not mix until you are ready to take your medicine.
While taking sertraline, if you miss a dose, take it as soon as you remember. However, if it's almost time for the next dose, skip the missed dose and resume your regular schedule. Do not take extra medicine to make up for a missed dose.
Help Is Available
If you are experiencing symptoms of depression, talk to your healthcare provider.
If you or someone you know is in suicidal crisis or emotional distress, you can call 988 for the Suicide & Crisis Lifeline.
The line is open 24 hours a day, seven days a week in the United States, providing free, confidential support. You can also call 911 or go to the nearest emergency room if you or someone you know is in a suicidal crisis.
Potential for Interaction
Before taking Zoloft, tell your healthcare provider about all of the medicines you take, including:
Prescription medications
Over-the-counter (OTC) medicines
Vitamins
Supplements
While taking sertraline, do not start any new medications without approval from your healthcare provider.
Examples examples of drug interactions include:
Monoamine oxidase inhibitors (MAOIs): Zoloft should not be taken with 14 days of an MAOI such as Zelapar (selegiline) or Parnate (tranylcypromine)
Other drugs that increase serotonin levels, such as other SSRI antidepressants, serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants (including Cymbalta [duloxetine]), tricyclic antidepressants (including Pamelor [nortriptyline]), triptans for migraine (including Imitrex [sumatriptan]), or the supplement St. John’s Wort. This combination can increase the risk of SS.
Drugs that can increase the risk of bleeding, such as Aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs)
Blood-thinning medications, such as Jantoven (warfarin), heparin, or Plavix (clopidogrel)
This is not a complete list of drug interactions. Other drug interactions may occur with Zoloft.
Consult your healthcare provider for more information about drug interactions and how they may affect you.
Summary
Depression is a common disorder, accounting for over 15 million healthcare provider visits in the United States every year.
Zoloft (sertraline) is an SSRI antidepressant that treats depression and other mental health conditions, including OCD, PTSD, SAD, PMDD, and PD.
Mild side effects, such as nausea and upset stomach, can be reduced or minimized by gradually increasing the dose, allowing the body time to get used to the medicine.
Often, these side effects dissipate within two weeks of use.
More severe side effects may require medical treatment, or, in some cases, the medication must be stopped or changed to another medication.
Talk to your healthcare provider about Zoloft and its potential side effects.
Frequently Asked Questions
How can I effectively store my Zoloft?
Store Zoloft at room temperature (68-77 degrees F), away from direct light, heat, and moisture.
Do not store it in a bathroom because of the humidity.
As with all medications, keep out of reach and sight of children and pets. Keep the bottle tightly closed when not in use.
How quickly does Zoloft begin working?
It may take several weeks to start to notice an improvement in symptoms. It may take even longer, up to several months, before you see the full benefit of this medication.
Your healthcare provider will tell you how to gradually increase the dose of Zoloft if needed.
Read the original article on Verywell Health.
