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Zoloft, or sertraline, is an antidepressant in a class known as selective serotonin reuptake inhibitors (SSRIs). It is often prescribed to treat depression, obsessive-compulsive disorder, post-traumatic stress disorder, panic attacks, social anxiety disorder, and premenstrual dysphoric disorder. Since Zoloft affects brain chemistry, it should not be stopped without consulting your doctor. In addition, discontinuation of Zoloft should only take place under the supervision of your doctor and according to the gradual schedule your doctor prescribes.
Steps
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Talk to your doctor. Discuss your side effects or other reasons for wanting to stop taking Zoloft with your doctor. This will help your doctor make an informed decision and decide if the time is right for you to stop taking Zoloft.
- If you have been on the medication for less than eight weeks, your doctor will likely suggest you give the medication the full eight weeks to take effect.
- If you feel like stopping Zoloft because it hasn't been effective, you may want to ask your doctor if increasing your dosage might have positive results.
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Discontinue Zoloft slowly. Antidepressants need to be slowly discontinued with gradual decrease in doses to avoid discontinuation symptoms. This is called tapering. Tapering can take weeks to months depending on the antidepressant, how long you have taken it, your dose, and your symptoms. [1] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source If you stop right away—go “cold turkey”—your body does not have enough time to adjust, and you may experience worse discontinuation symptoms. Symptoms may include: [2] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- Abdominal issues such as nausea, vomiting, diarrhea, or cramps
- Sleep issues such as insomnia or nightmares
- Balance issues such as dizziness or lightheadedness
- Sensory or movement issues such as numbness, tingling, tremors, and lack of coordination
- Feelings of irritability, agitation, or anxiety
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Taper based on your doctor’s schedule. The length of time it takes to completely stop taking Zoloft may depend on how long you were on the medication and the dose you were prescribed. Your doctor will determine the best schedule for you to taper off Zoloft while minimizing the potential for discontinuation symptoms.
- One suggested way is decreasing the dose by 25mg per dose reduction, giving at least two weeks in between each dose reduction. [3] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- Keep track of your tapering schedule by writing down the dates and the dosage changes.
- Expect to taper off the medication over several weeks. If you were on Zoloft for a long time, then you will likely taper off of it over four to six weeks. If you start to experience intolerable withdrawal symptoms, then your doctor may decide to taper the dosage at a slower rate.
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Document any effects you experience. Even if you are tapering Zoloft, it is still possible to experience discontinuation symptoms. You may also be at risk of experiencing a relapse with regard to your depression or disorder. Keep track and talk to your doctor if you develop any of these symptoms.
- Discontinuation symptoms have a quick onset, slowly get better over 1-2 weeks, and include more physical complaints. In order to differentiate between relapse and discontinuation symptoms, look at when the symptoms start, how long they last, and the type of symptoms.
- Relapse symptoms gradually develop after 2-3 weeks and get worse over 2-4 weeks. Contact your doctor if any symptoms last more than 1 month. [4] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source [5] X Trustworthy Source American Academy of Family Physicians Organization devoted to improving the health of patients, families, and communities Go to source
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Keep your doctor informed. Your doctor will monitor you for at least a few months after discontinuation. Inform him or her about any relapse symptoms or concerns you may have. You may want to follow-up with your doctor more closely during this time period.
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Take any new medications according to your doctor’s prescription. If you are discontinuing Zoloft because of side effects or if Zoloft is not controlling your depression, your doctor may prescribe a different antidepressant. The choice of medication depends on many aspects such as patient preference, prior response, effectiveness, safety and tolerability, cost, side effects, and drug interactions. [6] X Research source If you experienced side effects or inadequate control of your depression, you doctor may recommend:
- A different selective serotonin reuptake inhibitor (SSRI), including Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram), or Lexapro (escitalopram)
- Serotonin norepinephrine reuptake inhibitors (SNRIs), such as Effexor (venlafaxine)
- Tricyclic Antidepressants (TCA), such as Elavil (amitriptyline).
- Monoamine oxidase inhibitors (MAOIs) can also be used after waiting at least five weeks after discontinuation of Zoloft. [7] X Research source
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Try to exercise regularly. Studies show that regular exercise can help produce endorphins and increase neurotransmitters that may help with symptoms of depression and anxiety. [8] X Expert Source Liana Georgoulis, PsyD
Licensed Psychologist Expert Interview. 3 January 2019. Try to exercise for approximately thirty minutes each day. -
Change your diet. A healthy diet can help you overall. In particular, omega-3 fatty acids have been shown to help as an adjunctive therapy for depression.
- Omega-3- fatty acids are contained in foods such as kale, spinach, soybean or canola oil, flaxseeds, walnuts, and fatty fish such as salmon. They are also available over the counter, usually as fish oil gelatin capsules. [9] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Studies that showed benefit of omega-3 fatty acids in mood disorders included doses between 1–9 grams (0.035–0.32 oz). However, more evidence supports the lower doses in that range. [10] X Research source
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Follow a consistent sleep schedule. Sleep is often disturbed by depression. It is important to follow good sleep hygiene to ensure you are getting proper rest. Good sleep hygiene includes: [11] X Research source
- Going to bed and getting up the same time each day
- Avoiding stimulation before sleeping, such as exercise, watching TV, or doing computer work
- Avoiding alcohol and caffeine before bed
- Associating your bed with sleep as opposed to reading or doing other work
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Get some sun. There is not a consensus on how much exposure you need to help symptoms of depression. However, researchers agree some types of depression, such as seasonal affective disorder, may benefit from getting more exposure to sunlight. Research also suggests sunlight can affect your levels of serotonin.
- Sunlight may also decrease the risk for disorientation and depression in older patients with Alzheimer's.
- Generally, there isn’t a maximum amount of exposure for sunlight. Make sure you do wear sunscreen if you are going to be in the sun longer than 15 minutes.
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Have a good support system. [12] X Expert Source Liana Georgoulis, PsyD
Licensed Psychologist Expert Interview. 3 January 2019. Throughout the process, stay in touch with your doctor and let your doctor know about your status, feelings, or symptoms. Keep a relative or close friend involved as well. They may be able to provide emotional support or recognize signs of relapse. [13] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source- Having a good support system is very important. Try not to turn down invitations to activities, and try and get out more often.
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Consider psychotherapy. An analysis of different studies found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse. [14] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source Psychotherapy is a way to help people with mental disorders by teaching them ways to deal with unhealthy thoughts and behaviors. It gives people tools and strategies to manage their stress, anxieties, thoughts, and behaviors. There are different types of psychotherapy. Treatment plans depend on the individual, the disorder, severity of disorder, and numerous other factors such as if you are on medications. [15] X Trustworthy Source National Institute of Mental Health Informational website from U.S. government focused on the understanding and treatment of mental illness. Go to source [16] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source
- Cognitive behavioral therapy’s (CBT) goal is help a person think more positively and influence behavior. It focuses on current problems and solutions to those problems. A therapist helps the person identify unhelpful thinking and change inaccurate beliefs, thus aiding a change in behavior. CBT is particularly effective for depression.
- Other therapies—such as interpersonal therapy, which focuses on improving communication patterns; family-focused therapy, which helps by resolving family conflicts that may be influencing the patient’s illness; or psychodynamic therapy, which focuses on helping people gain self-awareness—are also available options.
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Consider acupuncture. Some studies have shown benefits of acupuncture for depression. Although it is not part of guideline recommendations, acupuncture can be useful for some. [17] X Research source Acupuncture is a technique in which thin needles are inserted through the skin to stimulate specific points on the body and relieve symptoms of diseases. If needles are sterilized properly there is little concern for risks.
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Consider meditation. [18] X Expert Source Liana Georgoulis, PsyD
Licensed Psychologist Expert Interview. 3 January 2019. A Johns Hopkins analysis of previous studies suggests that thirty minutes of daily meditation may improve symptoms of depression and anxiety. [19] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source Practical ways you can practice meditation are repeating a mantra, prayer, taking time to focus on breathing, or reflecting on what you have read. [20] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Aspects of medication include:- Focus - Focusing on a specific object, image, or breathing can free your mind of worry and stress.
- Relaxed breathing - Slow, deep, even paced breathing increases oxygen and helps you breathe more efficiently.
- Quiet setting - This is an important aspect to meditation, especially for beginners, so that you have fewer distractions.
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Expert Q&A
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QuestionIs it normal to feel like out of it and not here when tapering off Zoloft and like confused?Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.Sometimes confusion can be a problem. Talk to your doctor or psychiatrist to see if he/she wants to adjust the taper.
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QuestionWill it reduce the strength of the drug if break a pill in half?Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.Yes. You will get half the dose.
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Tips
- It is imperative to get proper sleep while withdrawing from Zoloft, as one uncommon, yet highly disturbing, side effect is wake dreaming.Thanks
- Report any symptoms of racing thoughts or sleeplessness after starting Zoloft right away, as these can be indicative of bipolar disorder.Thanks
- Some people tolerate discontinuation of SSRI's better than others. You may want to talk to your doctor about the oral version of the drug, which allows you to step down your dosage more gradually.Thanks
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Warnings
- Stop taking Zoloft and contact your doctor immediately if you begin experiencing any of the serious side effects associated with the medication, especially if you begin having thoughts related to suicide.Thanks
- This article offers medical information; however, it should not be taken as medical advice.Thanks
- You should always talk to your doctor before stopping a substance or medication. [21] X Expert Source Tiffany Douglass, MA
Substance Abuse Treatment Specialist Expert Interview. 10 March 2020.Thanks - Some reasons you should not discontinue Zoloft include:
- If you have recently (past couple months) started Zoloft, your depression has lifted, and you feel that you no longer need the medication
- If you don’t want to take an antidepressant or medication for reasons not listed above when your depression is still uncontrolled
- If you want to switch medications when it is not due to side effects or ineffectiveness
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References
- ↑ http://www.health.harvard.edu/diseases-and-conditions/how-to-taper-off-your-antidepressant
- ↑ http://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ http://www.health.harvard.edu/diseases-and-conditions/how-to-taper-off-your-antidepressant
- ↑ http://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ http://www.aafp.org/afp/2006/0801/p449.html
- ↑ https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
- ↑ https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
- ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 3 January 2019.
- ↑ http://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495
- ↑ https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
- ↑ http://sleepfoundation.org/ask-the-expert/sleep-hygiene
- ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 3 January 2019.
- ↑ http://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ http://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml
- ↑ http://www.mayoclinic.org/tests-procedures/psychotherapy/basics/what-you-can-expect/prc-20013335
- ↑ https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf
- ↑ Liana Georgoulis, PsyD. Licensed Psychologist. Expert Interview. 3 January 2019.
- ↑ http://www.hopkinsmedicine.org/news/media/releases/meditation_for_anxiety_and_depression
- ↑ http://www.mayoclinic.org/tests-procedures/meditation/in-depth/meditation/art-20045858?pg=2
- ↑ Tiffany Douglass, MA. Substance Abuse Treatment Specialist. Expert Interview. 10 March 2020.
About This Article
Article Summary
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To stop taking Zoloft, start by taking to your doctor about your reasons for stopping and the best way to go about it. If your doctor recommends tapering off, follow their schedule to safely decrease your dosage, which could take several weeks or months to complete. Additionally, include positive lifestyle changes to combat any symptoms of depression, such as exercising regularly. You'll also want to eat a diet high in omega-3 fatty acids, which can be found in kale, walnuts, and flaxseeds. To learn how acupuncture can help lift your mood as you taper off Zoloft, keep reading!
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