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Zoloft Side Effects: What are They and What Can You Do About Them?

Zoloft Side Effects: What are They and What Can You Do About Them?

With depression reaching epidemic levels in the United States, there is a good chance that you or someone you know has been affected by the condition. There are several different types of depression, but an 17.3 million American adults, or 7.1 percent of the population, were reported to experience an episode of major depression in 2017. The physical, mental, and emotional symptoms associated with depression can make it challenging for people who are suffering to perform even daily tasks, and many completely lose the desire to do even activities they used to enjoy. Hoping for relief from their symptoms, millions of Americans each year turn to prescription medications like Zoloft. Antidepressants like Zoloft can be very effective for some people, while others do not find them as useful. Often, side effects of medications like Zoloft are so bothersome that people stop taking the medications they need entirely. Fortunately, patients taking medications like Zoloft don’t have to choose between experiencing depression or experiencing side effects from their medication.

What is Zoloft?

Zoloft is a brand name medication sold under the generic name sertraline. The drug belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs, which are primarily used to treat mental illnesses like depression and anxiety. The U.S. Food and Drug Administration (FDA) approved Zoloft for use in the United States in 1991; today, Zoloft is one of the most commonly prescribed SSRIs on the market, with more than 38 million prescriptions for the medication written in 2017.

What is Zoloft used to treat?

Zoloft is used to treat a number of different mental health conditions, including major depressive disorder, panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD), but the medication is most commonly used for the treatment of depression.

What are the symptoms of depression?

Life is full of ups and downs, and everyone experiences high points and low points in regards to their emotions. However, when feelings of sadness, emptiness, or disinterest are intense, interfere with daily life, and last for an extended period of time (two weeks or more), individuals may be suffering from depression. People with depression experience both physical and emotional symptoms that vary in type and intensity. Depression is believed to have a number of triggers, including genetic, psychological, biological, and environmental factors. Many women experience depression as a result of hormonal changes or as a result of taking certain medications, such as oral contraceptives. Symptoms of depression commonly include:

  • Persistent sadness
  • Feelings of hopelessness or pessimism
  • Fatigue
  • Difficulty concentrating
  • Reduced libido
  • Suicidal thoughts
  • Aches
  • Digestive problems
  • Persistent anxiety
  • Irritability
  • Decreased energy
  • A loss of interest in hobbies
  • Change in appetite
  • Suicide attempts
  • Pains

What are the side effects of Zoloft?

Possible side effects associated with Zoloft generally fall into two categories: common adverse effects and rare but serious ones. 

Common side effects associated with Zoloft include:

  • Nausea
  • Diarrhea
  • Increased sweating
  • Trouble sleeping/tiredness
  • Upset stomach
  • Dizziness
  • Drowsiness
  • Loss of appetite
  • Dry mouth

Rare but serious side effects associated with Zoloft include:

  • Angle-closure glaucoma, as evidenced by:
    • Swelling or redness in or around the eye
    • Eye pain
    • Changes in vision
  • Low sodium blood levels, as evidenced by:
    • Weakness
    • Difficulty concentrating
    • Headache
    • Difficulty remembering
  • Serotonin syndrome, as evidenced by:
    • Shivering
    • Severe muscular tightness
    • Seizures
    • Diarrhea
    • Confusion
    • Death
    • Fever
  • QT prolongation and ventricular arrhythmia including changes in the electrical activity of your heart
  • Teeth grinding

How can the side effects of Zoloft be minimized or avoided?

Many prescription medications have unpleasant side effects, but until recently, researchers had not made the connection between nutrient depletion and the incidence of side effects. Nutritional deficiencies in several vitamins and minerals, including omega-3 fatty acids, vitamin D, magnesium, vitamin B-6, vitamin B-12, folate, amino acids, iron, zinc, iodine, and selenium, have been linked to higher rates of depression. For example, a study of older women with severe depression found that more than a quarter of the study participants were deficient in vitamin B-12.  Low folate levels have also been tied to depression, as only seven percent of people with low folate levels respond to treatment with antidepressants like Zoloft, while those with high folate levels report a 44 percent response. Similarly, approximately half of American adults are deficient in magnesium, which is a mineral linked to relaxation. Women with hormonal imbalances, such as those experiencing menopause, can also benefit from nutritional support that helps to support balanced hormones and reduce the side effects of hormonal imbalance, such as depression. It stands to reason that receiving support from a  dietary supplement that is specially formulated to address the nutritional deficiencies associated with depression, anxiety, and certain side effects can help to minimize the experience of side effects in patients taking medications like Zoloft. . When the missing vitamins and minerals are received at therapeutic doses in addition to mitochondrial antioxidants, patients are less likely to experience common side effects of antidepressants.

Are there any risks associated with taking Zoloft?

The FDA has issued a black box warning, the most serious warning issued by the agency, for Zoloft due to an increased risk of suicidal thinking, ideation, and behavior in children, adolescents, and young adults who are taking the medication and suffering from major depressive disorder. Patients with a diagnosis of major depressive disorder should be closely monitored while taking Zoloft.

Zoloft is also associated with a risk of withdrawal symptoms of the dosage of the drug is rapidly reduced or stopped abruptly, particularly in patients who have been taking the medication for at least six weeks. Patients who are taking Zoloft should not change their dosage or stop taking their medication without guidance from a healthcare professional in order to avoid withdrawal symptoms.  Symptoms of withdrawal from Zoloft include:

  • Nightmares and insomnia
  • Agitation
  • Irritability
  • Vertigo
  • Nausea
  • Gastrointestinal issues (diarrhea, nausea)
  • Aggression
  • Dizziness
  • Confusion
  • Flu-like symptoms
  • Anxiety
  • Tremors

Some medications can cause dangerous drug interactions with Zoloft, including monoamine oxidase inhibitors (MAOIs/MAO inhibitors) (particularly  rasagiline, selegiline, linezolid, isocarboxazid, methylene blue, phenelzine,moclobemide, procarbazine, safinamide, and tranylcypromine), drugs like clopidogrel that increase risk of bleeding or bruising, prescription or over the counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, blood thinners, other SSRIs like fluoxetine, citalopram, or paroxetine, St. John's wort, and certain selective serotonin and norepinephrine reuptake inhibitors (SNRIs).

Having certain other medical conditions may make you more likely to experience side effects while taking Zoloft, so it is important to use caution and give a thorough medical history to your healthcare provider. Make sure to specifically note any personal or family history examples of:

  • Hyponatremia (low sodium in the blood)
  • Bleeding problems
  • Glaucoma
  • Purpura (brownish-red or purplish discoloration of the skin)
  • Liver disease
  • Bipolar disorder
  • Diabetes
  • Mania or hypomania
  • Seizures

Older adults are more likely to experience certain side effects while taking Zoloft, including side effects related to bleeding, loss of coordination, or QT prolongation. Older adults may lose their balance or coordination more easily and experience falls, and they are also more prone to developing a salt imbalance (hyponatremia) as compared to younger people. 

Sources:

https://www.healthline.com/health/depression/effects-brain 

https://www.medicalnewstoday.com/articles/263773 

https://medlineplus.gov/druginfo/meds/a697048.html 

https://www.webmd.com/drugs/2/drug-1/sertraline-oral/details 

https://www.drugs.com/sertraline.html 

https://www.healthline.com/health/sertraline-oral-tablet 

https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd 

https://www.statista.com/statistics/781658/sertraline-hydrochloride-prescriptions-number-in-the-us/ 

https://www.everydayhealth.com/columns/therese-borchard-sanity-break/nutritional-deficiencies-that-may-cause-depression/