Zoloft | Usage | Side Effects & Dosage

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WHAT IS ZOLOFT?

With different depression and anxiety medications available as prescription pills, it is important to know how they function. Zoloft is one of the most common medications for anxiety and mood disorders. Due to the challenging symptoms of anxiety, it is imperative to opt for the right treatment method, including antidepressants like Zoloft. ¹

Zoloft is a brand name for the generic name sertraline hydrochloride. It is an approved medication for treating social anxiety disorder, a type of anxiety disorder. It helps individuals improve from the previous irrational fear of judgment or self-humiliation symptoms.

IS ZOLOFT AN SSRI?

As a selective serotonin reuptake inhibitor, the drug functions by slow reabsorption of serotonin. Note that serotonin is a neurotransmitter that plays an important role in mood regulation and anxiety. It helps treat various health conditions, including major depressive disorder, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD).

How Does Zoloft Make You Feel?

An appropriate dosage of the medication makes people feel less anxious or fearful. It also reduces the urge for compulsive behaviors. In addition, the antidepressant helps improve overall sleep quality, energy levels, and unwanted thoughts.

Since the drug may make individuals experience headaches, fatigue, and nausea during the first week, doctors may initially prescribe low doses. It is advisable to increase the dosage with time, based on the health professional’s advice.

Does Zoloft Work for Anxiety?

Zoloft is an approved antidepressant for the treatment of social anxiety disorder. In some cases, it is also suitable for treating generalized anxiety disorder (GAD). Compared to some other types of antidepressants, using Zoloft for anxiety works, and it typically improves symptoms of different types of anxiety disorders.

Since the medication does not work immediately, you must continue intake until symptoms improve. It takes between two to six weeks for anxiety symptoms to improve in individuals using the medication.

ZOLOFT DOSAGE, USES, AND WITHDRAWAL

When using the medication, it is imperative to follow the appropriate dosage for the appropriate results. Understanding the uses of the antidepressants and withdrawal effects of the condition is also imperative. Here’s what to know:

Zoloft Uses

Among other uses of sertraline, it can help treat depression, panic attacks, obsessive-compulsive disorder, and social anxiety disorder is common. It also helps improve one’s mood, sleep, energy levels, and appetite. With the right dosage, it can restore interest in certain activities. It may aid in decreasing unwanted thoughts, fear, panic attacks, and anxiety.

Other common mental health conditions that the medication may treat include premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder, and in some cases, eating disorders.

Zoloft Dosage

The appropriate Zoloft dosage depends on the mental health condition to treat. However, the best time of the day to take Zoloft for anxiety is either morning or night. Here are the different dosages of Zoloft for anxiety and other disorders:¹

• Panic disorder and post-traumatic stress: Is 25mg enough for anxiety? The initial Zoloft dosage is 25mg orally every day (once a day) for panic disorder and post-traumatic stress. After a week, the dosage should increase to 50mg orally every day (once a day). The maintenance dose falls between 50mg to 200mg orally every day (once a day).
• Premenstrual Dysphoric Disorder: The dosage falls into two different categories; the continuous and the cyclic regimen. For the continuous, the initial dose is 50mg a day during menstruation, while the maintenance dose is between 50mg to 150mg once a day orally during the cycle.For the cyclic regimen, individuals take 50mg of the medication orally every day (fourteen days before the start of menstruation down to the first full day of the cycle). With each new cycle, the same dosage applies. The maintenance dose is between 50mg to 100mg orally every day.
• Adult Obsessive-Compulsive Disorder: The appropriate Zoloft dosage for anxiety follows an initial dose of 50mg orally daily, while the maintenance dose is between 50mg to 200mg orally every day.
• Pediatric Obsessive-Compulsive Disorder: For children within the ages of six to twelve years, the initial dose of the medication should be 25mg orally once every day. The maintenance dose should be between 25mg to 200mg orally once every day. Older children between the ages of thirteen and seventeen should take an initial dose of 50mg orally once a day. The maintenance dose should be 50mg to 200mg orally daily.

Zoloft Withdrawal

An abrupt stop in the usage of sertraline results in various withdrawal symptoms, which is also the “discontinuation syndrome.” Chances of developing a withdrawal symptom due to the drug may relate to its half-life.

Half-life means the period it takes for the body to metabolize 50% of a medication’s active elements and flush them from the body. Most withdrawal symptoms of Zoloft fall within three to six weeks.

Some of the common Zoloft withdrawal symptoms:

• Nausea

• Irritability

• Dizziness

• Vomiting

• Headache

Common Side Effects

Side effects of sertraline may range from mild to severe, depending on dosage and sometimes age. If any side effects are frequent and severe, speak to the doctor for immediate help.

Note that for some Zoloft side effects first week experiences, individuals do not feel them for long. According to health experts, Zoloft weight gain may be inevitable as up to 25% of people who take antidepressants increased in weight.²

Here are the different categories of the Zoloft side effects in women and men:

Short-term Effects

Some of the prevalent side effects of Zoloft among young adults and older individuals include:

• Nausea

• Drowsiness

• Low appetite

• Sweating

• Insomnia

• Dizziness

• Diarrhea

Serious Effects

Severe side effects of Zoloft include:

• Persistent vomiting
• Seizures
• Abdominal pain
• Changes in stool or urine
• Tremors
• Suicidal thoughts
• Yellowing of the skin or eyes
• Nervousness
• Agitation

Sexual Side Effects

Zoloft causes sexual side effects that may require changing dosage plans or opting for an alternative medication. Here are the common Zoloft sexual side effects sexually:

PRECAUTIONS AND WARNINGS

Most doctors prescribe lower dosages from the start and increase later. In most cases, it should take up to a week before increasing the dose. Speak to a licensed doctor to know the appropriate dosage increase to follow.

Any dosage above the recommended 50mg to 200 mg of use is too high and can result in severe side effects. According to credible Zoloft for anxiety reviews, overdosing on the medication may cause nausea, lethargy, and tremor.

Before using a medication like sertraline, speak to the doctor about past medical history, especially relating to liver disease, thyroid disease, or any family history of glaucoma. The drug may result in QT prolongation, which causes a fast or irregular heartbeat.

Most liquid forms of the sertraline brand contain alcohol. For this reason, individuals with diabetes, alcohol dependence, or liver disease should speak to the doctor. Even though the medication is safer for pregnant women compared to other antidepressants, it’s imperative to use it when only required.

As a pregnant woman, the doctor may advise some alternatives to the medication, which include talk therapy or lifestyle changes.

Zoloft Interactions with Other Drugs

While taking the medication, it’s unadvisable to consume alcohol. Combining the antidepressant with alcohol will make someone feel very drowsy, which is dangerous. Mixing both substances also raises the risk of developing other unpleasant side effects of the drug. Individuals may observe increased signs of anxiety, nausea, depression, headaches, and drowsiness.

The US Food and Drug Law Administration advises avoidance of alcohol when using the sertraline brand.³

Other drugs to avoid interaction of the sertraline with include:

• Fentanyl
• Antipsychotic medications
• Monoamine oxidase inhibitors
• Certain serotonin reuptake inhibitors
• Non-steroidal inflammatory drugs (NSAIDs)
• Lithium
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Storage and Handling

It’s important to store the drug in its original container at room temperature. Similar to typical medications, it should be away from heat and moisture and also out of the reach of children. Do not share the medication with other people, even when they display any symptoms of anxiety.

Risks for Taking Zoloft for Long Periods

The risks of taking sertraline are low when managed for that long period of time. Most antidepressants have long-term risks of sexual problems, weight gain, emotional numbness, reduced positive feelings, and feelings of addiction.⁴

What Should I Avoid When Taking Zoloft?

It’s vital to avoid any substance, food, or drink that may cause a bad interaction affecting Zoloft and anxiety treatment. Besides alcohol, some other major foods or drinks to avoid are chocolate and caffeine-containing food items. Combining those with sertraline may result in high fever, nausea, trembling, sweating, and agitation.

ZOLOFT PROS AND CONS

As an antidepressant, the benefits of using Zoloft are evident. However, there are a few downsides to the medication from Zoloft reviews. Here are the pros and cons relating to Zoloft and anxiety:

PATIENT TIPS AND MEDICATION GUIDE

If you are experiencing any feelings of intense and unwanted symptoms of anxiety, consult the doctor to avoid self-medication. While taking the antidepressant, it is imperative to avoid consuming illicit drugs and alcohol. It is also important to stay mindful of any changes to the body within six to eight weeks of starting the medication.

Zoloft for anxiety; Dosages, interactions, and more

Zoloft for anxiety | Dosage | How long does it take Zoloft to start working? | Side effects | Warnings | Interactions | Alternatives

Living with anxiety can make daily life difficult. Fortunately, there are many treatment options available for anxiety that can help people find relief from their symptoms. Zoloft is one medication that may help. In this guide, we’ll explain to you what Zoloft is and how to take it for anxiety.

Taking Zoloft for anxiety

Anxiety is a prevalent condition that affects people all over the world. An estimated 31% of all adults will experience an anxiety disorder at some point in their life, and SingleCare’s anxiety survey found that 62% of respondents experienced some degree of anxiety. Zoloft is the brand name of a generic medication called sertraline. It’s a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) that treats anxiety by slowing down the reabsorption of serotonin. Zoloft treats several mental health conditions:  

• Social anxiety disorder
• Panic disorder
• Depression (also known as major depressive disorder) 
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Premenstrual dysphoric disorder

Zoloft may treat anxiety if psychological treatments, like cognitive behavioral therapy, aren’t working or if your healthcare professional/psychiatrist thinks it will improve your quality of life in combination with other methods like therapy.  

What’s the right Zoloft dosage for anxiety?

The right dosage of Zoloft for anxiety varies by the severity of anxiety and whether the patient has other medical conditions. In general, though, the initial therapeutic dosage of Zoloft for anxiety is 25 mg or 50 mg per day.  

Zoloft tablets are available in three dosage strengths: 25 mg, 50 mg, and 100 mg. The maximum dose of Zoloft is 200 mg per day (which can be taken as two 100 mg tablets).   

Most studies suggest that the most effective dose of Zoloft is 50 mg per day. This dose is proven to be the most effective and tolerable dose for most patients. People who don’t respond to 50 mg per day may be advised by their doctor to increase their dose of Zoloft by 50 mg per day at weekly intervals to a maximum of 200 mg per day. For example, a doctor might recommend taking 50 mg daily for one week, then 100 mg daily for one week, etc. Always follow your healthcare provider’s instructions for use—and only change doses under the guidance and direction of your provider. Do not initiate dosage changes on your own. 

Zoloft is also available in liquid form as an oral solution. The oral solution comes as a clear, colorless solution with a menthol scent that contains 20 mg of sertraline per mL, at 12% alcohol. It comes in a 60 mL bottle with a calibrated dropper with 25 mg and 50 mg measuring marks. Zoloft oral solution must be mixed (just before taking) into 4 ounces (one-half cup) of water, orange juice, lemonade, ginger ale, or lemon or lime soda before consumption.   

Always follow your healthcare provider’s instructions for use and do not change the dose of Zoloft on your own. Symptoms of a Zoloft overdose may include seizures, coma, heart problems, high blood pressure, and serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition that can occur from the buildup of excess serotonin and requires emergency medical attention. If you think you overdosed on Zoloft, you can call Poison Control at 1-800-222-1222, but if your symptoms seem severe or life-threatening, you should call 911 and go directly to the emergency room.  

When does Zoloft start working for anxiety?

Zoloft doesn’t work immediately, so don’t stop taking Zoloft if your symptoms don’t improve right away. It takes two to six weeks to start reducing anxiety symptoms. Some people may feel a reduction in their anxiety symptoms within the first week of taking Zoloft, but this shouldn’t be expected for everyone. 

How does Zoloft make you feel?

According to the National Alliance on Mental Illness, some of the earliest signs that Zoloft is working are improvements in sleep, energy, or appetite. These improvements could happen one to two weeks into taking the medication. 

More significant changes, like feeling less depressed or regaining interest in daily life, may take six to eight weeks to occur. Over time, many people will notice a substantial difference in their anxiety symptoms, and some people may eventually have no symptoms at all.

Side effects

Here are the most common side effects of Zoloft you may experience when you start taking it: 

• Dizziness 
• Loss of appetite
• Lightheadedness 
• Dry mouth
• Nausea
• Diarrhea
• Increased sweating
• Restlessness
• Sexual side effects like sexual dysfunction
• Fatigue
• Trouble sleeping
• Nervousness 

Some side effects may be more noticeable at first, but then disappear as your body gets used to the medicine.  

Sexual side effects

Sometimes, individuals who take an antidepressant like Zoloft may experience sexual side effects. In men, symptoms may include delayed ejaculation, decreased sex drive, and/or problems getting or maintaining an erection—and in women, decreased sex drive and problems having an orgasm. Patients who are experiencing sexual side effects should consult their healthcare provider. Although it may feel uncomfortable to talk about these issues with your prescriber, it is very common and there are solutions available. 

Serious side effects

Although it’s rare, Zoloft may cause more serious side effects like unusual weight loss, low sodium blood levels, increased risk of bleeding (especially when combined with certain drugs like blood thinners or NSAIDs), seizures, and serious allergic or skin reactions. 

Serious allergic or skin reactions

While rare, having a serious allergic or skin reaction can be life-threatening and cause death. People with symptoms of an allergic reaction (hives, difficulty breathing, swelling of the face, lips, tongue, or throat) should get emergency medical help right away. Likewise, those with symptoms of a serious skin reaction (hives, blistering or peeling skin, red or purple rash, fever, burning eyes, sore throat) should seek emergency medical attention. 

Increased risk of bleeding

SSRI drugs, including Zoloft, can increase the risk of bleeding (which may range from mild to life-threatening), especially when taken with certain other medications. Examples of these medicines include:

• Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as Celebrex (celecoxib), Mobic (meloxicam), or Motrin (ibuprofen)
• Anticoagulants such as Coumadin (warfarin)
• Antiplatelet drugs such as Plavix (clopidogrel)

Patients should discuss all the drugs they take with their healthcare professionals before taking Zoloft. This includes prescription and OTC drugs, vitamins, and supplements.

Warnings

Zoloft also comes with a black box warning for suicidal thoughts and behaviors. A black box, or boxed, warning, is the strongest warning required by the US Food and Drug Administration (FDA). Short-term studies have shown that antidepressants increased the risk of suicidality in children, adolescents, and young adults compared to a placebo. However, people of any age who take Zoloft should be monitored, so seek medical advice right away if you’re taking Zoloft and start to have mood changes and/or suicidal thoughts or behaviors.

Contraindications

Zoloft is not safe for everyone. Zoloft should not be used in:

• People who are allergic to sertraline or any SSRI medication such as Paxil (paroxetine), Prozac (fluoxetine), or Lexapro (escitalopram)
• People who have taken an MAOI drug in the last 14 days
• People with moderate to severe liver problems (Child-Pugh Class B-C)

Additionally, Zoloft should never be stopped abruptly (with few exceptions, such as in the event of a life-threatening reaction). When it is time to stop taking Zoloft, the healthcare professional will provide a tapering schedule so that the medication is stopped safely and slowly, over a period of time. Stopping Zoloft abruptly can cause withdrawal symptoms such as nausea, sweating, vertigo, shock sensations, confusion, sleep problems, and seizures. 

There are also certain instances when Zoloft may be used with caution and close monitoring. Before taking Zoloft, tell your prescriber about all of the medications you take and all of your medical conditions, especially if you:

• Consume alcohol
• Are at risk of bleeding
• Have liver problems
• Have mental health conditions or a history of mental health conditions
• Have glaucoma
• Have electrolyte abnormalities
• Have (or have a history of) heart or heart rhythm problems 
• Have a history of seizures 

Interactions

Talk to your doctor about how to take Zoloft if you’re taking any of the following medications:

• Other medications that increase serotonin because of the risk of serotonin syndrome (such as other antidepressants, opioid pain medications, muscle relaxants, cough suppressants, or migraine medications in the triptan drug class)
• Disulfiram
• Blood thinners such as warfarin 
• NSAIDs such as ibuprofen 
• St. John’s Wort 
• Lithium 
• Nardil (phenelzine) 
• Parnate (tranylcypromine) 
• Marplan (isocarboxazid) 
• Azilect (rasagiline) 
• Emsam (selegiline)
• Orap (pimozide) 

Zoloft taken with monoamine oxidase inhibitors (MAOIs) or other drugs that increase serotonin (such as other antidepressants, triptans, and dextromethorphan which is found in cough and cold products) could cause serotonin syndrome, a life-threatening emergency that can cause hallucinations, seizures, comas, tremors, delirium, and other serious side effects.   

RELATED: Is it safe to take anti-anxiety medication with alcohol?

What is the most effective antidepressant for anxiety?

There is no single antidepressant that’s best for treating anxiety. What works for one person may not work for another. Depression symptoms will completely go away for about 1 out of every 3 people who take SSRIs, but more research still needs to be done on why SSRIs work for some people and not for others. Your healthcare provider is the best person to ask which antidepressant will be most effective for you.  

“Other SSRI medications can be effective for anxiety such as Prozac or Celexa or Paxil, yet each has some side effects—notably lowered libido and weight gain,” says Uma Naidoo, MD, a psychiatrist at Mass General Hospital in Boston. “Benzodiazepines are very effective in the short term while under the care of a doctor, but these are potentially addicting medications and must be used with immense caution and only as a short-term measure, e.g., grief following the death of a family member,” says Dr. Naidoo. Benzodiazepines are controlled substances, and have the potential for abuse and dependence, and include drugs such as Klonopin (clonazepam) and Xanax (alprazolam). 

As mentioned earlier, your healthcare provider is the best person to ask about how to treat anxiety. Medications can be effective in treating anxiety, but Dr. Naidoo says you may have other options as well. Some additional ways to combat anxiety, in combination with your prescription medication, may include:

• Talk therapy: Patients with anxiety can benefit from regular sessions with a therapist.
• Physical exercise: Regular physical exercise (as approved by your doctor) can be helpful to many people, improving symptoms of anxiety and helping you sleep better, in addition to improving overall health. Talk to your doctor about an exercise plan that is appropriate for you. 
• Mindfulness and breathing exercises: Mindfulness can help people focus on the present and help reduce anxiety and depression. 
• Dietary changes: Eating regular, healthy meals will help keep your blood sugar steady, avoiding that jittery feeling from low blood sugar, which may add to anxiety. A registered dietician is often covered by insurance and can be a very helpful resource in instituting dietary changes. 

Your physician can help you come up with a treatment plan that will fit well into your life.   

When to see a doctor

If you are experiencing anxiety that is interfering with your quality of life, do not hesitate to seek treatment. Start with your primary care provider, who can often recommend some lifestyle changes, start you on a medication, and/or provide recommendations for a therapist. You will be on your way to feeling better soon, and you will be glad you reached out for help. 

Zoloft for Anxiety: Is Zoloft Good for Anxiety? When does he start working? – Product Information

Home >> Product Information >> Zoloft for Anxiety: Is Zoloft Good for Anxiety? When does he start working?

Product information

Living with anxiety can make daily life difficult. Fortunately, there are many anxiety treatment options that can help people manage their symptoms. Zoloft is one of the medicines that can help. In this guide, we will explain to you what Zoloft is and how to take it for anxiety.

Taking Zoloft for anxiety

Anxiety is a common condition that affects people all over the world. An estimated 31% of all adults will experience an anxiety disorder at some point in their lives, and the SingleCare Anxiety Survey 2020 found that 62% of respondents experienced some degree of anxiety. Zoloft is the brand name for a generic drug called sertraline. This is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) that treats anxiety by slowing the reabsorption of serotonin. Zoloft Treats Several Mental Illnesses:

• Social anxiety disorder
• Panic disorder
• Depression
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD) )
• Premenstrual dysphoric disorder

Zoloft can treat anxiety if psychological treatments, such as cognitive behavioral therapy do not work or if the psychiatrist believes they will improve the person’s quality of life. SSRIs like Zoloft are not always the best treatment for anxiety as they can make anxiety worse in some cases. People with mild or occasional anxiety should talk to their doctor about other anxiety medications before taking Zoloft.

What is the correct dosage of Zoloft for anxiety?

The correct dosage of Zoloft for anxiety depends on the degree of anxiety and the presence of other diseases in the patient. However, in general, the initial therapeutic dosage of Zoloft for anxiety is 25 mg or 50 mg per day.

Zoloft tablets are available in three strengths: 25 mg, 50 mg and 100 mg. The maximum dose of Zoloft is 200 mg per day (which can be taken as two 100 mg tablets).

Most studies suggest that the most effective dose of Zoloft is 50 mg per day. This dose has been proven to be the most effective and tolerated for most patients. For people who do not respond to 50 mg per day, the doctor may advise increasing the dose of Zoloft by 50 mg per day at weekly intervals up to a maximum of 200 mg per day. For example, a doctor may recommend taking 50 mg per day for one week, then 100 mg per day for one week, etc.

Zoloft is also available in liquid form as an oral solution. The oral solution is a clear, colorless solution with a menthol odor that contains 20 mg sertraline per ml at 12% alcohol. Supplied in a 60 ml vial with a calibrated pipette with 25 mg and 50 mg graduations. Zoloft Oral Solution must be mixed (immediately before use) with 4 ounces of water, orange juice, lemonade, ginger ale, lemon, or lemon soda before drinking.

When does Zoloft start to deal with anxiety?

Zoloft does not work immediately, so do not stop taking Zoloft if your symptoms do not improve immediately. It takes two to six weeks to start reducing anxiety symptoms. Some people may experience a reduction in anxiety symptoms within the first week of taking Zoloft, but this should not be expected for everyone.

How do you feel about Zoloft?

According to the National Alliance on Mental Illness, some of the first signs that Zoloft is working are improved sleep, energy, or appetite. These improvements may occur one to two weeks after taking the medication.

More significant changes, such as reduction in depression or restoration of interest in daily life, may take six to eight weeks. Over time, many people will notice a significant difference in their anxiety symptoms, and for some, the symptoms may not go away at all.

Side effects

Here are the most common side effects you may experience when you start taking Zoloft:

• Headache
• Dizziness
• Loss of appetite
• Lightheadedness
• Dry mouth
• Nausea
• Diarrhea
• Increased sweating restlessness
• Sexual side effects such as sexual dysfunction
• Fatigue
• Sleep problems
• Nervousness

Although rare, Zoloft may cause more serious side effects such as unusual weight loss, low blood sodium levels, increased risk of bleeding (especially when combined with certain medications such as anticoagulants or NSAIDs), seizures, allergic reactions, and withdrawal symptoms.

Warnings

Zoloft also contains a black box warning about suicidal thoughts and behavior. Short-term studies have shown that antidepressants increase the risk of suicidality in children, adolescents, and young adults compared to placebo. / or suicidal thoughts or behavior.

The FDA also cautions patients against taking sertraline (Zoloft) if they are pregnant, nursing, have pre-existing vision problems (sertraline makes patients more susceptible to developing glaucoma), and patients with bipolar disorder who are also not taking mood stabilizers.

Interactions

Talk to your doctor about taking Zoloft if you are taking any of the following medicines:

• Other medicines that increase serotonin levels due to the risk of serotonin syndrome
• Disulfiram
• Triptans ibuprofen
• St. John’s wort
• Lithium
• Nardil (phenelzine)
• Parnate (tranylcypromine)
• Marplan (isocarboxazid)
• Azilect (rasagiline)
• Emsam (selegiline)
• Orap (pimozide)

Zoloft taken with monoamine oxidase inhibitors (MAOIs) or other drugs that increase serotonin levels (such as other antidepressants, triptans, and dextromethorphan found in cough and cold products) can cause serotonin syndrome, a life-threatening emergency, which can cause hallucinations, convulsions, coma, tremors, delirium and other serious side effects.

What is the most effective antidepressant for anxiety?

There is no single antidepressant that best treats anxiety. What works for one person may not work for another. Depressive symptoms will disappear completely in about 1 out of every 3 people who take SSRIs, but more research is needed to find out why SSRIs work for some people and not for others. Your healthcare provider will best ask you which antidepressant will work best for you.

Other SSRIs may be effective for anxiety, such as Prozac, Celexa, or Paxil, but each has some side effects, such as decreased libido and weight gain, says Odin Naidoo, M.D., a psychiatrist at Massachusetts General Hospital in Boston. “Benzodiazepines are very effective in the short term as long as they are under medical supervision, but they are potentially addictive and should be used with great caution and only as a short-term intervention, such as grief following the death of a family member,” he says. Dr. Naidu.

commonly prescribed for depression, but doctors also may prescribe it to relieve symptoms of anxiety.

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As mentioned earlier, your PCP is the best person to ask about how to treat your anxiety. Medications can be effective in treating anxiety, but Dr. Naidu says you may have other options. She mentions dietary changes, mindfulness, breathing exercises, and exercise as additional ways to combat anxiety. Your doctor can help you create a treatment plan that fits well with your life.

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Medicine and health

Ekaterina Kushnir

treats anxiety disorder

I have generalized anxiety disorder.

For a long time I coped without pills and other help, but one day I got tired of constant anxiety and began to interfere with my normal life. As a result, I turned to a private psychiatrist.

The doctor prescribed an antidepressant from the SSRI group – these are selective serotonin reuptake inhibitors. Such drugs are the first thing prescribed in the treatment of depression and a number of other conditions, including my illness.

The doctor immediately warned me about some peculiarities associated with taking the drug. Some of them I then felt on myself. I think everyone who plans to be treated with antidepressants should know about them.

At the same time, it should be taken into account that most of the negative effects of therapy are temporary and not dangerous, and if they do not go away, one medicine can be replaced with another. Antidepressants help many people with mental disorders and other illnesses get rid of their symptoms and return to a full life, so you definitely should not be afraid of them. The main thing is to take such drugs when they are really needed: as prescribed by a competent doctor and under his control.

See a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we give recommendations. Relying on our point of view or not is up to you.

Fact No. 1

Antidepressants may make symptoms worse at first

Antidepressants can increase anxiety in anxiety disorders, as well as cause irritability and agitation – the so-called causeless motor agitation, the inability to sit still. It’s not dangerous, but rather unpleasant. This condition is sometimes referred to as initial anxiety, that is, the anxiety of starting therapy. Up to 65% of people face it.

Antidepressant-induced anxiety syndrome – a systematic review in the British Journal of Psychiatry

There is also evidence that some classes of antidepressants, including SSRIs, may increase suicidal ideation in depression in young people aged 18 to 24 years. These data are not very reliable, and in older people, the risk of suicide no longer increases and even decreases.

Without treatment, depression is more likely to lead to suicidal thoughts, and in case of anxiety, you just need to prepare for such an effect, then it will be easier to survive the attacks.

The doctor told me that in the first two or three weeks there may be an increase in anxiety, but I did not take it too seriously.

Everything was fine for the first week. After about seven days, I became nervous and irritable. And then I woke up at night and after a while I felt an incomprehensible fear. My heartbeat increased, my head was spinning, my throat was constricted. Because of this, I felt a real panic – I spent the rest of the night fighting terrible thoughts, in the morning I got up completely broken.

8 myths about antidepressants

I have never had such panic attacks before medication — my anxiety was background, general. I got scared and wrote to the doctor, who reassured me and said that it was not dangerous and would pass soon.

After that, I was already waiting for these panic attacks, immediately tried to relax, calm down, remember that this was just a temporary effect of drugs. And they ended faster, and then they completely disappeared.

My letter to a psychiatrist. I was scared: I expected an increase in background anxiety, but not panic attacks. I even thought about giving up the medicine

Fact No. 2

The effect of antidepressant treatment will not be immediate

Increase the dose of antidepressants gradually to reduce side effects. They usually start with the minimum, and then bring it up to the working one. For example, for SSRIs with the active ingredient “sertraline”, the working dose is from 100 mg per day. I started taking such a drug with 25 mg, and then gradually, in several steps, under the supervision of a doctor, raised the dose to 100 mg.

SSRI dosage – NHS

What doses of antidepressants will be optimal – an article in The Lancet

The process of reaching a working dose can take from two weeks to a month or more. It depends on the drug and its tolerance. I turned out to be sensitive to the medicine, it was hard for me to survive every increase in dosage: anxiety increased again, there were other side effects that then stopped. However, this is not the case for everyone, sometimes the process goes faster.

The full therapeutic effect, that is, the disappearance or a strong improvement in the symptoms of the disease, occurs some time after reaching the working dosage. As a rule, this is a week or two, although some positive changes may be earlier. For some people, this process stretches for a longer period: 6-12 weeks. Minimum initial doses of drugs usually do not work.

It is better to prepare for the fact that the symptoms of the disease will not disappear in the first weeks of treatment. And remember – this does not always mean that the drug needs to be changed, sometimes you just need to wait or further increase the dosage under the supervision of a doctor.

Fact No. 3

Antidepressants are usually taken in combination with other drugs

Another way to mitigate the side effects of antidepressants is to prescribe an additional drug along with them: for example, from the group of tranquilizers. Such drugs may have their own side effects, they should not be taken for a long time. Unlike antidepressants, some of them can be addictive. They are usually appointed for a month, but this period may be shorter or longer.

Antidepressants together with benzodiazepines work better for depression – BMJ magazine

My doctor prescribed a rather mild drug. However, he did not suit me. At first, it caused increased drowsiness: during the period of increased anxiety, it went away for a while, but then returned – even with half a pill I turned off and could sleep all day. And if I drank at night, I woke up with difficulty in the morning. The psychiatrist prescribed another medicine, but I could not buy it: the drug was not available in any pharmacy nearby.

As a result, I simply endured all the side effects of therapy – they were unpleasant, but tolerable. When discussing with the doctor, she called this option acceptable if the side effects of the second medicine only worsen the situation.

My prescriptions for drugs. I never used one, because there was no such medicine in pharmacies

Fact No. 4

Side effects are not always, but they are

Modern antidepressants, including SSRIs, are mild and have almost no side effects. Older drugs – tricyclic antidepressants and monoamine oxidase inhibitors – cause more side effects. Doctors usually use them when milder first-line drugs don’t work or when they can’t be prescribed.

Side effects of antidepressants – NHS

Side effects of different antidepressants – UpToDate

Side effects of antidepressants and their effect on the outcome of treatment of major depressive disorder – Nature

Selective reuptake inhibitors with erotonin – UpToDate

How to deal with side effects effects of antidepressants – advice from the Mayo Clinic staff

Choosing an SSRI drug does not guarantee the absence of side effects – many people tolerate treatment easily, but sometimes a change in drug may be necessary.

The first couple of weeks of taking there is a risk that the state of health will be so-so – it’s worth thinking about. It may be worth scheduling the start of therapy on vacation.

I work remotely, and it was easier for me: the first pill was taken on Saturday, I slept through the weekend. Then she continued to work, but refused any additional loads: housework, part-time jobs, training and everything else.

It was hard to work: I wanted to sleep, then I began to worry and get distracted. I also had diarrhea, nausea, headaches, tremors, i.e. hand trembling, hot flashes, sweating, palpitations. At night, panic attacks began, in the morning I had difficulty getting up because I was in pain and dizzy.

There are mixed data on how common side effects of antidepressants are. If we summarize them, then the numbers look something like this:

• nausea – about 25% feel it;
• diarrhea – it happens in 15% of people, and 5%, on the contrary, will have constipation;
• about 20% of people experience sweating and feeling hot;
• sexual dysfunction, decreased libido may occur in 80% of cases;
• insomnia – in 11% of cases;
• headache and dizziness – in about 10-11% of cases;
• weight gain – not all drugs give this effect. Some, on the contrary, can reduce weight. On my medicine, I lost 2 kilograms in the first month, despite the fact that I quit training due to poor health. True, then they returned back.

It can be seen that most side effects occur in less than half of the cases. In addition, in most cases they pass in the first weeks and are not dangerous.

Side effects not listed above are very rare. I was “lucky”, and I faced one such – a decrease in visual acuity. Once in the morning I noticed that I see worse without glasses. A little later, I realized that something was wrong with the glasses.

I wrote to the doctor, she replied that this happens, as a rule, is not dangerous and passes, but it is better to visit an ophthalmologist. I went to the ophthalmologist, everything was fine with my eyes, there was nothing terrible, but my vision really worsened – it was not a subjective feeling. On the right eye, it was -0.5 diopters, it became -0.75, and on the left eye it was -1. 5, and it became -3.5.

I was offered to try changing the drug, but I decided to wait. Vision was then restored. I have not yet gone to the doctor to have it measured, but according to subjective feelings, it is at the same level as before: I am comfortable again in my glasses.

Side effects should not be tolerated – if something greatly worries, scares or interferes with life, it is better to tell the doctor right away. The psychiatrist will be able to determine whether the side effect of the drug is dangerous and whether it is worth continuing to take it. There are several antidepressants of the SSRI group, in addition, there are groups of drugs with a slightly different mechanism of action. As a rule, doctors manage to find a medicine that gives a good effect without side effects.

If there is no danger, the doctor can adjust the dose or increase it more gradually – this often helps to cope with unpleasant effects.

I wrote to the doctor again when my visual acuity decreased

Fact No. 5

Antidepressants need to be taken long term

Antidepressants are not drugs that you can stop drinking as soon as you get better. They are taken for a long time: usually from several months, less often several years.

Anxiety Therapy – UpToDate

For example, for generalized anxiety disorder, the duration of treatment is at least a year. Moreover, the date is not counted from the very beginning, but from the moment when a lasting effect appeared from the pills. In fact, they will have to be drunk for about 1.5 years – it depends on how long it takes to reach the working dosage of the medicine.

The cost of a package of the most famous antidepressant “Zoloft” is about 700 R, enough for about a month. That is, a course of therapy will cost about 10,000 R – maybe more or less, depending on which drug is selected.

Psychotherapy review – UpToDate

Another drug of the same group already costs more than 2000 R per pack. Source: rigla.ru

The cost of an appointment with a good psychiatrist in Moscow is 3000-5000 R. At first, you will need to visit him about once every 1-1.5 months, then less often.

You can apply to the psycho-neurological dispensary at the place of residence under compulsory medical insurance – it’s free. At the same time, they will not put you on psychiatric registration: it was canceled in 1993. People with disorders that do not threaten their lives or those around them are on consultative and diagnostic care. If you stop going to the doctor, he will not find out what happened: a person seeks help at will.

Psychotherapy, usually cognitive-behavioral, is also commonly prescribed to enhance and sustain the effects of antidepressants. In many cases, it improves the effectiveness of drugs, including depression and generalized anxiety disorder. An appointment with a psychotherapist in Moscow costs an average of 5000 R. For treatment, you will need about 10 sessions or more.

How psychotherapy works

Fact No. 6

Antidepressants should not be stopped abruptly

Antidepressants do not develop dependence. However, if you abruptly stop drinking them, there will be a withdrawal syndrome. This is felt as electric current discharges while moving or turning the head, headaches, dizziness, insomnia. Many people experience symptoms similar to the flu or an intestinal virus: low fever, diarrhea, general malaise, chills. Often there is anxiety, there are intrusive images.

Withdrawal symptoms after taking serotonin reuptake inhibitors – Journal of Clinical Psychiatry

How difficult it is to stop antidepressants – American Psychological Association

Stopping antidepressants in adults – UpToDate

for some reason they changed their minds about taking the pills or the term has expired treatment, they should be canceled only under the supervision of a doctor.

Antidepressant withdrawal occurs as gradually as the start of treatment. The dosage is slowly reduced, usually at this time again a cover-up drug is prescribed to alleviate side effects. As a rule, this is the same medicine that was at the beginning of the intake.

Withdrawal is usually harmless and resolves within the first weeks of stopping the drug. Sometimes even within a few days – it still depends on which medicine was prescribed. If severely disturbing symptoms appear during the withdrawal period, you should consult a doctor.

Fact No. 7

If you need to change the drug, everything will start over

It is far from always possible to immediately find the right antidepressant – sometimes the side effects do not go away and you need to take a new one.

Changing antidepressants in adults – UpToDate

Serotonin syndrome – MSD

Most often, it is started again with a small dosage, this delays the process of obtaining the effect of treatment. The new drug may also have side effects – the same or different. We will have to wait again until they pass.

You won’t be able to change the drug on your own, since all antidepressants are sold only by prescription – and that’s good. Switching from one drug to another can be dangerous if you do not know the characteristics of different groups of drugs.

For example, taking SSRIs is possible only some time after the withdrawal of antidepressants from the group of monoamine oxidase inhibitors – due to the risk of developing serotonin syndrome. This is a potentially fatal condition, accompanied by a change in mental state, high fever, increased muscle tone and other symptoms.

If the drug is changed correctly, there will be no dangerous negative effects, so consultation with a doctor is required.

How to choose a psychotherapist

Fact No. 8

Among antidepressants there are original drugs and generics

Preparations may be original or generic. Originals are medicines first released by some pharmaceutical company that have passed all clinical trials and checks. Generics are drugs with the same active ingredient from another pharmaceutical company, that is, copied from the original drug.

Theoretically, the effect of generic drugs should not differ from the effect of original drugs. However, this is possible, since generics may contain other additional substances or the manufacturer may use other raw materials.

Due to my anxiety, I did not read anything in detail about specific drugs before I bought my first antidepressant in a pharmacy, so as not to be scared and not think about taking it. I also didn’t think to ask the doctor about this question.

Psychoneurological complications after covid: memory problems and depression

As a result, I first bought a generic because it was in stock. Then it turned out that, after all, according to the experience of my psychiatrist, the original drug often gives fewer side effects and is better tolerated. As a result, I changed the generic to the original drug – and, indeed, the side effects softened.

In my subjective opinion, which is supported by some data, in the case of antidepressants and other psychotropic drugs, you should always choose the original medicine. Moreover, the cost of originals and generics is not always very different.

Originals and generics of some SSRIs

Active ingredient	Original	Original cost	Generics	Cost of generics
Sertraline	Zoloft	About 700 R, 100 mg tablets	Serenata, Sirlift	500-600 R, 100 mg tablets
Escitalopram	Cipralex	3000 R, tablets 10 mg	“Selektra”, “Elycea”	500-1300 R, 10 mg tablets
Fluoxetine	Prozac	About 350 R, 20 mg tablets	Profluzak, Fluoxetine	100-200 R, tablets 20 mg

Sertraline

Original

Zoloft

Original price

About 700 R, tablets 100 mg

90 002 Generics

Serenata, Serlift

Cost of generics

500-600 R , tablets 100 mg

Escitalopram

Original

Cipralex

Original cost

3000 R, tablets 10 mg

Generics

Selektra, Elycea

Cost of generics

500-1300 R, tablets 10 mg

Fluoxetine

Original

Prozac

Original cost

About 350 R, tablets 20 mg

Generics

Profluzak, Fluoxetine

Cost of generics

100-200 R, tablets 20 mg

My pills: I bought several packs of Serenata at once, so one remained unclaimed ovannoy

Fact No. 9

Do not take alcohol along with antidepressants

Drinking alcohol while taking antidepressants may exacerbate unpleasant side effects. Also, alcohol is a depressant, that is, it has the opposite effect, and its intake can adversely affect the results of treatment.

Why you shouldn’t mix antidepressants and alcohol – Mayo Clinic

Alcohol is strictly forbidden to drink with some groups of antidepressants, for example, tricyclic antidepressants and monoamine oxidase inhibitors: combination with the latter, for example, can lead to an uncontrolled increase in pressure. MAO inhibitors in general require a special diet – it is unlikely that a doctor will prescribe such drugs as the first antidepressants, but if necessary, he will issue a list of what is allowed and prohibited.

With other antidepressants, moderate use may not be dangerous and even pass without consequences, but doctors still recommend abstaining so as not to increase side effects and improve treatment outcome.

The main thing is not to temporarily stop taking the drug in order to drink. This can lead to the development of a withdrawal syndrome.

How I Treated Generalized Anxiety Disorder under CHI

Fact No. 10

Antidepressants are incompatible with certain drugs and have contraindications

It is important to tell your doctor what medications you are taking and what chronic illnesses you have. For example, SSRIs may not be suitable for epilepsy and bleeding disorders, and tricyclic antidepressants are usually not prescribed for those who have recently had a heart attack, suffer from glaucoma, or porphyria.

Antidepressant Warnings – NHS

Drug Compatibility Test – Drugs.com

It is also important to be careful if you are about to take any over-the-counter medicine. For example, ibuprofen, which people often take on their own to relieve pain and reduce fever. It should not be taken with SSRIs as it increases the risk of gastrointestinal side effects.