Does Zoloft (sertraline) cause weight gain?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 26, 2022.

Zoloft (sertraline) may lead to a small weight gain ranging from 1% to 1.6% of initial body weight when used over 6 months to 1 year. For example, in a 150 lb (68 kg) person, this would equal an added 1.5 to 2.4 lbs (0.7 to 1.1 kg) of weight. Shorter-term treatment in adults usually does not lead to substantial weight gain, but most patients need to take Zoloft for an extended period of time.

In children, weight loss has been reported with Zoloft possibly due to side effects like nausea or loss of appetite. In 281 children treated with Zoloft, at least 2% reported decreased weight, at a rate that was twice that of placebo (an inactive pill).

Zoloft is a selective serotonin reuptake inhibitor (SSRI) approved to treat

• Depression
• Obsessive-compulsive disorder
• Panic disorder
• Post-traumatic stress disorder
• Social anxiety disorder
• Premenstrual dysphoric disorder

How does weight gain with Zoloft compare to other SSRIs?

Of the SSRIs, Zoloft (sertraline) and Prozac (fluoxetine) appear to cause the least amount of weight gain.

Weight gain with SSRI treatment can vary. In general, weight gain is ranked:

• lowest with fluoxetine
• slightly higher with sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro) and fluvoxamine (Luvox)
• highest with paroxetine (Paxil).

In a 26 to 32 week double-blind study, 284 patients with major depressive disorder were randomly assigned to long-term treatment with fluoxetine (Prozac), sertraline (Zoloft), or paroxetine (Paxil).

• Of the three SSRIs, paroxetine-treated patients had a significant weight gain, sertraline-treated patients had a modest but nonsignificant weight gain, and those receiving fluoxetine had a nonsignificant weight loss.
• The number of patients whose weight increased 7% or more from the start of the study was significantly greater for paroxetine-treated patients than for those receiving either fluoxetine or sertraline.

In another 2.5 year open-label study of 138 patients treated for obsessive-compulsive disorder (OCD), weight changes were assessed for several SSRIs (citalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline), as well as the tricyclic antidepressant (TCA) clomipramine.

• In all groups except fluoxetine, a significant weight gain was reported. Clomipramine (a TCA) was associated with the greatest weight gain. TCAs are well known to cause more weight gain than SSRIs.
• Of the SSRIs, fluoxetine (Prozac) and sertraline (Zoloft) had the lowest weight gain.
• Zoloft and Prozac also had the lowest percentage of patients with a weight gain of 7% or more over their initial body weight (4.5% for Zoloft and 8.7% for Prozac).

Do all antidepressants cause weight gain?

Treatment with antidepressants and selective serotonin reuptake inhibitors (SSRIs) in general tend to cause weight gain with long-term treatment (more than one year). Overall weight changes depend upon which antidepressant you use. Most antidepressants lead to only modest weight gain which can be addressed with diet and exercise.

• Older antidepressants like the tricyclic antidepressants (TCAs), for example amitriptyline or doxepin, cause more weight gain than the SSRIs but are infrequently prescribed today for depression.
• Mirtazapine (Remeron), a tetracyclic antidepressant, is known to be associated with significant weight gain. In studies, appetite increase was reported in 17% of patients treated with Remeron, and 7.5% of patients had a weight gain of at least 7% compared to the start of the study.
• In contrast, bupropion (Wellbutrin SR, Wellbutrin XL), an atypical antidepressant, is often linked with weight loss. In studies, between 14% and 19% of patients taking bupropion loss at least 2.2 kg (5 lb) compared to 6% on an inactive placebo.

A large cohort study (136,762 men and 157,957 women) in the United Kingdom looked at electronic health records to evaluate the long-term association between antidepressant prescribing and weight gain. Over 90% of patients had a diagnosis of depression.

Researchers looked at data over a 10-year period to determine the incidence of at least a 5% increase in body weight, and the number who transitioned (based on body mass index) to a status of overweight or obese.

• In the year of study entry, 13% of men and 22.4% of women (mean age of 51.5 years) were prescribed antidepressants, but may have had other diagnoses besides depression.
• Over the follow-up period, those prescribed an antidepressant had an increased risk of at least a 5% gain in body weight compared to those who were never prescribed an antidepressant.
• Weight gain substantially increased in the second and third years of treatment. During the second year of treatment, the risk of at least a 5% weight gain was found to be 46.3% higher than in a general population comparison group. Those originally classified as normal weight were more likely to transition to an overweight or obese category.
• Researchers concluded that antidepressant treatment was associated with a sustained increase in risk of weight gain over at least 5 years.

Why does Zoloft cause weight gain?

• It is not fully clear if weight gain with antidepressants and Zoloft in particular is due to an increased appetite after recovery from a mental health disorder, due to the medicine itself, or some other factor.
• Antidepressants may cause weight gain by interfering with serotonin or histamine neurotransmitters in the brain that control appetite.
• Some antidepressants may cause drowsiness or fatigue that lower levels of activity, leading to weight gain.

References

• Zoloft (sertraline) prescribing information. 9/2021. Pfizer Inc. New York, NY. https://labeling.pfizer.com/ShowLabeling.aspx?id=517#page=1
• Gafoor R, Booth HP, Gulliford MC. Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study. BMJ. 2018;361:k1951. Published 2018 May 23. doi:10.1136/bmj.k1951
• Maina G, Albert U, Salvi V, et al. Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. J Clin Psychiatry. 2004 Oct;65(10):1365-71. doi: 10.4088/jcp.v65n1011.
• Fava M, Judge R, Hoog SL, et al. Fluoxetine versus sertraline and paroxetine in major depressive disorder: changes in weight with long-term treatment. J Clin Psychiatry. 2000 Nov;61(11):863-7. doi: 10.4088/jcp.v61n1109.
• Hirsch M, Birnbaum R, et al. Selective serotonin reuptake inhibitors: Pharmacology, administration, and side effects. Up to Date. Accessed Jan. 26, 2022 at https://www.uptodate.com/contents/selective-serotonin-reuptake-inhibitors-pharmacology-administration-and-side-effects
• Bupropion prescribing information (FDA). Drugs.com. Accessed Jan. 26, 2022 at https://www.drugs.com/pro/bupropion.html

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Medical Disclaimer

Does Zoloft cause weight gain?

Learn how to minimize Zoloft weight gain and compare the symptoms to those of other popular SSRIs

Zoloft (sertraline) is a prescription medication that belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants. Zoloft is often prescribed as part of a treatment plan, which may include other methods such as cognitive behavioral therapy, to treat major depressive disorder (depression) or other mental health conditions, including:

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

Zoloft is a popular antidepressant medication. As of 2020, more than 38 million prescriptions have been written for this medication. Many patients want to know if Zoloft will cause weight gain. In fact, one of the most common reasons why people stop taking SSRIs is because of weight gain. Zoloft may cause weight gain with long-term use. It may also cause a slight weight loss in children. Continue reading to learn more about Zoloft and its effect on body weight.

Does Zoloft cause weight gain?

Because everyone is different in their symptoms of depression or anxiety, as well as side effects and response to medication, weight changes due to Zoloft will vary by individual. One person may gain weight while another may lose. Some people eat more when they are depressed, and when they start taking Zoloft and feeling better, they may return to a normal diet and lose weight. On the other hand, some people experience appetite loss when depressed and eat less. Then, when taking Zoloft and starting to feel better, they may start to eat more and gain weight. 

While it is difficult to know how each person will respond to Zoloft in terms of weight gain, we can look at the results of some clinical studies. 

• A 2016 study looked at weight gain in adults after two years of antidepressant use. In this study, people who took sertraline gained an average of 5.9 pounds after two years.
• A review of many studies published in 2017 noted that a small weight loss may occur with short-term use of SSRIs, including Zoloft—in an 8-week study, individuals who took Zoloft lost an average of 1.58 pounds. However, short-term use of SSRIs is very unusual, because most people take SSRIs for at least 6 months—or much longer. The review noted a 2000 study, which looked at people who took an SSRI for up to 32 weeks and found sertraline to cause a weight gain of 1% (this would equate to a 1.8-pound weight gain for someone who weighs 180 pounds). And 4.2% of individuals who took Zoloft gained more than 7% of body weight (which would equate to at least 12.6 extra pounds for someone who weighs 180 pounds). 

In terms of children, Zoloft may affect growth hormones, which may slow growth and cause weight loss. Children who take Zoloft will have their height and weight monitored regularly.

Why does Zoloft cause weight gain?

Weight gain due to Zoloft (or any SSRI antidepressant) is thought to possibly be due to several factors, including: 

• By affecting serotonin receptor activity, which may regulate appetite and weight
• By increasing appetite, especially carbohydrate cravings
• By improving symptoms of depression, and helping appetite return to normal in those who had appetite loss

Other SSRIs and weight gain

SSRI weight gain can occur with other SSRIs besides Zoloft. A 2018 study in the British Medical Journal (BMJ) looked at the long-term use of antidepressants and weight gain. The study found that those who took an antidepressant had an increased risk of at least a 5% increase in weight, as opposed to individuals who did not take an antidepressant. Weight gain increased in the second and third years of treatment. The study researchers concluded that antidepressant use increased the risk of weight gain over at least 5 years. 

A 4-year study published in 2017 concluded that SSRI use was associated with weight gain—in combination with certain lifestyle factors including a Western diet, lack of activity, and smoking.  

The 2017 review of studies (mentioned in the section above) noted that some individuals gain what is considered to be an “extreme” amount of weight, which is more than 7% of body weight. Paxil (paroxetine) caused the most weight gain. In the study, 25.5% of people who took Paxil, 6.8% of people who took Prozac (fluoxetine), and 4. 2% of people who took Zoloft (sertraline) gained more than 7% of body weight.  

Another study also concludes that Paxil (paroxetine) may be most likely to cause greater weight gain than other SSRIs during long-term treatment. Interestingly —bupropion, which is not an SSRI, also known by its brand name, Wellbutrin, is an antidepressant that may cause weight loss—and is one ingredient in the weight-loss drug Contrave. 

One study examined adults using antidepressants for 6 to 36 months and found that 55% of people gained weight. Of these, almost 41% gained 7% or more of their weight compared to baseline. The study found Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), and Zoloft (sertraline) to be associated with significant weight gain—but not Prozac (fluoxetine). The study also found some serotonin-norepinephrine reuptake inhibitors (SNRIs) to cause weight gain, including Cymbalta (duloxetine) and Effexor (venlafaxine).  

Although SSRIs and SNRIs may cause weight gain, other types of antidepressants may cause weight gain as well. For example, tricyclic antidepressants such as Elavil (amitriptyline) or Pamelor (nortriptyline) are well-known for causing weight gain. And Remeron (mirtazapine), which is classified as a tetracyclic antidepressant, is known for causing significant increases in body weight and body fat. 

How to avoid Zoloft weight gain 

Not everyone will gain weight when taking Zoloft or an SSRI, especially if you are aware and proactive. Here are some tips to help avoid weight gain while taking Zoloft—or any antidepressant: 

• First, do not stop taking Zoloft suddenly, even if you start to gain weight. Stopping an SSRI suddenly can cause withdrawal symptoms—as well as worsen depression or anxiety. If you have any concerns about your medication, consult your doctor first. You and your healthcare professional will need to consider all options regarding which medication is best and the possibility of weight gain. For example, a weight gain of 3 pounds over several years can be considered insignificant when compared to living with symptoms of depression. However, a larger weight gain caused by an antidepressant could lead to other health problems like high blood pressure, which could require either lifestyle changes or a change to a different drug.
• If you have gained weight, ask your healthcare professional if there could be another cause. The SSRI may not necessarily be the culprit of weight gain. Another medical condition could be the cause.
• Talk to your healthcare professional, or consult a registered dietician, about lifestyle changes, such as incorporating a healthy diet of nutritious foods and an exercise plan that will fit into your life. According to the Centers for Disease Control and Prevention (CDC), adults should get at least 150 minutes of moderate-intensity physical activity every week, plus two strength-training sessions. This can be done, for example, by walking for 30 minutes, 5 days per week, and adding in two strength-training workouts. You can walk outside, or even around a mall—or check YouTube for thousands of free exercise videos, including walking videos. In addition to helping avoid weight gain, this benefits overall health, too.
• Keep track of your weight while taking Zoloft. This way, you can see if there is a pattern of weight gain, and make changes if necessary.
• If weight gain becomes a problem, or you do not want to take a medication that may make you gain weight, ask your healthcare provider for medical advice about trying a different medication—such as bupropion—with a lower risk of weight gain. 

Ask your healthcare professional for other ideas that are personalized to your individual needs. Working together with your healthcare team, you will be able to find the treatment that works best for your depression or anxiety—while also minimizing weight gain. 

Seralin (sertraline) in the treatment of depression | #10/05

The prevalence of depressive disorders, the variability of their structure, combination with other neurotic or psychotic disorders, connection with personal attitudes, somatic and social factors give rise to a large number of clinical forms of depression and, therefore, require the use of a variety of therapeutic agents.

Affective disorders occur during the life of every fifth person. The risk of developing depression reaches a level of 20%, 1% of cases are diagnosed initially each year, depression recurs in 55% of individuals, and becomes chronic in 12–15%. More than 60% of patients with depression do not fall into the field of view of psychiatrists, since atypical clinical forms predominate in the structure of morbidity.

Only 10-15% of patients with depression receive treatment, and only 0.1% of patients are admitted to psychiatric hospitals. According to WHO estimates, major depression is now the 4th leading cause of reduced life expectancy, taking into account reduced work capacity.

30-40% of patients with depression remain resistant to adequate thymoanaleptic therapy. In this case, resistance to the first drug reaches 40-60%.

Modern requirements for an antidepressant, along with a sufficiently effective thymoanaleptic effect, include good tolerability and a favorable side effect profile, as well as the absence of “behavioral toxicity”.

In this regard, there is a constant search for drugs that would optimally combine both high thymoanaleptic efficacy and a sufficient degree of safety.

Antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs) are the most widely used in the world psychiatric and general medical practice. Their therapeutic effect is associated with inhibition of serotonin reuptake both in the central nervous system and in the peripheral nervous system. At the next stage, the blocking function of serotonin IA receptors located in the somatodendritic part of neurons in the raphe region of the midbrain is disrupted. At the same time, the side effects of the drug that occur at the 1st stage are mitigated, and signs of a therapeutic antidepressant effect appear. Serotonin neurons are disinhibited (disinhibited), and serotonin begins to rapidly release from the axons leading to different brain structures. SSRI preparations do not have pronounced “behavioral toxicity”, anticholinergic side effects, adverse hepato-, cardiotropic effects and teratogenicity. They are convenient to use, as they have a prolonged action up to a day, can be used without dose titration, do not cause dependence and withdrawal syndrome.

This group of drugs includes sertraline (zoloft, seraline). However, it has its own specific features that predetermine its relevance in clinical practice.

Firstly, it is a balanced type of drug that does not cause an exacerbation of anxiety and emotional tension, which makes it possible to expand the scope of its application.

Secondly, it can be attributed to the SSRIs of the second generation, since the geometry of the antidepressant at the molecular level has been changed in its structure, as a result of which it was possible to achieve a more “precise” interaction with the receptor. So, when comparing the S- and R-enantiomers, it turned out that the S-enantiomer of the active substance is 30 times more potent serotonin reuptake inhibitor than its optical antipode.

Thirdly, sertraline is one of the few antidepressants approved for use in pediatric practice, which, apparently, may indicate the level of its safety.

Fourthly, this drug has proven itself in the treatment of depression with comorbid mental disorders, which expands the range of its use both in psychiatry and in general medical practice: chronic pain syndrome, bulimia, obesity, alcoholism, obsessive-compulsive disorders, attention deficit disorder with hyperactivity, panic disorders, etc.

Side effects of the drug are associated with hyperstimulation of the serotonin system: gastrointestinal disorders, loss of appetite, dizziness, nausea, diarrhea, hyperreflexia.

Sertraline hydrochloride is a bicyclic drug, a derivative of naphthylamine. It is a potent selective inhibitor of serotonin reuptake, does not cause blockade of muscarinic, serotonin, adrenergic and GABAergic receptors. The drug has practically no anticholinergic, cardiotoxic and sedative properties. The basis of its action profile is a distinct thymoleptic effect with a weak stimulating component. Relieving depressive symptoms, the drug also successfully affects the parameters of the immune, neurotransmitter and hormonal systems.

A number of works by modern authors are devoted to the clinical evaluation of the use of sertraline for the relief of depression in patients [1, 2, 3, 4, 5, 6, 7, 8, 9].

Our study pursued the following objectives: to confirm the antidepressant activity of the drug seralin ^* ; determine the effectiveness of the drug depending on the complexity, depth of the structure of depressive disorders; clarify the spectrum of psychotropic activity of the drug, identify the side effects.

The study involved 40 patients (14 men, 26 women), whose clinical picture revealed depressive conditions within a single or recurrent depressive episode (F-33.1; F-33.2), bipolar affective disorder (F-31, 3; F-31.4), cyclothymia with comorbid anxiety-phobic personality disorders (F-60.1; F-60.3).

The selection criteria were: the leading mental disorder — depressive syndrome; relative monomorphism of the disorder.

Exclusion criteria: children’s and senile age; severe somatoneurological pathology; the severity of the schizophrenic defect; substance abuse.

The patients’ age ranged from 20 to 61 years. The duration of the disease ranged from 1 week to 18 years. The mental state of patients at the start of therapy was determined by depressive symptoms of varying depth and structure.

The patients were diagnosed with the following syndromes: typical classical depression; anxious depression; apathetic depression; obsessive-phobic syndrome; depressive delusional syndrome.

Comorbid anxiety-phobic disorders were represented by panic attacks in 21 patients, manifestations of the type of generalized anxiety – in 14, obsessive-compulsive disorders – in 5 patients. The duration of treatment was 6 weeks. The initial daily dose was determined individually (50 or 100 mg/day). The maximum dose is up to 150 mg / day. The drug was administered orally in the morning, along with food; combinations with other antidepressants were avoided whenever possible. However, the peculiarities of the mental state of patients dictated the need to prescribe sedative or hypnotic drugs. Therefore, we used clonazepam, phenazepam and small doses of neuroleptics: sonapax, chlorproxen. During the follow-up period, 5 patients dropped out of the study for various reasons: 2 of them were discharged from the hospital due to family reasons against the background of some improvement in their condition; in 2 clinical cases, there was a transition to another phase (affect inversion).

Feeling of nausea, mild diarrhea, increased heartburn, loss of appetite was noted by 1 patient.

The therapeutic effect of seralin was determined by the degree of reduction in the total score of the Hamilton scale (HDRS) to assess depressive symptoms at different periods of treatment. The total score was recorded during five visits: H0 — at inclusion in the study; H1 – 1 week after the start of the drug; H2 – after 2 weeks; H3 – after 4 weeks; H6 – after 6 weeks after the start of taking seralin.

The criterion for the effectiveness of therapy was a 50% reduction in symptoms according to HDRS. An additional assessment of the effectiveness of therapeutic measures was performed on the basis of the CGI scale of general clinical impression. All patients were examined daily by a doctor. The dynamics of the state was reflected in extended diaries according to rating scales and the results of paraclinical studies.

When analyzing the results of the study, attention is drawn to the dynamism and relative harmony of the reduction of depressive symptoms, the absence of a period of hyperstimulation, increased anxiety, agitation, and activation of suicidal tendencies. This is especially important for depressed patients with obsessive-phobic disorders in the form of panic attacks, since the initial level of anxiety in them at the beginning of therapy significantly exceeded the level of anxiety in other patients. At the 1st stage of treatment, the actualization of anxious fears decreases, a more relaxed attitude towards phobias is formed, hypochondriacal manifestations fade, by the end of the 2nd week, the manifestation of anxiety and somatization decreases in patients, the level of anxiety harmoniously decreases and mood improves.

Obsessive-phobic symptoms cease to dominate in consciousness, manifestations of avoidant behavior soften, obsessions and phobias cease to be painfully painful, their significance decreases. On the 4th week of therapy, patients have plans for the future, interest in cognitive and work activities awakens, they move more easily, communicate and gradually return to their usual way of life. Patients develop a positive attitude towards the drug and an understanding of the need for long-term maintenance therapy.

Dynamics in the form of a dissociated variant of the reduction of symptoms was observed in those clinical cases when melancholy or apathy was the predominant affect in the structure of the depressive syndrome, and comorbid symptoms were represented by a generalized anxiety state or “depressive alienation” of mental functions (apathy, anhedonia, abscess in the form of influxes of painful reasoning, without a pronounced somatovegetative component, adynamia, etc.). At the 1st stage of the study, anxiety and the relevance of painful experiences decreased, and at the 2nd stage, mood improved and vital activity appeared.

At the end of the study, the results of therapy showed that 22 patients had a “marked improvement” (according to the CGI scale), 11 patients had a “moderate improvement”, 4 patients had a “slight improvement”, 2 patients had an “undetermined antidepressant effect” ( short-term improvement, without stabilization of the condition) and 1 – no change.

The pronounced thymoleptic activity of the drug was confirmed by the dynamics of the HDRS depression scale indicators: a pronounced therapeutic effect (a decrease in indicators by more than 50%) was registered at the transition from the 3rd to the 4th week of the study. By the end of therapy, a decrease in the average score on the HDRS scale by 34% from the baseline was noted.

In all patients, the stimulating effect appeared on the 4th week of therapy.

In the course of the study, side effects were identified in 5 patients. On the 3rd day, 1 patient developed anxiety, an excited state, which, apparently, is associated with the still insufficiently formed anxiolytic effect of the drug. In three clinical cases, transient symptoms of nausea were observed. In 1 patient, there was a short-term urinary retention, which resolved without discontinuation of the drug and dose reduction. Side effects described in the literature (L. Ziplinski et al., 1989; H. Gommans, 1990) were not registered in our study.

Analyzing clinical observations, we can draw the following conclusions.

• Seralin (sertraline) has a pronounced thymoleptic effect.
• The profile of the therapeutic activity of the antidepressant seralin consists of a harmonious, sequentially formed anxiolytic, thymoleptic and stimulating effects.
• Seralin can serve as the drug of choice in the treatment of depression with a predominance of anxiety, especially with comorbid obsessive-phobic disorders.
• The peculiarity of the therapeutic profile of the drug makes it possible to avoid an increase in suicidal risk in the early stages of depression treatment.
• The drug seralin is well tolerated, side effects are minor, quickly stopped and do not interfere with therapy.
• The antidepressant seraline (sertraline) is characterized by a balanced therapeutic effect with sequentially occurring anxiolytic, thymoleptic and weak stimulant effects.

For literature, please contact the editor.

B. A. Tashmatov , Doctor of Medical Sciences, Professor
N. Bulycheva, Associate Professor
1st Tashkent State Medical Institute , Tashkent

^* The drug is registered in Ukraine, Kazakhstan, Uzbekistan and a number of other CIS countries; in Russia passes the stage of registration.

Zoloft – consequences of use and methods of addiction treatment

Sertraline is actively used in psychiatry and is most commonly known as Zoloft. This drug is usually recommended for the treatment of depression. However, if taken without proper control, pharmacy addiction may occur.

After this, the patient will no longer be able to do without the drug and will constantly need to increase the dose in order to maintain a positive effect.

Description, composition, effect and properties of Zoloft

Zoloft is not a narcotic, but a pharmaceutical that belongs to the group of antidepressants used to treat various mental and emotional disorders. Its action is based on the inhibition of serotonin reuptake. However, improper use of Zoloft can lead to unwanted side effects and addiction to the drug. In this regard, it is very important to follow the doctor’s recommendations for the duration of the course of treatment and dosage.

The choice of treatment regimen is made for each patient individually, taking into account his condition and diagnosis.

Zoloft has a precursor – tametralin, which is an inhibitor of the reuptake of neurotransmitters responsible for a positive emotional background. Therefore, the substance acted as a barrier to deactivate the “happiness hormones”. Initially, tametralin was developed as an effective antidepressant, but did not achieve the expected results. Although clinicians were satisfied with the results of the studies, during the use of the drug, properties were found that are characteristic of most prohibited substances.

• Negative impact on the functioning of many internal organs.
• The appearance of symptoms of withdrawal syndrome when the drug is discontinued;
• Development of persistent dependence on drugs;

Pharmacists were persistent in their search for an effective drug and, based on tametralin, a drug called sertraline was developed. The chemical composition of the substance is almost identical, but chlorine atoms are added to it. The therapeutic properties remain unchanged, but differences have been identified – unlike tametraline, sertraline acts selectively on serotonin.

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The main pharmacological properties of the drug Zoloft include:

• Prevention of the reuptake of the “hormone of happiness”;
• Ability to increase the action of serotonin;
• Some, not too pronounced, obstruction of the reuptake of dopamine and norepinephrine;

These properties are due to the fact that when using this antidepressant, there are no certain effects that are characteristic of other types of antidepressants:

• no excess weight;
• no effect on allergic manifestations.
• no possibility of developing a manic syndrome;
• lack of effect on depressive disorders associated with lack of dopamine;

The effect of the drug on the human body

Zoloft works by blocking the uptake of serotonin, but has little effect on norepinephrine and dopamine. Although less potent than tametralin, Zoloft causes far fewer side effects. Its sedative, stimulant, and anticholinergic effects appear gradually as the substance accumulates in the body. Patients notice an improvement in their condition 7-10 days after the start of therapy, when taking a drug dose. The therapeutic effect increases within a month, and the maximum effect is achieved after 90 days after starting the pills.

When using medication, remember that all types of antidepressants are psychotropic substances. They effectively fight the symptoms of depression and well reduce various neurasthenic deviations. However, for the treatment of mental disorders, they must be used with caution and only under medical supervision to minimize the risk of addiction and serious complications.

Zoloft has a serotonergic effect that helps to cope with such pathologies as:

• Ideas of persecution
• Symptoms following traumatic events
• Depressive disorders
• Panic episodes
• Neurological and compulsive conditions
• Obsessive thoughts and behavior disorders
• Pathological abnormal behavior

Sometimes the drug is used to reduce symptoms associated with the withdrawal of substance use. If the patient experiences apathy, mood deterioration, loss of energy and other adverse manifestations, then Zoloft does a good job of mitigating them.

The drug causes pleasant emotions in patients, promotes relaxation and carelessness. However, drug dependence occurs with continuous use. A person cannot do without medicine, because its absence causes a lack of positive emotions. As the body gets used to the dosage, the sensitivity to the drug decreases, and the patient can independently increase the dosage, which can lead to serious consequences.

Dependence on the use of Zoloft

Typically, antidepressants are prescribed for 7-8 weeks, and changing this period is considered unjustified. Do not stop therapy, even if the patient begins to feel better after 60 days. After completing the course of treatment with Zoloft, it is necessary to gradually reduce the dose, otherwise withdrawal symptoms may develop. The risk of this syndrome increases in case of the following factors:

• Increased patient anxiety
• Co-administration of Zoloft with antipsychotics and antihistamines.
• Long term pills over 8 weeks
• Rapid drug withdrawal

Antidepressants affect the brain and stopping abruptly can cause serious complications. Usually the dosage is gradually reduced by 25 mg every 2 weeks. Discontinuation of the drug is necessary not only when a stable remission is achieved, but also in case of serious side effects from Zoloft or low effectiveness of treatment.

The following are signs that may indicate treatment failure:

• Excessive irritability and anxiety
• Thoughts of suicide
• Feelings of pain
• Loss of interest in usual activities
• Loss of appetite
• Decreased concentration
• Force reduction

Reducing the dosage of Zoloft is a process that requires considerable time and depends on the initial dose of the drug and the patient’s well-being. If the drug is quickly stopped, the body will not be able to quickly adapt to the changed conditions. Symptoms of Zoloft withdrawal syndrome may appear as early as 3 days after discontinuation, but may also occur when the next dose is missed. During this period, the patient may feel even worse than at the beginning of the course of therapy.

Symptoms of Zoloft withdrawal are listed below:

• Sleep and coordination disorders
• Alarm
• Anxiety
• Numbness or trembling in limbs
• Gastrointestinal symptoms: diarrhoea, nausea, vomiting

Most patients experience mild discomfort from these symptoms and are able to continue working as usual. However, in some severe cases, patients may be hospitalized for several days. Withdrawal symptoms can last from 7 to 14 days. The appearance of these symptoms is associated with the adjustment of the activity of brain neurons when taking the drug. After some time after drug withdrawal, it takes time to restore the normal function of the nervous system.

If the dosage of the drug was high and the course of treatment was long, the recovery process may be more difficult and protracted. Until the blood flow is completely cleared of the metabolites of the drug, the negative manifestations of the withdrawal syndrome will not disappear. Among these manifestations may be apathy and weakness. In order to distinguish symptoms from relapse, it is important to carefully monitor the dynamics of well-being. If the patient’s condition improves within 2-4 weeks, this indicates a possible failure of treatment.

Side effects of this drug.

Symptoms associated with the use of Zoloft depend on the dosage of the drug, the duration of the course, the general condition of the patient and the diagnosis. Almost all patients using Zoloft may experience some side effects such as fatigue, extreme thirst, swelling and muscle weakness. The central nervous system (CNS) most often suffers from prolonged use of Zoloft. Some patients may also experience the following complications:

• Loss of consciousness
• The appearance of nightmares
• Hallucinations
• Paranoia
• Headache
• Decreased concentration
• Confusion
• Dizziness
• Sleep disorders
• Alarm

One of the most dangerous consequences of the continuous use of Zoloft is the formation of dependence. It is impossible to determine the exact moment when the narcotic effect will occur, since it depends on many factors, including the individual characteristics of the patient, dosage and frequency of taking the pills. The process of addiction formation is slow, but getting rid of it is very difficult. Treatment and rehabilitation in a specialized clinic may be required for a long period of time.

Abuse of Zoloft not only negatively affects the central nervous system, but also harms the physical health of the patient. Some of the most common complications experienced by abusers include:

• Vision and hearing problems that can manifest as increased tearing, glaucoma, and ear pain.
• Disorders of the cardiovascular system, which may manifest as tachycardia, rapid pulse and changes in heart rate.
• Abnormalities in the functioning of the respiratory system, which may manifest as shortness of breath, bronchospasm and nosebleeds.
• Abnormalities in the functioning of the gastrointestinal tract, which can manifest as pain in the abdomen, vomiting, constipation and flatulence.
• Reproductive disorders, which may manifest as menstrual irregularities, loss of libido and decreased ejaculation.
• Disorders of the urinary system, which may manifest as enuresis and frequent urination.

Regular use of this drug may lower your immune system and increase your risk of getting infections.

The combination of antidepressants with alcoholic beverages is not allowed. A mixture of Zoloft and alcohol is dangerous, as this greatly enhances the effect of the active components of the drug. This can cause overstimulation of the central nervous system due to the increased production of adrenaline, which increases the likelihood of serious complications. If the patient drinks alcohol while taking Zoloft, this may reduce the effectiveness of the drug. Increasing the dose to achieve the desired effect may increase the risk of heart attack, kidney and liver damage, and poisoning of the body.

There is no lethal dose for this drug, however an overdose of Zoloft is possible if more than 13.5 g is consumed. Combining medication with alcohol or other drugs may increase the risk of death. The main symptoms of overdose include:

• Convulsive manifestations.
• Trembling of limbs.
• Unreasonable increase in physical activity.
• Rapid heartbeat.
• Vomiting reactions.
• Feeling sleepy.

Sometimes the patient may go into a coma while using the drug. To avoid adverse effects, it is not recommended to combine Zoloft with drugs that stimulate neuronal metabolism. You should also be careful when combining the drug with drugs that suppress the central nervous system.

Treatment

To prevent the development of tolerance to Zoloft, therapy with the use of this drug should be carried out under the strict supervision of a physician. The selection of the dosage and class of medications depends on the medical history, age and severity of the underlying disease of the patient. The treatment regimen should also be corrected only by a qualified specialist. Particular attention should be paid to people who are prone to mental disorders.

Patients taking Zoloft should be constantly monitored and monitored for their health status. The physician must ensure that the drug is taken as recommended and respond immediately to any changes in the patient’s behavior. Zoloft can cause psychological dependence, so it is difficult for patients to resist the urge to take it. This often happens to people who have experienced mental turmoil. The drug helps them feel better, but patients don’t always realize the risks associated with addiction.

To achieve stable remission, not only drug treatment is necessary, but also sessions with a psychotherapist. The doctor can conduct individual and group trainings, using various techniques to identify and eliminate psychological vulnerabilities in the patient. In the classroom, patients understand that there are safer and more effective ways to get positive emotions than simply using drugs.

In addition to the physician, the patient’s family and friends should also support the patient during therapy. Communication can be a good way to take your mind off negative thoughts. If a patient notices sudden changes in mood while taking antidepressants, it is necessary to inform the doctor about this in order to exclude (or confirm) the presence of bipolar disorder through differential diagnosis.

Experts recommend following a few simple rules to prevent possible development of dependence on Zoloft:

• Follow a normal daily routine, sleep at least 7-8 hours a day.
• Tell your doctor about any unpleasant symptoms that occur during treatment.
• Avoid drinking alcohol during therapy, as this may increase the effect of drugs and cause adverse reactions.
• Avoid alcohol and caffeine, increase time spent outdoors.
• To undergo medical treatment under the supervision of a specialist, without changing the regularity of intake and dose size on your own.
• Adjust your diet to include kale, spinach, sea fish and walnuts, which can help restore mental health.
• Avoid concomitant use of the drug with MAO inhibitors, as this may lead to complications.
• Follow all doctor’s recommendations, including taking a course of psychological studies if necessary.

It should be remembered that antidepressants are not a universal solution for all problems and their prescription must be justified. Following the doctor’s recommendations will help to avoid many problems. If the patient was prescribed Zoloft for prophylaxis after recovery, then the dose reduction should occur gradually and under the supervision of a specialist.

References:

1. Butko, D. Yu., Strelnikov, A. A., Kotelnikova, T. L., Davydov, A. T., & Zagrebelny, I. A. (2007). Clinical use of sertraline and afobazole in patients with comorbid depression and anxiety in the post-stroke period. Psychopharmacology and Biological Narcology, 7(1), 1464-1470.
2. Pankova, O. F. (2020). Modern psychotropic drugs used in psychiatry: a teaching aid. Moscow: FGAOU VO RNIMU im. N. I. Pirogov of the Ministry of Health of Russia.
3. Maksimova, N.