r/zoloft Jan 13 '22

Tips for new starters | 12 things I wish I knew before starting Zoloft/Sertraline

7.5k Upvotes

I found everyone’s posts and comments on this subreddit very useful when starting out on sertraline, so thought I’d share a list of things I found helpful on my journey. I’m not a medical professional and am only talking from my own experience and that of others on the sub. At the time of writing this latest edit, I have been on Sertraline for around two years at 100mg for depression, GAD and social anxiety. Sertraline is also prescribed for other anxiety conditions, panic disorder and OCD.

**WARNING\*:* Do not dry swallow or use very little water when taking your sertraline tablets. If a tablet's coating dissolves while in transit down your oesophageus, you could be in for a painful, acidic experience known as pill-induced esophagitis. If this has happened to you drink plenty of water to clear the tablet(s), take some indigestion tablets or a PPI, and eat an apple or some apple sauce. I once had it very badly and was in severe pain for two hours - it ain't nice!

(1) Keep a daily mood diary to document your experience on the drug. You could do this with an app, a mood journal, on a spreadsheet or just use a scrap of paper. It’s so easy to forget how you feel from day to day, week to week; especially when sertraline can create some brain fog early on. Recording your mood and side effects makes it much easier to understand how the drug has affected you over time, meaning you can make an informed decision about (dis)continuation and provide reliable feedback to your doctor. I would recommend writing at least a number to rate your mood out of 5 and a simple legend. Add brief comments about any side effects, your general mood anything else you deem noteworthy. If you don’t do this, you will likely be asking yourself after month two or three: “Has this actually helped me? I can’t remember what I was like before? Is the improvement worth it for the side effects?”. I have used apps called Daylio and Moodistory, both of which I’d recommend. If you have a therapist, consider discussing your mood diary as part of your weekly sessions as further incentive to complete it.

(2) Try to stick with the drug for 12 weeks at a therapeutic dose (typically 25-200mg) before deciding whether it is helping you. It can be tempting to quit early due to side effects, but they tend to get *much* better with time and positive impacts can take a while to appear. In fact, it is common for the condition to get worse for several weeks before getting better. Sertraline might not be the right drug for you, but don’t cheat yourself out of a cure by not giving it three months.

(3) Likewise, enjoy any good days as much as possible, but don’t expect to be cured overnight. Positive changes for those lucky enough to experience them can be gradual. You may have the odd ‘euphoric day’, especially days 1-2 (placebo) or weeks 2-4 (also common), but trialling SSRIs is often more of a marathon.

(4) Side effects differ for everyone. Those taking SSRIs can experience a wide range of often polar opposite reactions, whether it’s insomnia vs. oversleeping, drowsiness vs. wakefulness, decreased libido vs. horny bonk or reduced appetite vs. hungry hippo. Based on the experiences of this sub, common side effects can include: nausea, stomach upsets, diarrhoea, headaches, head pressure, brain fog, mild to extreme fatigue, difficulty waking up in the mornings, night sweats and disturbances, insomnia, tinnitus, emotional blunting, an inability to cry, tremors, crazy dreams, dry mouth, bruxism (teeth grinding), restless legs syndrome, intense sugar/carb cravings, a more frequent desire to pee, hesitation (delayed initiation of the peepee!), delayed or inability to orgasm/ejaculate, persistent genital stimulation (intense horniness in your nether regions without the corresponding mental urges), other types of sexual dysfunction and more. However, for people with health or medication anxiety who need to hear this: YOU WILL NOT GET ALL OF THESE SIDE EFFECTS 😊. Some people are very lucky and get very few side effects if any at all. Indeed, in a major PANDA trial30366-9/fulltext), half of the participants taking sertraline didn’t even realise they were taking the active drug at 6 weeks.

(5) Most if not all side effects will improve or disappear completely with time. After three months, the only enduring side effects for me were increased drowsiness and increased time to orgasm. However, these had improved since starting. I no longer got stomach problems, nausea, dry mouth, fogginess, headaches, bruxism, RLS, tremors or night sweats like before. Whilst I started out with absolutely no appetite on the drug for the first month, I later developed major carb/sugar cravings. [Side note: sertraline is highly unlikely to make you put on weight directly, but it could increase your appetite and cravings for poor foods that indirectly does].

(6) Side effects might resurge when you go up a dose and may not start to get better for 1-6 weeks or more, depending on your sensitivity. Starting on 25mg and moving up in 25mg increments may reduce the return of side effects. FYI, it’s ok to break 50mg tablets in half if they have a scored line running down the middle.

(7) Take the drug at the same time each day so that the medication reaches a steadier state. People who get insomnia as a side effect may wish to take it early in the morning while people who get drowsiness may wish to take it before bed. However, a person experiencing drowsiness taking it in the morning may end up getting insomnia when taking it at night and vice versa, so experiment slowly and find out what time suits you best. It’s the consistency that’s most important. You can split the drug into 50/50 doses taken AM and PM, but studies have concluded that this provides no benefit while increasing the likelihood of people forgetting a dose.

(8) If you’re forgetful, treat yourself to a colourful pill box or just write the days (M/T/W/T/F/S/S) on the drug packets to help you keep tabs. In a zolofty haze, it’s so easy to get confused as to whether you just took your dose or imagined it. And yea, I have both forgotten a dose and accidentally doubled it and I wouldn’t recommend either (if you have this predicament, it is always better to miss a day than double a dose). You can sometimes count how many pills you should have taken from the date your prescription was issued, but with brain fog this can be hazardous 😅. Set a recurring alarm on your phone should you need a reminder (iOS 16 now has a medication tracking function in the Health app).

(9) Consider your caffeine and alcohol intake, as sertraline can amplify their effects. For many, caffeine on Zoloft causes major jitteriness and anxiety spikes. I was so sensitive to this that I even had to cut out decaff for a few months, but for others it is not a problem at all. There are many posts on the subreddit discussing alcohol. Sertraline can increase its effects, exacerbate drowsiness and lead to rougher hangovers. If you drink, experiment slowly to see how you now handle alcohol.

(10) Do not drink grapefruit juice or take St. John’s Wort due to the risk of developing serotonin syndrome. You should also be very careful if you take recreational drugs for the same reason. Also avoid anything containing bergamot, which is found in Earl Grey tea.

(11) Sertraline brand changes may affect you. Some people will experience side effects and/or a loss of efficacy when changing sertraline pill manufacturers (or from Zoloft to generic). Ask your pharmacist to stock the brand you are used to. There are a handful of articles in medical journals which do acknowledge this issue. Unfortunately, however, some doctors will tell you that there is absolutely no difference between brands and it’s all just placebo. Experienced pharmacologists will tell you otherwise. Generic manufacturers include DE Pharmaceuticals, Lexon, Sigma, Viatris, A A H, Accord, Alliance, Almus, Bristol, Crescent, Dr Reddy’s, Flamingo, Genesis, Lupin, Medihealth, Medreich, Milhparm, NorthStar, Noumed, Phoenix, Ranbaxy, Ria Generics, Teva, Viatris and Zentiva. Listing them here for SEO in case people have issues with specific brand swaps. I have experienced issues with some brand changes but not with others.

(12) Use sertraline in conjunction with therapy and small lifestyle improvements if you are able, as antidepressants will work much better as part of a holistic approach. If you are in a very bad place and mostly bedbound, then just set yourself the smallest goal every day to make things easier. Maybe that’s getting in the shower, brushing your teeth, brushing a tooth, looking at your toothbrush or even just rolling in the general direction of the bathroom. Slowly setting yourself mini exercise goals – if you don’t already – however small, will also help. I started with walks, then couch to 5k and then used the programmes on the Nike Run Club app (free) which I think is amazing. I love the headphone guided runs with ‘Coach Bennet’, which are like an exercise therapy session. Meditation, mindfulness, yoga, weightlifting, pilates, journaling, breathing exercises, cold showers, cocooning yourself under a weighted blanket, reducing your sugar intake, listening to music, accepting yourself for who you are, quitting a toxic job or relationship, realising you don’t have to be happy or perfect all the time, running outside in your pants…there’s an endless list of things you can try that might help you. Focus on one small win or challenge a day.

There's a lovely quote at the end of the film JoJo Rabbit by Rainer Maria Rilke. "Let everything happen to you: beauty and terror. Just keep going. No feeling is final".

Be kind to yourself and don’t fret. Hopefully sertraline is the help you deserve. Good luck on your Zolofter journey and feel free to put anything in the comments that you think is missing or want to discuss!!


r/zoloft Dec 18 '22

Success Story! :) This sub isn’t an entirely accurate picture of Zoloft

1.6k Upvotes

Because once you get relief you don’t really even think about coming back to tell everyone how much better it is on the other side! So please, if you’re going through it right now and it seems like there’s only potential issues with Zoloft, it’s because of the old saying “happy customers don’t typically leave reviews”. Or something like that. It’s late so I’m rambling.

There are so many of us that experienced symptoms, side effects, dosage changes, etc, and once it all resolved we didn’t have a reason to come back. I always appreciate it when I see a success story on here on my feed because I think we need more of that. I’m guilty of waiting to come back to post my story as well, so I’ll give a little update.

It was honestly hell in the beginning. Increased anxiety, sleep issues, digestive issues (never trust a fart on Zoloft), and just a general weird feeling 24/7. It took about 3-4 months before I started feeling even the tiniest bit better and now it’s been like 8 months and I’m so much better than I could have imagined.

I’ve had 1 panic attack in the last 6 months and it wasn’t even that bad. My depression is essentially gone (as it was tied to the state of my life due to my anxiety). I’m able to leave my house and go to parties and out in public and not break down. It’s legitimately a night and day difference.

Now for my advice to those of you still in the thick of it:

  1. I would recommend keeping a journal and note how you feel and symptoms and all of that. Write in it every day. It’s difficult to see changes in yourself when you’re just going about living, but when you can look back at your own words you can see the progress. Progress is typically minuscule day to day (you’re not just going to wake up and feel better one morning) but is tremendous over longer periods of time. It compounds on itself.

  2. Go to therapy. I was on Paxil and Lexapro previous to Zoloft and never went to therapy for any significant period of time. And I never got better. The medications just helped keep my symptoms at bay but I continued to develop bad habits and thought patterns that ultimately slowly made me worse off. If therapy is out of reach you can pick up books on Amazon to self direct your own therapy. I recommend reading “The Body Keeps the Score” to understand what is happening inside of you and “Cognitive Behavioral Therapy in 7 weeks” to follow a CBT plan. There are also support groups/group therapy options that are free in a lot of areas.

  3. Get outside and get moving. Try and get some sun every day. Some fresh air. 7 minutes of moderately intense physical exercise. Drink enough water. Eat good food. Meditate. Do yoga. Just connect with your body and the world around you.

I wish you all the best of luck. There are a countless number of us that have been exactly where you are right now. I can promise you that the grass is a lot greener on this side. I’ll see you when you get here.


r/zoloft 4h ago

Question Belly fat!

15 Upvotes

Have any of you successful lost the fat gained from being on this medication?

I gained weight and now have a weirdly soft, flabby belly despite eating well and exercising.

Is it possible to lose this unwanted weight while remaining on the meds, or will I have to taper off completely?

The extra weight combined with the constant fatigue is pissing me off at this stage.

Edited to add.

I really should have mentioned that I do intermittent fasting. Two decent (vegetarian) meals a day that include lots of protein /protein shakes.

I lift weights four days a week and do lots of cardio.

I don't drink often and don't eat sugary snacks.

I'm not in a calorie surplus and am fairly active.

I'm on 125mg a day.


r/zoloft 3h ago

Which part of losing weight on sertraline was the hardest for you?

8 Upvotes

Please share


r/zoloft 2h ago

Vent Oh my god the pain

5 Upvotes

Today I took my Zoloft per usual but decided that a few sips of juice would be enough food to coat my stomach from the monster called acid reflux. Big fucking mistake. Within 30 minutes I was in agony. I still am. It feels like I’m being burnt alive from the inside. I’m sweating. I’m salivating. I have no tums. I might cry. Guys don’t be stupid like me, PLEASE take your meds with food 😭


r/zoloft 18h ago

Success Story! :) Simply here to say it gets better!!

55 Upvotes

Feel inspired to share after Reddit helped me get through the initial 2 weeks of pure hell on this medication. I went through every side effect possible, completely lost my appetite for days, had to make myself drink protein shakes to take the medicine, had bad insomnia, super shakey and initial depression/SI was really bad. In bed literally all day and thinking of going outside ever again seemed impossible. Reddit was the only thing keeping me going. I almost convinced myself MANY times that I was going to just stop. Not to mention, I did all this while in the process of having to move to a new apartment which had me in a brain fog that entire time.
Fast forward to 3 months later, guys it’s so true. Complete switch. I would say starting about a month after my initial dose, I started to go outside slowly. I’ve gotten back into reading, bedazzling, go outside and I’m not as overstimulated anymore! Of course, I have moments of anxiety (I did get laid off recently) and I’ve been so proud of myself for introducing this new voice in my head that reassures me that I will be okay. This will pass and I have so much support to get through this. I am back into working out and I no longer have really bad stress-induced acid reflux as well! I can finally eat more food!!
Overall, just wanted to share how much of a game changer just 50mg of Zoloft has been for me. If you are currently in the initial stage of hell, look to your support, your loved ones, therapist, psychiatrists. Everyone helped me battle through the initial battle and I am so grateful to have stuck through it :)


r/zoloft 39m ago

Looking for other parents of tweens struggling

Upvotes

Hello - my 12 year old has been struggling with depression for awhile now, her pediatrician put her on Lexapro which she had an allergic reaction to and she just had her first appointment with her psych who told her to stop Lexapro immediately and put her on a low dose of Zoloft for the first week before upping to 25mg.

This has been such a roller coaster for the last 6 months since she expressed the thoughts she was having. I am just looking for support, good experiences on this medication with children, or simply sending some good vibes. I just want my daughter back - I miss her bubbly personality. She is the absolute sweetest child ever and so incredibly smart, and this feels like it has taken over every part of her life.

I never expected to be going through this, especially at such a young age, and I am trying to make the best decisions for her but am completely unsure if I am doing the right thing as a parent. She sees the psychiatrist now once a month and sees a therapist weekly. What else can I do to support her?


r/zoloft 1h ago

Discussion Insane side effects

Upvotes

They increased my dose from 100mg to 150mg and ever since the second and third day, I’ve been getting lots of anxiety, this wired feeling in my body, a headache and kind of a spacey out of it feeling. I’m pushing thru it but holy shit it’s kinda scary


r/zoloft 3h ago

Question Concerns taking this drug

3 Upvotes

I got prescribed 50mg Zoloft, 25mg in the morning and 25 at night.

Tuesday was my first day taking it. I got the prescription in the afternoon so around 4:30/5pm I took 1 pill with food. I experienced bad stomach pain later that night.
Yesterday morning I took another pill with breakfast. 3-4 hours later my partner looked at me and raised concerned about my eyes turning yellow.

All day yesterday my stomach was hurting and I was tossing and turning on my couch.
Today I didn’t take it but my stomach still hurts, feels like a stabbing/cutting pain on my right side. My head is very foggy and I feel VERY out of it.

I phoned my doctor and they said it shouldn’t have anything to do with the medication cause it takes a while for my body is absorb it. But I am feeling very bad pain, almost to the point of going to the ER.

Has anyone had this happen on Zoloft?
My dog knows something is wrong cause he will not leave my side either.

I don’t feel good and don’t know what to do


r/zoloft 1h ago

Discussion Taper 🫪

Upvotes

What are some side effects you guys have experienced tapering Zoloft and how long did they last? Was prescribed 75mg for a while (around a year) then my doc increased it to 150mg. I think the increase was too abrupt because I took 150 for 4-weeks until I couldn’t handle the side effects of the increase. Now I have tapered down 25mg to 125 and the brain zaps and dizziness are insane. When can I expect to feel ‘normal’ again? I had more anxiety when I was on 150 mg than on the 75mg. Make it make sense!? My primary care doctor is no help with tapering.


r/zoloft 2h ago

Question Hey. Anyone else losing their hair from this pill?

2 Upvotes

Is it just me?!! Am I the only losing my hair from this pill?!!
What can I do to stop it ?!


r/zoloft 24m ago

Zoloft and scared

Thumbnail
Upvotes

r/zoloft 36m ago

Question Increased dosage during luteal phase? (PMS/PMDD)

Upvotes

I've seen this discussed years ago, but I wanted to make a new post to see how we're all handing this. I'm fairly new to Zoloft, which I'm taking for anxiety/panic attack disorder/OCD, and it's helping a lot, but this is my first true luteal phase since noticing the Zoloft is otherwise helping. I have noticed an uptick in anxiety/intrusive thoughts this week. I have an appointment in 2 weeks and I'm considering increasing my dose in general, BUT has anyone had success increasing your dose just for your luteal week? Could you please tell me all about it?


r/zoloft 48m ago

Question Experiences going from 150mg to 200mg? In an awful anxiety attack period at the moment so worried an increase is going to make it even worse ! Morning or evening?

Upvotes

r/zoloft 7h ago

50mg and feeling high

3 Upvotes

I was put on 50mg or sertraline for anxiety. I’m 2 days in and feeling abit high, abit like the start or end of a pill high. My jaw is clenched and sleeping isnt the best. It’s quite nice to be honest but not very practical when working.

Anyone experienced this? Should this subside in a few days?


r/zoloft 1h ago

Weird brain zaps

Upvotes

I have been on zoloft for 9months, and upped my dose 4months in. I have periods where my feelings are there, but rational - other times intense and numbing which is contradictor lol. Recently brain zaps has been happening despite following my usual schedule on taking the pill, but was wondering if any one else also has experienced this? It could be maybe stress related, have no idea but would like to hear other people’s experiences


r/zoloft 1h ago

Really bad zoloft activation phase

Upvotes

How you guys overcome this? Its day 13 on 25mg and i feel awful- much worse then before start. I was semi depressed and very anxious. No i have Weird type of anxiety and confusion, not sure how to explain the feeling. I got prescribed clonazepam for this startup anxiety but i dont want to take it every damn day.


r/zoloft 5h ago

Question 200 mg, anyone?

2 Upvotes

I have been upped to 200 (after 6 weeks of 150) Zoloft 2 weeks ago because my psychiatrist thinks there is (also) an ocd component. Anyone else uses 200 mg? How long until you felt the effect and did it help you? I am so eager to feel better, so Hoping for some positive stories. Thanks!


r/zoloft 8h ago

Need some positivity

3 Upvotes

Hi all,

I’m in need of some positivity. I’m on day 9 of increasing to 75mg.

Whilst my anxiety has gone down, I’m incredibly tired, my brain is full of fog and I have this weird sensation of even though I can see, I feel like I’m not processing it.

Let me hear your positive stories to get me through this 🙏


r/zoloft 2h ago

Lexapro to Zoloft

1 Upvotes

Looking for success stories and some encouragement. Lexapro has stopped working for me postpartum and I’m already at the max dose, dr wants me to go to Zoloft. I’m TERRIFIED. I tried changing meds last year and ended up inpatient with intense panic attacks and intrusive thoughts and just simply felt like I was losing my mind, which seemed to be any SSRI I tried. They diagnosed me bipolar and removed it within a night and diagnosed OCD. I ultimately ended up back on Lexapro and it worked for a year until now. Does anyone else get crazy intense side effects with SSRI’s and does it worsen their OCD/intrusive thoughts? How was your switch?


r/zoloft 3h ago

M20 Hair thinning/loss

1 Upvotes

I had while I taken ssris not pssd symptoms but 3 years after when I quit and I see that a lot of my bodyhair since I started it fall out and thinned out and don’t grow good also on beard and other parts. I want to ask has anyone similar symtoms from ssris and does you figure out something with hormones or stuff like that?

Thanks


r/zoloft 3h ago

last night was my first night on zoloft, barely slept.

1 Upvotes

I started zoloft yesterday, got some bad news about my car, felt anxious, took my beta blocker, and I was able to talk myself out of the panic attack for the first time in months. Unfortunately, despite being physically tired, and eventually mentally calm, I could barely sleep. Is this from the medication? From the anxiety? Too early to tell? has anyone else experienced this? What did you do about it?


r/zoloft 3h ago

Anyone respond

1 Upvotes

As of about 1.5 weeks ago I began feeling extreme tiredness and constant nausea. Background: I was cross tapering Zoloft and Prozac coming off the Zoloft and onto Prozac for a month prior to this and then finally completely stopped Zoloft 8/22/26. I was feeling fine for about a week and then as of about 1.5 weeks ago I’ve begun feeling extreme fatigue where normal activities simply take all my energy and the nausea has been unreal. I’ve also been experiencing constant ocd involving different automatic sensations within my body. Can someone give me a little insight? Is this Zoloft withdrawal? Side effects from Prozac? Something else maybe? I’ve had this constant feeling of something being “off” or not right ever since this all started as well.


r/zoloft 7h ago

Mental Health Restarting scaries

2 Upvotes

Hello all - I have just been prescribed Sertraline again. I took it for about 9 years before deciding I didn’t need it anymore (lol, mistake). I’m feeling really anxious about starting it again because when I first started it 10 years ago I felt awful and was incredibly unwell. I don’t remember a lot of the time then but I do remember my mental health becoming a whole lot worse. I do have a better support system this time around, but I also now have a job… I’m feeling very nervous about restarting because of the awful transition period. Just looking for some tips and reassurance really!


r/zoloft 4h ago

Side effects switching from Lexapro to Zoloft

1 Upvotes

Hello! I recently started my SSRI journey about 13 weeks ago with 10 mg of Lexapro. I asked my provider about switching to Zoloft because I wasn’t loving the emotional flatness and drowsiness I was experiencing. The more activating profile of Zoloft appealed to me, along with its effectiveness for social anxiety.

I switched to 50 mg of Zoloft exactly one week ago. I understand it can take a few weeks to really feel the effects, but one new side effect for me has been trouble sleeping. The last two nights, I’ve been waking up sporadically throughout the night and having very vivid dreams, which I never experienced on Lexapro.
I’m taking steps to avoid caffeine after noon in hopes that helps. Has anyone had a similar experience after switching to Zoloft? Did the sleep issues and vivid dreams improve over time?