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Zoloft, or sertraline hydrochloride, is one of the older selective-serotonin reuptake inhibitors (SSRIs) and has traditionally been used to treat depression, anxiety disorders, post-traumatic stress disorder, and panic disorders. Millions of Americans use prescription Zoloft safely and responsibly.
However, increased availability and variety of medications with psychoactive effects have contributed to prescription misuse, dependence, and addiction. Zoloft misuse occurs when the drug is taken other than intended and can be linked to a psychological addiction.
Why is Zoloft addiction a problem and what should you do if you believe you may be addicted to Zoloft? Let’s explore the issue of Zoloft misuse and how you can get help.
What Is Zoloft?
Zoloft is an SSRI administered in tablets or oral concentrate (liquid) and usually comes in 25, 50, and 100 mg doses. Zoloft oral concentrate is available in a multidose 60 mL bottle and needs to be diluted before it’s taken. Zoloft works by balancing serotonin in the brain. Serotonin is a neurotransmitter that regulates emotions. If you have healthy serotonin levels, you will tend to experience positive emotions, have a better quality of life, have increased energy levels, and sleep well, so Zoloft is typically prescribed for people who have low serotonin.
Zoloft is used to manage and treat the following conditions:
- Major depressive disorder
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysmorphic disorder (PMDD)
- Social anxiety disorder
Possible Zoloft Side Effects
Zoloft, like other antidepressants, may increase the risk of suicidal ideation and behavior in children, adolescents, and young adults with major depression. For this reason, it is important to monitor patients taking Zoloft for unusual changes in behavior like anxiety, suicidality, or other questionable conduct.
Zoloft may also cause erratic changes in sleep patterns and mood. If you are prescribed Zoloft, it’s important to follow the guidelines and avoid abusing or misusing the medication to lower your risk of side effects and addiction.
Zoloft Misuse and Addiction: Signs and Symptoms
Zoloft is generally safe and has historically been used to treat some mental health disorders. However, it also poses a risk for dependency, misuse, and withdrawal.
The majority of individuals prescribed SSRIs do not misuse the medication. However, certain classes of antidepressants do carry misuse potential. Taking Zoloft in a way other than prescribed is considered substance abuse. This includes self-medicating, altering the dosage amount, or taking it more often than prescribed.
How People Become Addicted to Zoloft
Sometimes, people respond well to their prescribed dose, so they decide to take more medication. In other words, “if one pill is good, two will be better.” This type of thinking is problematic for several reasons: The dosage prescribed is based on individual factors, like weight, age, medical history, and more, so it’s a health risk to take more than your prescribed dose. Second, the “more is better” thinking may lead to abusing the medication, which increases the likelihood of dependency.
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that psychological dependence “may occur with or without physical dependence and is conceptually characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving for the psychic effects of the drug.” So even if you don’t develop a physical dependence, you can become psychologically addicted to Zoloft, which can impact your life in severe and negative ways.
Generally, cravings for Zoloft are uncommon, but you may experience withdrawal symptoms when you stop taking the drug or lower your dosage. If you start to experience uncomfortable physical withdrawal, it may lead to a psychological battle between stopping the drug or continuing to take it. Continuing Zoloft to avoid withdrawal would be considered Zoloft misuse and may worsen into Zoloft addiction.
Symptoms of Zoloft Withdrawal
In some cases, the first time a person becomes aware of their Zoloft addiction is when they try to stop and they experience withdrawal symptoms. If you’ve developed a Zoloft dependence, you might have these withdrawal symptoms:
- Dysphoric mood
- Irritability
- Agitation
- Dizziness
- Sensory disturbances (e.g., paresthesias such as electric shock sensations)
- Anxiety
- Confusion
- Headache
- Lethargy
- Muscle spasms
- Suicidal ideation
- Vertigo
- Nightmares
- Poor cognitive and motor performance
Effects of Zoloft Addiction
What likely starts out as a medication you’re taking for the benefit of your mental health can become harmful if you develop an addiction. Misusing Zoloft can lead to a range of both short-term and long-term symptoms and issues.
Short-Term Effects of Zoloft Misuse/Addiction
- Insomnia
- Paranoia
- Depression
- Aggression
- Anxiety
Long-Term Effects of Zoloft Misuse/Addiction
- Mania/hypomania
- Weight loss
- Seizure
- Suicidality
- Serotonin syndrome
Serotonin syndrome is an excess of serotonin flooding your system, which can become very serious. Symptoms may include mental health issues (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular problems (e.g., hyperreflexia, incoordination), and gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
In its most severe form, serotonin syndrome can resemble muscle rigidity, autonomic instability with possible fluctuations in vital signs, and mental status changes. If you suspect that you are experiencing serotonin syndrome, it’s important to get medical help right away because it can be life-threatening.
Additionally, liquid sertraline contains alcohol. Someone who is prone to alcohol misuse and is prescribed Zoloft in this liquid form is highly susceptible to addiction and/or alcohol misuse. If you have a problematic history with alcohol, liquid sertraline may not be appropriate for you. Talk to your doctor if you feel you are at risk.
Bleeding Risks from Zoloft
SSRIs and SNRIs, including Zoloft, may increase the risk of bleeding. The use of aspirin, nonsteroidal anti-inflammatory drugs, warfarin, and other anticoagulants may add to this risk.
Seek help immediately if you experience any of the following:
- Abnormal bleeding
- Ecchymoses (bleeding-related discoloration which looks like unexplained bruising)
- Hematomas
- Epistaxis (frequent nosebleeds)
- Petechiae (small red or purple dots from broken blood vessels)
What Happens When You Overdose on Zoloft
To avoid uncomfortable withdrawal symptoms, people sometimes continue using Zoloft even after they no longer need it. It’s not uncommon for people prescribed prescription drugs to “doctor shop” and obtain multiple prescriptions from several different pharmacies to maintain their habit. Or, they may try to get the drug illegally or purchase it online from foreign sources to avoid going into withdrawal. This vicious cycle is synonymous with Zoloft addiction and can lead to a Zoloft overdose.
A Zoloft overdose occurs when someone takes too much of the medication. Although many symptoms of a Zoloft overdose are uncomfortable and may damage your health, a Zoloft overdose alone isn’t typically life-threatening. However, some Zoloft overdoses happen when a person combines this medication with other medications or substances, and those drug interactions could become severely damaging or even fatal.
Non-life-threatening symptoms of Zoloft overdose include:
- Agitation
- Dizziness
- Fever
- Increased heart rate
- Nausea and vomiting
- Shaking and tremors
- Tiredness
If you believe you’re experiencing a Zolft overdose or a drug interaction between Zoloft and another medication or substance, seek medical help immediately.
Zoloft Addiction Treatment
If you have developed a Zoloft dependence, weaning off Zoloft is the first step in recovery. A program to treat this addiction usually begins with medically supervised detox, where individuals can gradually taper off Zoloft in a medically supported setting. In this safe environment, medical staff can monitor the patient and help to ease the intensity of withdrawal symptoms.
Once you are fully weaned off the Zoloft, you may want to enter a short-term or long-term treatment program to help you overcome the psychological aspects of the addiction, as well as receive therapy for the co-occurring diagnosis you were originally prescribed Zoloft for. Co-occurring mental health disorders are often exacerbated by substance abuse, and vice versa.
Several options have been successful in treating drug addiction, including short-term outpatient care, which involves a day program or several hours of therapy a week, and inpatient or residential rehab, which can also be especially effective for those with more severe addiction or those with co-occurring disorders.
Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Both outpatient and residential rehab centers may use various therapeutic approaches and are generally aimed at helping you develop the skills, healing, and mindframe shifts to maintain recovery after treatment.
Outpatient Behavioral Treatment
Outpatient programs to treat Zoloft addiction often include:
- Cognitive behavioral therapy (CBT): Helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs
- Family group therapy: Addresses a range of influences on the person’s drug abuse patterns and is designed to improve overall family interaction while teaching the family how to support the person’s recovery
- Motivational interviewing: Works with people’s readiness to change their behavior and enter treatment
- Motivational incentives (contingency management): Uses positive reinforcement to encourage abstinence from drugs
- Alternative therapies (yoga, meditation, breathing techniques): Can be highly beneficial natural therapies and substitutes for medication
Inpatient or Residential Treatment
For people who need more intensive rehab or whose home isn’t an environment where they can reliably stay sober, there are different types of residential facilities:
- Therapeutic communities: Highly structured programs in which patients remain at a restricted residence, typically for 30 days to 1 year
- Short-term residential treatment: Focuses on detoxification as well as providing initial intensive counseling and preparation for treatment in a community-based setting
- Recovery housing (also called sober living or halfway houses): Provides supervised, short-term or long-term housing for patients in a substance-free environment among sober peers, often following other types of inpatient or residential treatment. Recovery housing can help people transition to an independent life—for example, helping them learn how to manage finances or find employment and connecting them to social services in their community.
Addiction treatment should be tailored to your specific needs. Whether you are struggling with Zoloft addiction only or a co-occurring mental health issue, a treatment that addresses your situation is key to your recovery. A variety of treatment options are available, but it can be overwhelming to research resources on your own.
We can help locate resources to start the journey toward recovery. Contact us at
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