How long does Zoloft (sertraline) withdrawal last?

Zoloft (sertraline) withdrawal symptoms typically last up to 1 to 2 weeks, but may last even longer in some people. You should avoid abruptly stopping sertraline treatment unless otherwise directed by your healthcare provider. Gradually reducing the dose over 2 to 4 weeks can help to prevent severe withdrawal symptoms in most people.

Abruptly stopping antidepressant treatment, or tapering your dose down too quickly, can result in withdrawal side effects which are usually mild but can be severe in some people. Withdrawal symptoms may begin within 3 to 5 days after stopping treatment, but this is variable and can range from 1 to 10 days.

Do not discontinue sertraline treatment on your own. Your doctor can set up a tapering schedule to help you safely discontinue sertraline and lower your risk for withdrawal side effects. If you have taken sertraline for at least 3 to 4 weeks, or are on higher doses, you may be more likely to have withdrawal symptoms, also known as antidepressant discontinuation syndrome.

Withdrawal symptoms may also occur even if you gradually stop your medicine. However, some people may not experience withdrawal side effects at all after stopping sertraline.

All classes of antidepressant medicines can cause an antidepressant discontinuation syndrome to varying degrees. In general, only about 30% to 50% of people who stop antidepressant therapy will experience some level of antidepressant withdrawal.

What sertraline (Zoloft) withdrawal symptoms can I expect?

The most common side effects that may occur with abruptly stopping sertraline (Zoloft) may include:

• nausea
• sweating
• severe mood changes, emotional lability, irritability, agitation
• dizziness
• sensory disturbances (such as electric shock sensations or "brain zaps")
• tingling sensations or "pin-and-needles" (paresthesias)
• tremor
• anxiety
• confusion
• headache
• lethargy
• insomnia (trouble sleeping)
• hypomania (abnormally high energy behavior)
• tinnitus (ringing in the ears)
• seizures

If you experience withdrawal symptoms, you are unlikely to have all, or even most, of these side effects. In general, the most common symptoms tend to be dizziness, fatigue, headache and nausea. Anxiety and trouble sleeping may also occur for a brief period of time.

What sertraline (Zoloft) withdrawal schedule should I follow?

Follow your doctor's directions on how to best discontinue sertraline (Zoloft).

In general, it is recommended most antidepressants be reduced over at least 2 to 4 weeks to help reduce symptoms. But if you have been on a higher dose or taking your antidepressant for an extended period of time, your healthcare provider may decide to decrease your dose even more slowly, in some cases over over 6 to 12 weeks.

• As one example, if you are taking 100 mg per day of sertraline, your doctor may decide to lower your dose by 25 mg each week for 3 weeks until you are done with the medicine at the end of week 3.
• This means that during the first week you would take 75 mg per day for 7 days, then 50 mg per day for 7 days, then 25 mg per day for 7 days then stop.
• If intolerable withdrawal symptoms occur, your doctor may need to readjust your sertraline dose upwards to help alleviate these side effects, and then decrease your dose more slowly over a longer period of time.

For some tapering schedules, your doctor may need to prescribe different strengths or dosage forms (like a liquid solution) to help you correctly taper your dose.

The lowest available tablet dose of sertraline is 25 mg. If you need to taper your dose even more slowly, your doctor may order you the sertraline oral solution (20 mg per mL) to take at lower doses and over a longer period of time.

Be aware that sertraline oral solution contains 12% alcohol and may cause drug interactions with disulfiram (Antabuse) and should not be used during pregnancy.

Why does sertraline (Zoloft) cause withdrawal symptoms?

Quickly stopping sertraline treatment can lead to withdrawal symptoms due to its relative short half-life of about 26 hours. A half-life is the time it takes a dose of the drug to be reduced by one-half. It takes on average 4 to 5 half-lives for a drug to be fully eliminated.

Studies have shown that selective-serotonin reuptake inhibitors (SSRIs) such as sertraline with shorter half-lives can have more side effects when treatment is stopped abruptly. Taking higher doses and being on treatment for a longer period of time may also worsen these side effects.

In contrast, fluoxetine (Prozac) is an SSRI antidepressant with a very long half-life (ranging from 4 to 16 days). Plasma levels of the drug decrease gradually when treatment is stopped which may minimize the risk of discontinuation symptoms with this drug, but a long half-life also means that side effects due to the drug itself may be ongoing as the drug slowly eliminates from the body.

In some cases, your doctor may decide to use an antidepressant with a longer half-life, such as Prozac, to help control withdrawal symptoms while you taper down your treatment.

The half-life can vary based on your age, weight, genetics, kidney / liver function, drug interactions, and your medical conditions. Your doctor may decide to discontinue your dose even more slowly due to these factors.

This is not all the information you need to know about sertraline (Zoloft) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.