Zoloft, or sertraline hydrochloride, is an antidepressant drug that belongs to the family of selective serotonin reuptake inhibitors (SSRIs). It is mostly prescribed for the treatment of depression, obsessive-compulsive disorders, post-traumatic stress disorders, panic attacks, social phobia and premenstrual dysphoria. As this medicine alters brain chemistry, its intake should not be stopped without your doctor's advice. In addition, the process should be gradual, under the supervision of the practitioner who will establish a dosage reduction schedule.
Steps
Method 1 of 2: Cut down on Zoloft
Step 1. Evaluate the reasons that lead you to stop taking it
Generally, this therapy should be continued if it proves effective in controlling the depression or disorder. However, there are valid reasons why an individual may decide to stop it or change its doses, always under the supervision of a doctor. Eg:
- In case of severe side effects.
- If Zoloft does not manage depression or disorder effectively. This means that you constantly feel sadness, anxiety or a sense of emptiness; you feel irritable, have no interest in pleasant activities or hobbies, are fatigued, unable to concentrate, sleep disturbed, suffer from insomnia, or sleep excessively; your appetite has also changed, you are thinking about suicide or experiencing physical pain and neuralgia. However, remember that Zoloft usually starts working after eight weeks and in some cases you need to increase the dosage.
- If you have been on Zoloft therapy for some time (6-12 months) and your doctor believes that you are not at risk (or do not suffer from) chronic or recurrent depression.
Step 2. Monitor all side effects
Zoloft generally includes nausea, dry mouth, weight loss, insomnia, libido changes or uncontrollable tremors among its side effects. Tell your doctor if you have any medicine-related disorders that do not go away or are very serious.
Suicidal thoughts can be very common among young adults and children; promptly inform your doctor if they show up
Step 3. Discuss with your psychiatrist
Talk about all the side effects and all the reasons that lead you to want to stop taking Zoloft. This way your doctor will be able to make an informed decision and decide whether, in your case, it is worth stopping the drug.
If you have been on treatment for less than eight weeks, your doctor will advise you to wait this time for the drug to take full effect
Step 4. Stop taking Zoloft gradually
Antidepressants need to be reduced slowly to avoid withdrawal symptoms. It may take several weeks or months to get rid of the medicine entirely, depending on the type of antidepressant, the length of time you took it, the dosage, and the symptoms you exhibit. If you suddenly stop taking the drug, then your body won't have time to adjust and you may suffer from more severe withdrawal symptoms. Among these we remember:
- Abdominal problems such as nausea, vomiting, diarrhea or cramps;
- Sleep disturbances such as nightmares and insomnia
- Difficulty with balance such as dizziness and vertigo
- Sensitivity and movement problems such as numbness, tremors, tingling, or poor coordination
- Feelings of irritability, agitation or anxiety.
Step 5. Reduce Zoloft by following your doctor's schedule
The time required to completely interrupt the therapy depends on the duration of the therapy and its posology. The psychiatrist is able to draw up the best reduction program for your specific case, minimizing related symptoms.
- One of the reduction rates is to lower the dosage by 25 mg, waiting two weeks before decreasing the amount of the drug again.
- Monitor the process by noting the dates and dose changes.
Step 6. Make a note of all symptoms
Even if you gradually reduce your Zoloft, you can still experience withdrawal problems. You also run the risk of a relapse of your disorder or depression. Document this and discuss it with your doctor.
- Withdrawal symptoms arise quickly, improve over a week or two, and have a lot of physical discomfort. To understand whether it is a relapse of the disease or a withdrawal pattern, you need to look at the type of symptoms, when they start and how long they last.
- If you are experiencing a relapse, you will notice that the symptoms develop gradually after two to three weeks and worsen over a period of 2-4 weeks. Call the psychiatrist immediately if they last longer than a month.
Step 7. Keep in touch with your doctor
After stopping the medicine, the psychiatrist will still want to see you for at least a couple of months. Communicate any relapsing problems, fears, or symptoms.
Step 8. Take any new medication strictly following medical directions
If you have decided to stop Zoloft because of its side effects or because it is unable to control your condition, then your psychiatrist may recommend another antidepressant. The type of product you will be prescribed depends on many factors, such as your personal preferences, body response, efficacy, safety, tolerance, cost, interactions with other medications, and side effects. If you find that the medicine does not control your condition or you are experiencing severe side effects, your doctor may suggest:
- An alternative selective serotonin reuptake inhibitor (SSRI), including Prozac (fluoxetine), paroxetine, citalopram and escitalopram (Cipralex).
- A serotonin-norepinephrine reuptake inhibitor (SNRI) such as Effexor (venlafaxine).
- A tricyclic antidepressant such as amitriptyline.
- A monoamine oxidase inhibitor (MAOI) that is prescribed after waiting at least five months after stopping Zoloft.
Method 2 of 2: Lifestyle Change and Alternative Therapies
Step 1. Try to train regularly
Several studies have shown that physical activity produces endorphins and increases the release of neurotransmitters which, in turn, reduce symptoms of depression. Try to work out about half an hour a day.
Step 2. Change your diet
Healthy eating improves overall well-being. In particular, Omega-3 fatty acids have proven effective against depression, if taken together with drug therapy.
- Omega-3 fatty acids are contained in certain foods such as kale, spinach, soy beans, canola oil, flax seeds, nuts and fatty fish such as salmon. They are also available in the form of supplements, typically as gelatinous fish oil capsules.
- Research has shown the benefits of omega-3 fatty acids against mood disorders at doses between 1 and 9 grams, although there is a lot of evidence to support the minimum dosage.
Step 3. Follow a regular sleep / wake pattern
Depression profoundly alters sleep, for this reason it is necessary to follow good practices to rest properly. Sleep hygiene procedures include:
- Go to bed and get up at the same time every day;
- Avoid all kinds of stimuli before bed, such as TV, exercise or computer use;
- Don't drink alcoholic or caffeinated beverages before bed
- Try to associate sleep with the bed and not read or do other work once you are in bed.
Step 4. Get some sun
There is no universally valid sun exposure time for treating symptoms of depression. However, researchers agree that some types of depression, such as seasonal ailments, may benefit from exposure to sunlight. There is also evidence that the sun affects serotonin levels.
Generally speaking, there is no upper limit for staying in the sun. Remember, however, to apply protection if you intend to be outside for more than 15 minutes
Step 5. Surround yourself with supportive people
Throughout the tapering process, you need to be in contact with the psychiatrist who will monitor your physical, emotional and withdrawal symptoms. Also involve a relative or close friend. This way you will have some moral support and the person will be able to recognize in you the first symptoms of a relapse.
Step 6. Consider psychotherapy
An analysis of several studies shows that people who underwent psychotherapy during the phase of reduction and elimination of antidepressants ran less risk of relapse into the disease. Furthermore, psychotherapy can help people with mental disorders by teaching them to manage unhealthy behaviors and thoughts. In practice, it provides patients with the tools and techniques to manage stress, anxiety, behaviors and thoughts. There are different types of psychotherapy and treatment depends on the individual, the disorder and its severity, as well as numerous other factors, such as the medications taken.
- The goal of cognitive-behavioral therapy is to teach the patient to think positively to influence behavior. The therapist helps the person recognize unnecessary mental patterns and change false beliefs, all to change behavior. Cognitive-behavioral therapy is very effective for cases of depression.
- There are also other therapies, such as the interpersonal one (which focuses on improving communication), the family one (which tries to resolve family conflicts that could affect the patient's pathology) and the psychodynamic one, whose goal is to develop in the individual self-awareness.
Step 7. Look at acupuncture
Studies have shown that it has benefits against depression. Although it is not part of the recommended treatment protocol, some patients find it helpful. It is a technique whereby fine needles are inserted into the skin in order to stimulate specific points on the body. This stimulation provides relief from symptoms. If the needles are properly sterilized, there is no reason to fear this practice.
Step 8. Evaluate Meditation
A Johns Hopkins University study suggests that half an hour of daily meditation improves symptoms of depression and anxiety. To meditate in a simple way, you can repeat mantras, a prayer, focus on the breath or reflect on a reading. Here are some aspects of this practice.
- Concentration: Focus your attention on a specific object, image or breath to clear your mind of worries and stress.
- Relaxed Breathing: Deep, slow, steady breaths increase oxygen supply and make breathing more efficient.
- Quiet Environment: This is an important detail, especially for beginners, to avoid most distractions.
Advice
- Getting adequate sleep is imperative while you are trying to get over your Zoloft withdrawal crisis, as a very serious, albeit rare, side effect is sleep disturbance such as lucid dreaming.
- Tell your doctor if you have symptoms of racing thoughts or insomnia soon after starting Zoloft therapy, as these could be signs of bipolar disorder.
- Some people tolerate stopping non-tricyclic antidepressants better than others. Ask your doctor for advice on the oral version of the medicine, as this gives you more control over the dosage and can set a gradual withdrawal.
Warnings
- Stop taking Zoloft and call your doctor right away if you start experiencing any serious side effects, especially if you are having thoughts of suicide.
- This article is for informational purposes only and does not replace medical advice. Before modifying or discontinuing any drug therapy you should always contact your doctor.
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You shouldn't stop taking Zoloft:
- If you started treatment recently (in the previous two months), your depression has improved and you feel like you no longer need the drug.
- If you don't want to take an antidepressant or drug for reasons that haven't been described before, but your depression is still out of control.
- If you want to change medicines, even if the current ones are effective and show no side effects.
