How Long Does Withdrawal From Sertraline Last?

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In This Article

Sertraline (Zoloft) is a commonly prescribed antidepressant. It is part of a class of drugs known as selective serotonin-reuptake inhibitors (SSRIs). It is used to treat major depression, anxiety disorders, post-traumatic stress disorder (PTSD), panic disorders, and eating disorders. It is also used to treat severe pre-menstrual symptoms caused by premenstrual dysphoric disorder (PMDD) and obsessive-compulsive disorder (OCD).

Overview

More than half (56 percent) of people quitting antidepressants experience withdrawal symptoms. The experience is different for everyone, with some people experiencing mild symptoms while others have symptoms severe enough to interfere with daily life.

Sertraline withdrawal symptoms may persist for anywhere from a few days to several months after your last dose. The most common symptoms include dizziness, irritability, nausea, headache, or prickling sensations on the skin.

Sertraline has a relatively short half-life compared to other SSRIs—about one day. This means that within a few days you will have very little sertraline in your bloodstream. Short-acting antidepressants like sertraline can cause severe withdrawal symptoms, as your body is essentially shocked by the absence of the drug—or more accurately, by the decrease in serotonin levels that happens when you stop taking it.

It’s important for you to know that such a rapid change in antidepressant levels can increase your risk of suicide. Even if you don’t feel at all suicidal before you stop your dose, these feelings can creep up on you. A relapse of your original symptoms may also occur.

Signs & Symptoms

Sertraline works by preventing the reabsorption (reuptake) of serotonin, thereby increasing your serotonin levels. Serotonin, a neurotransmitter, plays an important role in your moods and emotions. When you stop or reduce your dose of sertraline, your serotonin levels will drop, eventually reaching pretreatment levels. Withdrawal symptoms happen because this process is hard on both the mind and the body.

For most people, sertraline withdrawal begins within three to four days of your last dose. Unfortunately, researchers don’t know a lot about the duration of SSRI withdrawal, but you can expect it to last anywhere from a few days to a few months.

Withdrawal symptoms vary from person to person. Some people have no symptoms at all, whereas others have symptoms severe enough to interfere with their typical responsibilities at home, work, or school. If you do have severe withdrawal symptoms, it does not mean that you are addicted to sertraline. Addiction is a disease characterized by intense cravings for a drug. Withdrawal can happen to anyone taking a sertraline for a few months or longer.

Overall, research shows that roughly one half (46 percent) of people going through SSRI withdrawal describe their symptoms as severe.

To get a better idea of the range of symptoms and symptom severity, you may want to check out the Discontinuation-Emergent Signs and Symptoms Scale (DESS), which is sometimes used by clinicians to measure the severity of SSRI withdrawal symptoms.

The most common symptoms that develop during sertraline withdrawal include:

  • Irritability
  • Nausea or vomiting
  • Dizziness
  • Nightmares or vivid dreams
  • Headaches
  • Prickling or tingling sensation on the skin

While these may be the most common symptoms, SSRI withdrawal is known to affect many of the body’s systems. The full range of potential withdrawal symptoms include:

  • Digestive. You may experience nausea, vomiting, cramps, diarrhea, or appetite loss.
  • Balance. You may become dizzy or lightheaded, sometimes making it difficult to walk.
  • Sleep problems. You may have nightmares, unusual dreams, excessive/vivid dreams, or insomnia.
  • Overall. You may have flu-like symptoms including headache, muscle pain, weakness, and tiredness.
  • Mood. You may have anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, mania, or mood swings.
  • Bizarre sensations. You may experience brain zaps (like an electrical shock or shiver in your brain), pins and needles, ringing in the ears, strange tastes, or hypersensitivity to sound.
  • Heat tolerance. You may have excessive sweating, flushing, or an intolerance to high temperatures.
  • Motor control. You may have tremors, muscle tension, restless legs, unsteady gait, or difficulty controlling speech and chewing movements. 

Coping & Relief

One method that people use to quit SSRIs is a medication taper. If you were to taper sertraline, you would gradually reduce your dose over the course of several weeks or months. While this is an option, some doctors prefer to switch their patients to a longer-acting SSRI before beginning a taper. Because sertraline has such a short half-life, the amount of drug in your system can drop off quickly. Switching to a longer-acting SSRI, like Prozac, may help you avoid these unnecessary peaks and valleys.

In the past, doctors weren’t sure whether tapering SSRIs was an effective treatment for withdrawal. However, new research suggests that a slow taper stretched out over the course of several months may be more effective than traditional tapering schedules. The researchers recommend continuing the taper until your dose is nearly zero—well past therapeutic levels. This means that by the end of the taper you may be breaking pills into tiny pieces or switching to a liquid dose.

If you are still experiencing withdrawal symptoms, consider the following remedies:

  • Psychotherapy. Therapy can improve mood, reduce anxiety, soothe irritability.
  • OTC medications. You can treat aches and pains or flu-like symptoms with over-the-counter pain relievers and anti-nausea medications.
  • Exercise. Getting about 45 minutes of moderate activity three times a week can improve mood and reduce stress.
  • Natural remedies. Vitamins, minerals, and herbal supplements can boost energy, reduce stress, and treat insomnia.

One of the most important factors in SSRI withdrawal management is the presence of a social support system. Having people around who can help and support you through a difficult time can reduce stress and anxiety, both of which can make withdrawal symptoms even worse. When your friends and family understand that you are in withdrawal, they will be more forgiving of irritability and mood swings. By preventing interpersonal conflict at home, you will avoid some of the negative social effects of withdrawal.

Warnings

Sertraline, like other SSRIs, comes with a warning from the FDA about the risk of suicide. When your dose is reduced or stopped, your risk of suicidal thoughts and behaviors increases. Suicidal ideation can affect people of all ages. Recognizing the signs of suicidal ideation in yourself or someone else can help save your life or the life of a loved one. Call for help right away if you or a loved one shows any of the following symptoms:

  • Planning how you would commit suicide if you were going to do it
  • Talking or thinking about suicide more than normal, for example, “I wish I were dead”
  • Gathering the means to commit suicide, such as bullets or pills
  • Feeling hopeless or trapped
  • Having intense mood swings
  • Engaging in risky or self-destructive activities, such as driving drunk
  • Becoming preoccupied with death, dying, or violence
  • Getting affairs in order or giving away belongings
  • Saying goodbye to people as if it were the last time

If you are pregnant or planning to become pregnant, you will want to talk to your OB-GYN or psychiatrist about the risks and benefits of continuing and discontinuing sertraline. There is a small risk of giving birth too early if you take antidepressants during your second and third trimesters. On the other hand, if you do discontinue sertraline while you’re pregnant, you are five times more likely to relapse.

Long-Term Treatment

Whether or not you require any long-term treatment will depend on what symptoms, if any, you experience after the withdrawal period has ended. If you are still suffering from mental health symptoms, like depression or anxiety, you may require continued care. About 50 percent of people who recover from depression experience another depressive episode in their lifetime.

Some people choose to stay on antidepressants indefinitely in order to prevent such an outcome. Other people choose alternative treatments, like psychotherapy. Researchers at Harvard Medical School and other universities found that psychotherapy reduces the risk of relapse in people discontinuing antidepressants.

Resources

If you or someone you love is experiencing suicidal thoughts, call the National Suicide Prevention Lifeline (1-800-273-8255). You will be connected with staff or volunteers at a crisis center near you. The people on the other end of the line can help you calm down and figure out what to do next. It is available 24/7, 365 days per year. If you are hesitant to call, you may prefer to chat with a counselor. The chat services are also open 24/7.

If you are interested in finding a new psychiatrist, psychologist, or therapist in your area, there are several ways to find one. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357) and a knowledgeable operator will search for you.

If you have health insurance, you can also search the company’s list of local providers who accept your insurance. Most insurance companies have at least some mental health coverage, including state and federal plans.

A Word From Verywell

Antidepressant withdrawal doesn’t get the attention that it should. Sertraline withdrawal is a real thing and quitting it is a real challenge for lots of people. Don’t hesitate to talk to your doctor or other members of your support system about the way it’s impacting your life. And remember—your symptoms are only temporary; they will stop sooner or later.

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Article Sources

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