Last updated: 04/19/2021
Author: Dr Anjali Talcherkar
Reading Time: 6 minutes
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 medications safely and responsibly.
However, increased availability and variety of medications with psychoactive effects have contributed to prescription misuse, dependence, and addiction.1 Zoloft misuse occurs when the drug is taken other than intended and can be linked to a psychological addiction. If you are struggling with a Zoloft addiction, treatment is available.
Table of Contents
What Is Zoloft?
Zoloft, sertraline hydrochloride, 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 taken.1 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.2
Zoloft is used to manage and treat the following conditions:2
- Major Depressive Disorder
- Obsessive-Compulsive Disorder
- Panic Disorder
- Post-Traumatic Stress Disorder
- Premenstrual Dysmorphic Disorder
- Social Anxiety Disorder
Zoloft, like other antidepressants, may increase the risk of suicidal ideation and behavior in children, adolescents, and young adults with major depression.3 For this reason, it is important to monitor patients taking Zoloft for unusual changes in behavior—anxiety, suicidality, or other questionable conduct.3
Zoloft may also cause erratic changes in sleep patterns and mood.3 If you are prescribed Zoloft, it’s important to follow the guidelines and avoid abusing or misusing the medication.
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.3 Taking Zoloft in a way other than prescribed is considered substance misuse. This includes self-medicating, altering the dosage amount, or taking it more often than prescribed.
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 is borderline addictive and 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.”4
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 to stop the drug or continue taking it. Continuing to take Zoloft to avoid withdrawal would be considered Zoloft misuse and may worsen into Zoloft addiction.
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 of alcohol, liquid sertraline may not be appropriate for you. Talk to your doctor if you feel you are at risk. Zoloft can have various side effects that may be heightened if you are misusing or addicted to Zoloft.
Short-Term Effects of Zoloft Misuse/Addiction
Long-Term Effects of Zoloft Misuse/Addiction
- Weight Loss
- Serotonin Syndrome
Serotonin syndrome symptoms may include mental health issues (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular aberrations (e.g., hyperreflexia, incoordination), and/or 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.1 If you abruptly discontinue the use of Zoloft, you may experience withdrawal, which is one sign you may be addicted.
Symptoms of Zoloft Withdrawal1
- Dysphoric mood
- Sensory disturbances (e.g., paresthesias such as electric shock sensations)
- Muscle spasms
- Suicidal ideation
- Poor cognitive and motor performance
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. 1
Seek help immediately if you experience any of the following:1
- Abnormal bleeding
- Petechiae to life-threatening hemorrhages
Zoloft Addiction Treatment
To avoid uncomfortable withdrawal symptoms, people may continue using the drug 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 Zoloft overdose.
Zoloft overdose occurs when someone takes too much of the medication. Although many symptoms of a Zoloft overdose are uncomfortable, Zoloft overdose is not necessarily life-threatening. However, in severe cases, an overdose can cause organ damage and may even turn fatal.1,2
Non-life-threatening symptoms of Zoloft overdose include:1,2
- Increased heart rate
- Nausea and vomiting
- Shaking and tremors
Seeking substance misuse treatment can help ease these symptoms, and weaning off Zoloft is the first step in recovery. Patients undergoing detoxification often present with psychological issues that affect the detox process.5 A program that begins with a medically-supervised detox program, where individuals can gradually taper off Zoloft in a medically-supervised setting is important. 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 address any possible substance misuse/addiction problems as well as receive therapy for the co-occurring diagnosis you were originally prescribed Zoloft for. Co-occurring mental health disorders are exacerbated by substance misuse.5
Several options have been successful in treating drug addiction, including short-term outpatient care, which involves a day program or several hours a week, and inpatient residential treatment, which can also be especially effective for those with more severe problems (including 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 the individual maintain recovery after treatment.6
Outpatient Behavioral Treatment
- 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: Developed for adolescents with drug misuse problems as well as their families, addresses a range of influences on their drug misuse patterns and is designed to improve overall family interaction.
- 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
- Therapeutic communities: Highly-structured programs in which patients remain at a restricted residence, typically for 30 days to 1 year
- Shorter-term residential treatment: Focuses on detoxification as well as providing initial intensive counseling and preparation for treatment in a community-based setting
- Recovery housing: Provides supervised, short-term housing for patients, 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 researching resources on your own.
We can help locate resources to start the journey toward recovery, contact us at 800-926-9037 Who Answers? today. Our support specialists are on standby to assist you.
- Federal Drug Administration. (2008). Zoloft.
- Singh HK, Saadabadi A. Sertraline. [Updated 2020 Nov 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
- Evans, E. A., & Sullivan, M. A. (2014). Abuse and misuse of antidepressants. Substance abuse and rehabilitation, 5, 107–120.
- Substance Abuse and Mental Health Services Administration. (2012). Substance abuse treatment advisory: Prescription medications, misuse, abuse, dependence, and addiction.
- Substance Abuse and Mental Health Services Administration (2015). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol (TIP 45).
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.