Zoloft for Panic Disorder

How a Common Antidepressant Can Help Ease Other Symptoms

Zoloft

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Zoloft (sertraline) is a medication that's frequently prescribed to treat a number of different psychiatric disorders including depression, obsessive-compulsive disorder, and social anxiety disorder. It's also often prescribed for people who've been diagnosed with panic disorder, a condition that causes frequent episodes of specific symptoms call panic attacks.

If your doctor suggests you take Zoloft as part of a treatment plan for panic disorder, it can be helpful to learn how the drug might work to help you manage your symptoms. The more you understand about any medication you take, including how it affects the body and any potential side effects it might cause, the more comfortable you're likely to feel about taking it. 

How Zoloft and Other SSRIs Work

The generic form of Zoloft, sertraline, has been used to treat anxiety orders since the mid-1990s. In that time many studies have found the drug to be highly effective for treating panic disorder as well. is a medication that is prescribed to treat mental illnesses like depression, obsessive-compulsive People who take Zoloft often report improvements in mood, appetite, sleep quality, energy level, and interest in daily life. Many say that they feel less afraid or anxious and have fewer panic attacks.

Zoloft belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Examples of other SSRIs include Prozac (fluoxetine), Paxil (paroxetine), and Lexapro (escitalopram). These medications work by increasing the amount of serotonin in the brain. Serotonin is a neurotransmitter—a chemical that carries signals between brain cells—that among other things helps to regulate mood.

In particular, serotonin is associated with positive emotions; in fact, it's sometimes called the "feel-good" chemical. As an SSRI, Zoloft and other SSRIs do exactly what the name suggests—they block the reabsorption, or uptake, of serotonin in the brain, leaving more of the chemical available. According to the Mayo Clinic, SSRIs are "selective" because they seem to primarily affect serotonin rather than other neurotransmitters such as dopamine. 

Panic disorders are associated with prolonged periods of stress, which can cause serotonin levels to be depleted. This is why Zoloft may be so effective in treating them. Research has found that for many people, taking 80 to 175 milligrams of Zoloft per day can reduce the severity and frequency of panic attacks and baseline anxiety, and is as effective as cognitive behavioral therapy.

Side Effects

Since drugs like Zoloft affect the brain, you may be worried about how taking them will affect you—that you'll feel strange or have trouble thinking, for instance. Truthfully, there's no way to predict how an SSRI will make you feel since everyone responds differently to the drug.

One thing that is for sure is that you won't get relief from your symptoms right away as the drug will need to be in your system for a week or two before you feel the full effects. 

Common Side Effects

You may experience side-effects of Zoloft before you notice you're feeling better though. These may include: 

  • Drowsiness
  • Nausea (which you may be able to avoid by taking your medication with food)
  • Dry mouth
  • Insomnia
  • Diarrhea
  • Nervousness, agitation, or restlessness
  • Dizziness
  • Headache
  • Blurred vision

Sexual Side Effects

One of the most potentially bothersome side effects of Zoloft and other SSRIs are sexual problems. These can include reduced sexual desire or difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction). These can be so distressing for some people that they choose not to take the medication and live with their psychiatric symptoms. 

If taking Zoloft interferes with your sex life, the Mayo Clinic suggests some things you can try before you quit the medication:

  • Give it time. Sometimes sexual side effects of antidepressants get better on their own. 
  • Adjust your dose. Speak to your doctor first, of course, but you may be able to take a lower dose and still get the same benefits with less impact on your sexual function.  
  • Adding a second antidepressant. One in particular, Wellbutrin (bupropion), has been found to counter the sexual side effects of SSRIs. 
  • Take a medication to improve sexual function. You can try Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil), which all are approved by the U.S. Food and Drug Administration to treat sexual problems in men. Limited research suggests sildenafil may improve sexual problems caused by antidepressants in some women, but more information is needed on its effectiveness and safety in women.

If none of these measures work, you may need to try a different antidepressant to find one that doesn't have the same effect on your sexual function.  

Serious Side Effects

Contact your doctor immediately if you experience any of the following less common side effects of Zoloft:

  • Signs of an allergic reaction: hives, rash, difficulty swallowing or breathing, and swelling of the face, mouth, throat, or tongue
  • Vomiting
  • Confusion
  • Extreme nervousness, irritability, or anxiety
  • Rapid heart rate
  • Seizures

Serotonin Syndrome

In very rare cases, an antidepressant such as Zoloft can cause high levels of serotonin to build up in the body. This is most likely to happen to someone who's taking another medication that can elevate serotonin such as other antidepressants, certain pain or headache medications, and the herbal supplement St. John's wort. This is one reason it's important to always make sure your doctor knows which other drugs—including over-the-counter medicines and supplements—you might be taking before he prescribes something new for you.

Signs and symptoms of serotonin syndrome include anxiety, agitation, sweating, confusion, tremors, restlessness, lack of coordination and a rapid heart rate. Seek immediate medical attention if you have any of these signs or symptoms.

Black-Box Warnings

All antidepressants, including Zoloft, have a "black box warning." Black box warnings are assigned to medications by the U.S. Food & Drug Administration. In some cases, children, teenagers, and young adults (under 25) may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting the drug or after the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Stopping Zoloft

If you decide you want to stop taking Zoloft, do not go cold turkey. Talk to your doctor first so he can help you gradually wean off the drug. Quitting abruptly can cause you to experience some serious withdrawal-like symptoms, such as nausea, sweating, depression, mood changes, frenzied or abnormally excited mood, irritability, anxiety, confusion, dizziness, headache, tiredness, seizures, ringing in the ears, numbness or tingling in your limbs, hands, or feet, and trouble falling asleep or staying asleep. Even if you're very ready to go off Zoloft, the process will be more pleasant if you take your time. 

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