Every month, on an average around 13% of the adult US population take antidepressants, with women recording higher usage. Statistics also show that dependence on antidepressants increases with age. Among the various antidepressant medications, Zoloft is regarded as one with relatively better tolerance and lesser side effects. However, it is important to know more about the side effects and the best methods to reduce or mitigate side effects through proper dosage and following recommendations. Before we take a detailed look at the side effects of Zoloft it is necessary to understand more about the drug and its mechanism of action.

What is Zoloft and what are the common side effects of Zoloft?

Belonging to the category of selective serotonin reuptake inhibitor (SSRI), Zoloft is the brand name of the drug Sertraline. It is used for treating various conditions including major depressive disorder, depression, PSTD (post traumatic stress disorder), OCD (obsessive compulsive disorder) and premenstrual dysphoric disorder in addition to treating panic attacks. The medication is also used for treating social phobias, known as social anxiety disorder. Additionally, the medication is also famous for its off label uses including, diabetic neuropathy, premature ejaculation, and fibromyalgia. Let’s look at the mechanism of action of the drug before checking out the commonly reported side effects of Zoloft.

Mechanism of action of Zoloft

The drug helps manage the symptoms associated with the conditions listed above and this is primarily achieved by preventing the reuptake of serotonin. By virtue of being a selective serotonin reuptake inhibitor, the medication is known to result in enhanced cognition among patients suffering from depression. The drug has reduced sedative qualities when compared with other drugs of the same category. This is attributed to the different mechanism of action, unlike other drugs that work through anticholinergic, adrenergic blocking activity.

As a result of the different mechanism of action, the medication offers slightly delayed results when compared with other antidepressant medication. It typically takes around 4 to 6 weeks for patients to experience desired outcomes. The drug works by inhibiting the absorption of serotonin, and as a consequence, there is an increase in the concentration of serotonin. This in turn is responsible for the desired outcomes – antidepressant action. This helps manage symptoms and behavior associated with obsessive compulsive disorders and other disorders for which the drug is prescribed. The unregulated or imbalance in the levels of serotonin is considered as the primary reason for conditions associated with disorders.

Frequently reported side effects of Zoloft

The side effects of Zoloft are broadly classified into common and serious side effects. The common side effects include possible drowsy feelings, change in sleep patterns and timings, abnormal sweating, sudden lack of appetite, digestion problems, nausea, experiencing difficulty in ejaculating, decreased libido, unusual tiredness, and agitation. There is a possibility of individuals experiencing tremors without any particular reason. Additionally, children are also likely to experience side effects that include increased frequency of urination, inability to control or stop urination, and abnormal aggressive behavior. Nose bleeds and a sudden increase in muscular movements or agitated movements are also possible. Young girls are also likely to experience abnormally heavy menstruation. Additionally children are also likely to experience lesser than normal rate of growth and lesser than normal weight increase.

The serious side effects of Zoloft include suicidal tendencies, extremely compulsive or impulsive behavior, abnormal levels of violence, sudden aggression, panic attacks, apprehensions and depressive episodes, anxiety, difficulty in falling asleep, and increased time spent in talking. Serotonin syndrome is considered as one of the serious side effects of Zoloft as it can be life endangering in nature.

Other serious side effects include allergies that are severe in nature. For instance, there is a possibility of difficulty in breathing, or swelling in the face and tongue. Allergies include the development of rashes and welts that itch. The outbreak of blisters accompanied by pain and/or fever is also a possibility.

Side effects of Zoloft are not limited to the above, but also include the possibility of sudden bleeding, episodes of manic depression, and abnormal changes in weight. Individuals are likely to experience changes in their appetite, apart from sudden convulsions. Manic episodes are indicated through increased energy levels, difficulty in falling asleep, irrational or illogical behavior, grandiose imagination, uncontrollable thoughts, and extreme happiness or irritation. Elderly patients are at risk of having higher sodium levels in the body, which can result in headache, confusion and sudden weakness. There is a possibility of individuals exhibiting instability in movements, apart from difficulties in focusing or concentrating. The ability to think clearly or memorize is also likely to be impacted.

Other common side effects include pain in the eye, blurred vision, double vision or some abnormal change in vision. Individuals are also likely to experience swelling around the eyes that could also be accompanied by redness.

Commonly reported side effects of Zoloft – serotonin syndrome

Serotonin syndrome is one among the commonly reported side effects of Zoloft. Here is a detailed look at the syndrome and its effects. The syndrome is caused when medications result in accumulation of higher levels of serotonin in the body. The neurotransmitter is necessary in the nerve cells and the brain for normal healthy functioning. However, when the levels of serotonin are excessive, certain side effects are experienced. In rare instances, there is a possibility of fatality as a result of higher levels of serotonin. Common effects due to serotonin syndrome include a feeling of restlessness, increased sweating, lack of proper coordination between muscles, dilation of pupils, increased confusion, abnormal shivering sensation, stiffness in the muscles, pacy heartbeat, increased blood pressure and possible headache.

Among the side effects of Zoloft the following serious levels of serotonin syndrome is dangerous and is regarded as life endangering in nature. For instance, abnormal heart beat rhythm, losing consciousness, fever are possible indications of serious levels of serotonin syndrome. There is also the possibility of patients developing high fever during this condition. The reason behind serotonin syndrome is attributed to the introduction of new medication or as a result of increased dosage. It is possible to manage the conditions effectively by either stopping the medications or by taking serotonin blockers. Side effects associated with mild levels of serotonin syndrome are likely to reduce to resolve in a few days after the medication has been stopped.

Classification of the drug by FDA and interactions

The drug is classified by the FDA with a black box warning, which essentially indicates that the warning is serious. The warning is intended to alert the patients and doctors alike about potential side effects of Zoloft. Additionally, the drug is known to have contraindications/interactions with other medications. It is therefore necessary to share details of all medications and supplements that are being consumed. This includes all herbal formulations and vitamins that may be taken for various purposes. There are specific drug combinations and active ingredients that are known to have interactions with Zoloft. Consequently, it may be necessary to discontinue either of the medications, depending on the need and the priority. For instance, individuals on monoamine oxidase inhibitors are advised to stop the medication if Zoloft is intended to be used for treating depression.

The combination of both medications can result in serotonin syndrome. There needs to be a gap of atleast two weeks between one medication and the other. Similarly, individuals on antipsychotic drugs need to stop the medication before or after taking Zoloft. This is because the combination of both medications can result in heart problems of a serious nature. Additionally, there are other medications that are known to increase the side effects of Zoloft. It is therefore necessary to avoid or stop the medications that can aggravate the side effects. For instance, non-steroidal anti-inflammatory drugs are known to increase the possibility of bleeding. Similarly, serotonin receptor agonists are also known to aggravate the risk of serotonin syndrome.


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