Content

• To step
• Method 1 of 2: Taper off Zoloft
• Method 2 of 2: Lifestyle changes and alternative therapies
• Tips
• Warnings

Zoloft or sertraline is an antidepressant of the type SSRI (selective serotonin reuptake inhibitors). It is often prescribed for depression, compulsive compulsive disorders, post-traumatic stress syndrome, panic attacks, social anxiety disorders and premenstrual dysphoria. Because Zoloft affects brain chemistry, you should not stop without consulting a doctor first. In addition, tapering and stopping Zoloft should only be done under medical supervision and on a gradual schedule that your doctor will establish.

To step

Method 1 of 2: Taper off Zoloft

1. Consider why you want to stop Zoloft. In general, you should keep taking Zoloft if the drug has gotten your depression or condition under control. However, there are good reasons to stop or change medications under medical supervision. Some of these reasons are:
   • If you experience severe or persistent side effects.
   • If your depression or condition is not being addressed by Zoloft. This could mean that you have persistent sad, anxious or empty feelings, are irritable, have no interest in fun activities or hobbies, have fatigue, have trouble concentrating, have sleep disorders such as insomnia or excessive sleeping, is changes in appetite, that you are having suicidal thoughts or that you are in physical pain. It is important to note that Zoloft generally takes up to eight weeks to work fully and the dose may need to be increased.
   • If you have been taking Zoloft for a while (6-12 months) and your doctor thinks you are not at risk and do not have chronic or recurring depression.
2. Review any side effects you have experienced. Some side effects of this drug may include nausea, dry mouth, drowsiness, insomnia, altered sex drive, and uncontrollable shaking. Tell your doctor if any of these side effects are severe and persist.
   • In addition, young adults and children can also have suicidal thoughts. Notify your doctor immediately if you are considering suicide.
3. Talk to your doctor. Discuss the side effects or other reasons why you may want to stop taking Zoloft. This will help your doctor make an informed decision and determine the right time to stop taking Zoloft.
   • If you are on medication for less than eight weeks, your doctor will likely suggest that you keep taking Zoloft for eight weeks so that it can take effect.
   • If you want to stop Zoloft because it has not helped, you can ask your doctor to increase the dose in order to possibly still get positive results.
4. Slowly phase out Zoloft. Antidepressants should be tapered off slowly to avoid withdrawal symptoms. Depending on the antidepressant, this can take weeks or months; this depends on the duration of intake, the dose and your symptoms. If you quit immediately, "cold turkey," your body will not have enough time to adjust and you may experience severe withdrawal symptoms. Some of these symptoms are:
   • Digestive problems such as nausea, vomiting or cramps
   • Sleep disturbances such as insomnia or nightmares
   • Balance problems such as dizziness
   • Sensory or motor problems such as numbness, tingling, shaking or lack of coordination
   • Irritability, anxiety or fear
5. Taper off based on your doctor's schedule. The time it takes to stop Zoloft may depend on how long you have been taking the medication and the specific dose. Your doctor will determine the best schedule for you to stop taking Zoloft to minimize possible withdrawal symptoms.
   • One possible way to reduce it is to reduce the dose by 25 mg every two weeks.
   • Keep track of your taper schedule by writing down dates and dose changes.
   • Expect tapering to take several weeks. If you have been taking Zoloft for a long time, you should probably count on it for four to six weeks. If you start to experience excruciating withdrawal symptoms, your doctor may decide to slow you down.
6. Keep track of any side effects you experience. Even while you are tapered off Zoloft, it is possible to experience withdrawal symptoms. You may also be at risk for a relapse of your depression or illness. Keep a close record and consult your doctor if you experience any of these symptoms.
   • Withdrawal symptoms can flare up quickly, will usually ease after one to two weeks, and can also cause physical symptoms. To distinguish between withdrawal symptoms and relapse, look at when the symptoms start, how long they last, and what kind of symptoms they are.
   • Relapse symptoms develop gradually after 2-3 weeks and get worse after 2-4 weeks. Contact your doctor if you experience symptoms that last for more than a month.
7. Keep your doctor informed. Your doctor will monitor you for at least several months after you stop taking Zoloft. Inform him or her of any relapse symptoms or concerns you may have. You may want to reduce your wait for follow-up consultations with your doctor during this time.
8. Take new medication according to your doctor's prescription. If you stop taking Zoloft because of the side effects or if Zoloft is not helping to relieve your depression, your doctor may prescribe a different antidepressant. The choice depends on many aspects such as your preference, your first reaction to it, effectiveness, safety and tolerance, price, side effects and interactions with other medications. If you are experiencing side effects or if your depression is not being mitigated enough, your doctor may recommend the following:
   • Another SSRI such as Prozac (fluoxetine), Seroxat (paroxetine), Cipramil (citalopram), or Lexapro (escitalopram)
   • SNRIs such as Efexor (venlafaxine)
   • Tricyclic antidepressants (TCA) such as Sarotex (amitriptyline).
   • Monoamine oxidase inhibitors (MAOIs) can also be used if delayed until five weeks after stopping Zoloft.

Method 2 of 2: Lifestyle changes and alternative therapies

1. Try to exercise regularly. Research shows that regular exercise can stimulate the production of endorphins and neurotransmitters that help with the symptoms of depression. Try to exercise for about 30 minutes daily.
2. Change your diet. A healthy diet will benefit you in every way. Omega-3 fatty acids, in particular, can be useful as adjunctive therapy for depression.
   • Omega 3 fatty acids are found in foods such as kale, spinach, soy and canola oils, flaxseeds, walnuts and fatty fish such as salmon. You can also buy them over the counter, usually in the form of gelatin capsules with fish oil.
   • Research shows the benefits of omega 3 fatty acids in mood disorders at doses between 1-9 grams. However, there is more evidence for the lower dosages in that range.
3. Follow a consistent sleep schedule. Sleep is often disturbed by depression. It is important to maintain a good sleep pattern so that you get enough rest. This because, among other things:
   • Go to sleep and get up at the same time
   • Avoid stimulation before bed, such as exercising, watching TV, or working on the computer
   • Avoid alcohol and caffeine before bed
   • Using your bed to sleep instead of reading or doing other work
4. Seek the sun. There is no consensus on how much sun exposure is needed to treat symptoms of depression. However, researchers agree that some types of depression, such as winter depression, can be mitigated by exposure to sunlight. Research also indicates that sunlight can affect serotonin levels.
   • Sunlight can also reduce the risk of disorientation and depression in elderly patients with Alzheimer's disease.
   • In general, there is no maximum exposure to sunlight. Make sure to use sunscreen if you will be spending more than 15 minutes in the sun.
5. Make sure you have enough support. During the process, you should stay in touch with your doctor and tell him or her about how you are doing, your feelings, and the symptoms you are experiencing.Also, have a close friend or family member involved. He or she will provide emotional support or be able to recognize the symptoms of a relapse.
   • Getting support is very important. Try not to decline invitations to participate in activities. Try to go outside more often.
6. Consider psychotherapy. An analysis of several studies has found that people who undergo psychotherapy while stopping antidepressants are less likely to experience relapses. Psychotherapy is a way to help people with mental health problems by teaching them ways to deal with unhealthy thoughts and behaviors. It provides people with tools and strategies to manage stress, anxiety, thoughts and behaviors. There are different forms of psychotherapy. Treatment plans depend on the individual, the condition, the severity of the condition, and a variety of other factors such as medication.
   • The goal of cognitive behavioral therapy (CBT) is to make people think more positively and to influence their behavior. It focuses on current problems and finding solutions to these problems. A therapist helps the person recognize unhealthy thoughts and change false beliefs, changing their behavior in general. CBT is particularly effective in depression.
   • Other therapies - such as interpersonal therapy, which focuses on improving communication patterns; family therapy, which helps to resolve family conflicts that may affect the patient's disease; or psychodynamic therapy, which focuses on giving people more self-awareness - are all possible options as well.
7. Consider acupuncture. Some research has pointed to the benefits of acupuncture for depression. As much as it isn't part of the general recommendations, acupuncture can help some people. Acupuncture is a technique in which thin needles are inserted through the skin at specific points to relieve symptoms of disease. If the needles are properly sterilized, there are few risks.
8. Consider meditation. An analysis of past studies by Johns Hopkins University in the United States suggests that meditating for 30 minutes a day can relieve symptoms of depression and anxiety. Practical ways to meditate include repeating a mantra, praying, taking time to focus on your breath, or reflecting on what you have read. Aspects of meditation include:
   • Attention - By focusing your attention on a specific object, an image, or your breath, you can free your mind from worry and stress.
   • Relaxed Breathing - Breathing slowly, deeply and at the right pace provides more oxygen and helps you breathe more effectively.
   • Peaceful Environment - This is an important aspect of meditation, especially for beginners, so that you have fewer distractions.

Tips

• It is imperative to get enough sleep when you stop taking Zoloft, because a less common but very disturbing side effect is waking dreams.
• Report any symptoms of dreadful thoughts and insomnia immediately after starting Zoloft as they may indicate bipolar disorder.
• Some people tolerate SSRIs better than others. Talk to your doctor about the oral version of the medicine, which will allow you to taper off the dose more gradually.

Warnings

• This article provides medical information; however, it should not be construed as medical advice. Consult your doctor before stopping or making any adjustments to any prescription medication.
• Stop taking Zoloft and contact your doctor immediately if you experience serious side effects related to the drug, especially if you start having thoughts of suicide.
• There are certain reasons why you should not stop taking Zoloft:
  • If you started taking Zoloft recently (in the last few months), your depression has resolved and you feel like you no longer need the medication
  • If you don't want to take an antidepressant or medication even though your depression hasn't been resolved yet
  • If you want to change medications without having to do with side effects or effectiveness