Zoloft for Panic Disorder

Zoloft can be used to alleviate symptoms of panic disorder.

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Zoloft (sertraline) is a medication that's frequently prescribed to treat a number of 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 called 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 when taking it. 

How Zoloft and Other SSRIs Work

Zoloft (sertraline) has been available for the treatment of depression since the mid-1990s. At that time, many studies found the drug to be highly effective for treating panic disorder as well. It is a medication that is prescribed to treat mental illnesses like depression, obsessive-compulsive disorder, social anxiety disorder, post-traumatic stress disorder, and more.

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 available 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. Research has found that for many people, taking 50 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 of Taking Zoloft

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 some time before you feel the full effects. 

Common Side Effects

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

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

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 less frequently 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 quitting the medication:

  • Add a second antidepressant. One, in particular, Wellbutrin (bupropion), has been found to sometimes counter the sexual side effects of SSRIs. 
  • Adjust your dosage. 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.  
  • Give it time. Sometimes sexual side effects of antidepressants get better on their own. 
  • Take medication to improve sexual function. Viagra (sildenafil), Cialis (tadalafil) or Levitra (vardenafil), are all approved by the U.S. Food and Drug Administration to treat sexual problems in men. Limited research suggests sildenafil may improve sexual issues caused by antidepressants in some women, but more information is needed to confirm this benefit.

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:

  • Allergic reaction symptoms like hives, rash, difficulty swallowing or breathing, and swelling of the face, mouth, throat or tongue
  • Confusion
  • Extreme nervousness, irritability or anxiety
  • Rapid heart rate
  • Seizures
  • Vomiting

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 why 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 increased 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 are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. 

For more mental health resources, see our National Helpline Database.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Discontinuing 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 potentially experience some serious withdrawal-like symptoms. 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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