Zoloft (Sertraline) Withdrawal: Symptoms, Duration, & How to Cope

What Is Zoloft?

Zoloft (sertraline) is a medication in a class of medications called selective serotonin reuptake inhibitors (SSRIs). It works by inhibiting the serotonin reuptake in the brain to balance neurochemical levels, improving its effectiveness in mood regulation.¹ SSRI medications differ from serotonin-norepinephrine reuptake inhibitor medications, which touch on serotonin and norepinephrine neurotransmitters.

Zoloft is an FDA approved for the treatment of:¹

• Major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder (PD)
• Post-traumatic stress disorder (PTSD)
• Social Anxiety disorder (SAD)
• Premenstrual dysphoric disorder (PMDD)

What Is Zoloft Withdrawal

When you stop taking Zoloft abruptly, you will likely withdraw from it, experiencing what is known as antidepressant discontinuation syndrome. If you take Zoloft for extended periods, your body may likely become dependent on it. This dependency does not mean you are addicted to the medication. SSRI medications are not addictive. It simply means that your body has become dependent on the level of serotonin. There are methods to counteract withdrawal; therefore, it is never recommended to stop Zoloft abruptly or without proper tapering methods to decrease the dosage slowly.

Causes of Zoloft Withdrawal

The most likely cause of Zoloft withdrawal is quitting the medication cold turkey. Some patients have favorable responses to Zoloft and feel that their disorder has been treated, abruptly stopping the medication as they feel it is no longer needed. Others may think that side effects are too disruptive or that the drug is ineffective and quit without discussing their choice with their doctor.

You will unlikely withdraw from Zoloft after missing just one dose as Zoloft has a half-life of 22-36 hours.²A drug’s half-life is how long it takes for the drug concentration in your blood to reach half of the original concentration. However, missing multiple doses can cause withdrawal symptoms from Zoloft, with a 20% chance of severe symptoms.²

Prescribers can help prevent withdrawal by tapering the medication dose and slowly reducing your intake. The time needed to taper depends on how long you have been taking the medication, with more extended periods increasing the level of dependency.

Zoloft Withdrawal Symptoms

Withdrawal symptoms from Zoloft are more likely to happen the longer you take the medication. However, they typically self-resolve in a few weeks.

Common withdrawal symptoms of Zoloft may include:¹

• Nausea
• Vomiting
• Fever
• Chills
• Soreness
• Hyperarousal
• Anxiety
• Mood swings
• Confusion
• Hypersexuality
• Tiredness
• Insomnia 
• Headaches

Severe symptoms of Zoloft withdrawal that may need immediate medical attention include:²

• Suicidal ideation
• Mania
• Panic attacks
• Seizures

Those using Zoloft should never stop taking the medication abruptly. It is always recommended that they speak to a physician about stopping to consider a tapering dose to prevent withdrawal symptoms as much as possible. If you feel severe physical sensations or have suicidal ideation, you should seek medical attention immediately.

Discontinuation vs. Relapse of Depression Symptoms

Stopping SSRI medications can cause antidepressant discontinuation syndrome but also could cause a relapse of your depressive symptoms. These may appear similar, but there are a few ways to differentiate them. Generally, depression does not cause flu-like symptoms or nausea/vomiting like withdrawal does.²

Withdrawals typically self-resolve in 2-3 weeks, while depression relapse is a more slow onset of increased symptoms. However, suppose you are having increasing symptoms from your disorder that was being treated by an SSRI medication. In that case, it may be worth going and speaking with your physician to consider other treatment options.

Zoloft Withdrawal Timeline

Withdrawal symptoms typically start a few days after stopping Zoloft and last for 2 to 3 weeks.²The severity of withdrawals depends on the amount of the drug in your body, which depends on the medication’s half-life (when the concentration reaches half its original prevalence in the body). The half-life of Zoloft ranges from 22-36 hours. Zoloft is considered a low-risk SSRI medication for withdrawal because it has a longer half-life than other SSRIs. Medications considered a higher risk for withdrawal due to shorter half-life include paroxetine, while fluoxetine is considered a lower risk even with abrupt discontinuation. ²

Coping With Zoloft Withdrawal Symptoms

Zoloft withdrawal, while low risk, still affects patients’ quality of life. Luckily there are ways to minimize or even prevent symptoms. The first way is to speak to your physician about a tapering dose of medications, especially if you have been taking Zoloft for a long time. Similarly, it is crucial to talk to your physician if you have withdrawal symptoms, as they may recommend that you return to a higher dose before trying a different tapering dose.

Seven strategies to help relieve symptoms of Zoloft withdrawal include:

1. Getting Adequate Sleep

Getting a whole night of sleep can be challenging, especially if you have insomnia. Often, improving sleep hygiene can be beneficial. Sleeping seven to eight hours of sound sleep can drastically change your withdrawal-affected mood. Even more, sleep can be beneficial for mental health as symptoms may arise after discontinuing Zoloft.

2. Exercising

Exercising daily and incorporating it into your daily living is always recommended. It can be simple things such as walking or going to the gym for half an hour a day. Exercise has numerous benefits for mental health, which will help to prevent any relapsing symptoms once Zoloft is discontinued.

3. Creating a Safety Plan With Family & Friends

Speaking to your trusted friends and family about your depression and withdrawal from SSRI medications can also be beneficial. You can create safety plans with them so they know how to intervene and help if needed.

4. Maintaining a Healthy Diet

Creating a healthy and well-balanced diet can improve health and well-being. Calorie-poor and even calorie-rich diets can make you feel depleted. It may be beneficial to talk to a nutritionist to create healthier eating habits.

5. Tapering the Dose of Medication

Talking to your physician and taking your medication as prescribed decreases the chances of withdrawal. Know that taking it slow is the best route to stopping the medication, as your body will need time to adjust to not having Zoloft in your system appropriately. Similarly, knowing what to expect from withdrawals and when to alert your physician or emergency department will help you navigate the symptoms you may experience.

6. Joining Support Groups

Patients often find that joining a support group for their anxiety or depression is beneficial. It may be good to talk to other peers who have stopped the medication and learn about their experiences. Often they may provide tips that only someone who has gone through the process knows about.

7. Taking Time Off from Work

Often, with our busy schedules, it is easy to fall behind on our health which can only exacerbate withdrawal symptoms. Taking a few days off after stopping medications may be beneficial to focus on your health and get rest your body will need to manage the change.

Discontinuation of Zoloft While Pregnant

Patients that are or are thinking of becoming pregnant can take Zoloft. They may elect to discontinue it at any time during their pregnancy. Pregnant patients should also be advised to discuss tapering doses with their physician before stopping the medication. This being as there are potential risks to the unborn baby while taking Zoloft. Pregnant patients should talk with their doctor about the risks and benefits of taking or continuing the medication while pregnant.

Questions to Ask Your Doctor

Talking to your doctor or psychiatrist is the first step to starting and stopping treatments,  including medications. It is crucial to discuss stopping medicines with your physician to avoid withdrawal or unwanted relapse of your depression/anxiety. With better knowledge of how your body will respond, you can make better decisions on how to care for yourself.

Questions to ask your care team about discontinuing Zoloft include:

• Why do you think I should stop this medication?
• Is it going to be dangerous to stop taking Zoloft?
• Should I stop taking Zoloft all at once or over some time?
• What are the risks of stopping Zoloft?
• When should I expect to notice the influence of Zoloft withdrawal?
• What should I do if something feels off during my withdrawal process?
• Who should I call, and what should I do if I get sick?
• Would starting a new medication help limit the withdrawal symptoms?
• Could my depression get worse after I stopped taking Zoloft?
• Will I have to restart Zoloft at some point?
• Is it possible to switch to a Zoloft alternative?
• Can you mix Adderall and Zoloft at the same time?

Final Thoughts

With any medication, side effects will vary based on the individual. It’s important to discuss the discontinuation of Zoloft with your doctor and care team before changing the dose or abruptly stopping use. While Zoloft is considered a low-risk medication with appropriate medication use, caution should still be taken when altering the medication. It never hurts to have guidance when using medications, as they can always come with unintended consequences that require prompt medical intervention.