The antidepressants most likely to cause troublesome symptoms are those that have a short half-life — that is, they break down and leave the body quickly. See the chart "Antidepressant drugs and their half-lives.
Extended-release versions of these drugs enter the body more slowly but leave it just as fast. Antidepressants with a longer half-life, chiefly fluoxetine, cause fewer problems on discontinuation. Besides easing the transition, tapering the dose decreases the risk that depression will recur. In a Harvard Medical School study, nearly patients two-thirds of them women were followed for more than a year after they stopped taking antidepressants prescribed for mood and anxiety disorders.
Participants who discontinued rapidly over one to seven days were more likely to relapse within a few months than those who reduced the dose gradually over two or more weeks. Source: Adapted from Joseph Glenmullen, M. If you're thinking about stopping antidepressants, you should go step-by-step, and consider the following:. Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon.
Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years.
Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether and when to stop using them. Before discontinuing, you should feel confident that you're functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge.
Don't try to quit while you're under stress or undergoing a significant change in your life, such as a new job or an illness. Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions.
Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you're taking, how long you've been on it, your current dose, and any symptoms you had during previous medication changes.
It's also a good idea to keep a "mood calendar" on which you record your mood on a scale of one to 10 on a daily basis. Consider psychotherapy. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.
Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. Spotting early warning signs requires a little time and thought. It also helps if you can share this task with someone close to you - a medical professional, a therapist or someone who knows you well. There might be some experiences that only you would spot; particular thoughts or feelings that no one else would know about.
Other signs, though, are easier for those around you to spot - behaviours that people may have noticed you do last time. So, ideally, sit down with someone who knows you well and work out early warning signs together. When thinking about experiences, it can be helpful to divide them into three different elements: thoughts, feelings and behaviours. These three elements tend to come as a package, almost like a pre-recorded message that you might have heard many times before.
Sometimes, the message is so repetitive that you can barely notice that it is playing at all; you might need the people around you to notice it for you. A particular thought will be accompanied by its usual feeling. It will trigger you to act in a particular way too.
For example, people who have had symptoms of obsessive-compulsive disorder OCD might remember feeling anxious, having obsessional thoughts and performing compulsive behaviours. It isn't only OCD which comes with packages of thoughts, feelings and behaviours.
We all do this, even when life is going well. We are all creatures of habit. These habits can be useful when it comes to spotting early warning signs of illness.
Sometimes, changes in behaviours are easier to spot than changes in how you feel. Watch out for changes in your activity levels, your sleep, appetite, weight, time off work, avoiding people, keeping yourself clean and the house clean. If you think your old symptoms are coming back, tell the people who are supporting you as soon as possible. Antidepressants are just one way to stay well. There are lots of other ways to look after yourself without needing medication.
Here are some ideas:. Finally, don't forget that your GP is always there to help and advise you if you run into problems. If you feel that you are taking a step back, talk with your GP as soon as you can. That way, you can get the extra support you need sooner and recover quicker. Do you take regular exercise? Exercise can help to prevent depression and low mood. It can also help to prevent other physical illness which in turn can affect your well-being. As well as the benefits to your physical and mental health, fitness can be a social activity and can help you to get out into the world and meet people.
Is your diet adequate? Eating a balanced diet is a vital part of a healthy lifestyle. Ask your GP or dietician about how to improve your diet to remain both physically and mentally well. Are you getting enough sleep? Low mood and sleep problems are very closely linked. If your sleep pattern is a problem, find out how 'sleep hygiene' can help. Try cutting down on caffeine, especially later in the day, setting a regular bedtime, reducing screen use in the evenings and using your bedroom only for sleeping.
If sleep remains a problem, talk to your GP about it. Are you drinking too much alcohol? Current recommendations for alcohol consumption per week are 14 units for women and men. As well as other health risks, drinking alcohol is linked to increased rates of depression and other mental illness. Are you using any other drugs which might affect your mental wellness? Occasionally, prescribed medications might add to your chances of becoming depressed.
Check with your GP that you are on the best medication choices for you. Unless there is a medical reason why you must stop, taking antidepressants is not harmful.
Fortunately, addiction to any prescription drug can be cured with medically-supervised detox and therapy at a rehab facility. Learn More. Since Zoloft has a short half-life the length of time a drug stays in the bloodstream before it leaves the body , when someone decides to stop taking Zoloft its effects quickly wear off.
That means if a person suddenly stops taking Zoloft, their serotonin levels will abruptly decline. The brain will adjust to post-Zoloft serotonin levels, but until it does the body may react adversely to lower amounts of serotonin in the nervous system. The severity of the withdrawal symptoms will vary depending on how long a person had been taking Zoloft.
In many cases, people will experience rebound depression or anxiety when they stop taking the medication. The other possible symptoms of Zoloft withdrawal are:.
Like all medications, Zoloft may cause some side effects. The most common side effects of Zoloft are not long-lasting or life-threatening, but there are cases where the medication can cause more serious problems.
The most common side effects of Zoloft include:. The FDA has issued a black box warning for Zoloft. A black box warning is a notification about a dangerous potential effect of a prescription drug. According to the FDA, Zoloft can provoke or aggravate suicidal thoughts in children and young adults.
For this reason, the FDA has not approved Zoloft to treat depression in children. The symptoms of an allergic reaction to Zoloft are trouble breathing, swelling, and hives. Additionally, health care professionals recommend avoiding alcohol or illegal drugs while taking Zoloft. They also warn that pregnant women who take Zoloft risk giving birth to children with hypertension and neonatal withdrawal. Make a Call It is possible to overdose on Zoloft. An overdose occurs when someone takes too much of the medication.
Although many symptoms of a Zoloft overdose are uncomfortable, an overdose is not necessarily a life-threatening emergency. However, in severe cases, an overdose can cause organ damage and may even turn fatal.
The milder and more common symptoms of an overdose include:. When someone suffers a serious Zoloft overdose, they may faint or experience delirium and hallucinations.
Furthermore, a Zoloft overdose can become serotonin syndrome. The syndrome is rare, but when it does occur it usually begins within one day of taking too much of an SSRI. Serotonin syndrome is a medical emergency that causes fever, shivering, muscle tightness, confusion, and potentially lethal seizures. PMDD is a condition where a woman experiences depression, tension, and irritability for a few days prior to menstruation that end when menstruation begins.
These symptoms are more severe than those of premenstrual syndrome PMS. Panic Disorder occurs when a person experiences unexpected and repeated episodes of intense fear. These episodes have physical symptoms including chest pain, shortness of breath, heart palpitations, sweating, dizziness, and nausea. Fear of future episodes is also part of panic disorder. Obsessive Compulsive Disorder OCD occurs when a person experiences the following symptoms at the same time:.
Symptoms include:. They should be clear about the limits of the research around that medication and if there are any other options. Do not stop taking sertraline, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine. Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for "switching" from depression into mania.
Symptoms of mania include "high" or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences for example, excessive buying sprees.
Medical attention should be sought if serotonin syndrome is suspected. If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.
For women who take antidepressant medications during weeks 13 through the end of their pregnancy second and third trimesters , there is a risk that the baby can be born before it is fully developed before 37 weeks.
This is a potentially fatal condition that is associated with use of the antidepressant in the second half of pregnancy.
However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your health care provider. Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks. The dose usually ranges from 50 mg to mg. Only your health care provider can determine the correct dose for you.
If you are taking it for PMDD, sertraline can be taken once daily everyday or intermittently usually starting 14 days prior to menstruation through the first full day of menses of each cycle.
The liquid should be measured with an oral syringe or dropper which you can get from your pharmacy.
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