Zoloft depression treatment and side effects, information - What is the right dosage, can it be combined with 5-HTP, SAM-e or St. John's wort vitamins and supplements?
September 15 2016 by
Ray Sahelian, M.D.


Zoloft is used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won't go away and the need to perform certain actions over and over), panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks), PTSD posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). Zoloft is also prescribed to relieve the symptoms of PMS premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness.


How Zoloft works, mechanism of action
Zoloft is in a class of prescription medications called selective serotonin reuptake inhibitors (SSRIs). Zoloft works by increasing the amounts of serotonin, a natural substance in the brain that helps maintain mental balance.


Zoloft side effects

Possible Zoloft side effects include: Nausea, diarrhea / loose stools, dyspepsia, sexual dysfunction (primarily ejaculatory delay), insomnia, somnolence, tremor, increased sweating, dry mouth, and dizziness. A possible higher rate of suicide from Zoloft has been reported but this claim is controversial. It has been suggested that SSRIs may cause depression to worsen and even lead to suicide in a small number of patients. These potential Zoloft side effects are difficult to evaluate in depressed patients because depression can progress with or without treatment, and suicide is itself a consequence of depression.


Q. I have had great success using LJ100 and other herbs for sexual enhancement. I recently just started taking Zoloft which is working wonderfully for me but I am experiencing a loss of libido. I read that you don't recommend taking LJ100 with an SSRI such as Zoloft. Is there any sexual enhancement herbs that are safe with Zoloft? Can I take Korean Ginseng while on Zoloft. I know that you aren't supposed to respond to these emails but please help It is hard to find any information on this subject.
   A. Antidepressants of the SSRI class such as Zoloft increase serotonin in the brain and thus dampen libido and erections. Unexpected side effects can occur when Zoloft and such drugs are combined with sexual herbs, such as LJ100. Hence, even though there may be people who can tolerate the combination of Zoloft and LJ100 or other sex herbs, some people may not and get side effects and we cannot predict who will have such untoward reactions and we cannot predict which sexual herb will be tolerated and effective and which will not. We don't want to take the chance recommending a particular sex herb to be taken with Zoloft and then having reports back of unexpected side effects. There have been no studies that we know of combining Zoloft with sexual herbs except perhaps ginkgo biloba, which is not a true libido enhancer.


Case Rep Pediatr. 2013. Serotonin syndrome after sertraline overdose in a child: a case report.


A 2015 study shows that women who take antidepressants in the later stages of pregnancy are more likely to have a child with autism. The study specifies one particular group of antidepressants in particular the SSRIs, or selective serotonin reuptake inhibitors, such as Prozac, Zoloft or Paxil.


Curr Drug Saf. 2013. Liver injury associated with antidepressants. Antidepressants are commonly prescribed and used in the management of depression, anxiety disorders, and other psychiatric illnesses. Antidepressants used in therapeutic dosing ranges are associated with causing several adverse drug reactions including hepatotoxicity. Paroxetine, fluoxetine, fluvoxamine, citalopram, mirtazapine and venlafaxine are associated with reversible liver injury upon discontinuation of the agent. Patient cases of hepatotoxicity involving the use of nefazodone, trazodone, duloxetine, bupropion, and sertraline Zoloft are linked to causing death in its users. Due to the idiosyncratic nature of hepatotoxicity, monitoring of liver function tests and immediate discontinuation upon abnormal lab findings or signs and symptoms of liver dysfunction are crucial since most cases of hepatic damage are reversible when detected early. Onset of antidepressant-associated hepatotoxicity varies from 5 days to 3 years. Antidepressant-induced liver injury can occur in the absence of identifiable, underlying risk factors such as cirrhosis and hepatitis infection; only a few cases of hepatic injury involve patients with chronic hepatitis infection.


How Zoloft works
The antidepressant effect of this medication is presumed to be linked to its ability to inhibit the neuronal reuptake of serotonin. Zoloft has only very weak effects on norepinephrine and dopamine neuronal reuptake. At clinical doses, Zoloft blocks the uptake of serotonin into human platelets. In receptor binding studies, Zoloft has no significant affinity for adrenergic (alpha(1), alpha(2) and beta), cholinergic, GABA, dopaminergic, histaminergic, serotonergic (5-HT1A, 5-HT1B, 5-HT2) or benzodiazepine binding sites.


Does Zoloft Increase Suicide Rates?

Studies have shown that children and teenagers who take antidepressants such as Zoloft may be more likely to think about harming or killing themselves or to plan or try to do so than children who do not take antidepressants.


Zoloft for Depression after Stroke

In non-depressed patients who have recently suffered a stroke, prophylactic treatment with Zoloft does not prevent the onset of depression in the following 6 months. Depression after stroke is common, affecting approximately 1 in every 3 survivors.


Zoloft medication questions and interactions with nutritional supplements
Q. I currently am taking 150 mg Zoloft for about 3 years. I really want off of it but when ever I try, with doctor guidness, when I get done to getting off of them my whole body goes into a complete shock. If feels as everything is trying to get out of the insides of the body, and it puts me on edge. I really want off this Zoloft stuff. Just turned 46 and moving on up. How would I go about making the switch from the Zoloft prescription to the Herbal? ( hopefully Mind Power Rx ). It also has effected my sexual life, by taking all sexual desires completely away, when I use to have not a problem in this area. I know it's from the Zoloft, but the doctors are not doing much to help me. They just keep me on it and raise my dosage back up to 150mg, which I happen to function well with, excluding the areas I stated earlier.
   A. Unfortunately we are not in a position to advise anyone how to change their medicines or treatment. You can read about natural ways to treat depression at this depression web page. Keep in mind that 5-HTP also increases serotonin and decreases sexual drive. You can discuss the research on natural supplements with your doctor. We don't suggest using Passion Rx or Mind Power Rx the same day as Zoloft.


Q. I'm 32 years old and have had a history of depression, anxiety, etc. Brain chemistry is always changing and at this point in my life I'm off all medications. All I know is that I recently took Zoloft for 3 weeks to help with some Obsessive thoughts and I quickly realized Zoloft med was doing nothing but numbing me mentally and sexually and that I could get through my Obsessive thoughts alone and with the aid of talk therapy. After getting off Zoloft med I experienced a rush like no other. I felt extreme energy and excitement and a sexual appetite I haven't had in years upon years. It seems that some brain chemicals were triggered after getting off the med. After about 3 days the "Mental Sex and Excitement Buzz" wore off. And shortly after that my RLS kicked in tremendously.


Is there a natural product that acts similar to Zoloft medication. i mean, one that affects serotonin and helps with depression and panic.
    I am not aware of a natural supplement that works exactly like Zoloft, but 5-HTP does influence serotonin levels and many people find it useful for depression and panic disorder.


is it safe to take 5htp if you are on Zoloft?
    There is no simple answer to this since much depends on the dosage of Zoloft, how long it has been used, the dosage of 5htp, your age, other medications used, hormone status, overall medical health, and other factors.


My teenage son took a handful of about 16 anti anxiety pills consisting of Klonapin and maybe Zanax over a two day period to help him with the stress of finals. He said he didn't feel their effects right away so that is why he kept taking more.( stupid child!) Well he ended up doing things he did not remember and totally breaking down crying with lots of fear and anxiety. He curled up on our couch for days and was acting child like. But what this DID do to him was it induced panic attacks. He did not have them before. So my question is can this mixture of pills induced his now present panic attacks and has it caused a chemical imbalance that we can fix? Before that he was staying clean (for 5 months) from doing Crystal Meth that he did for several months. We are so worried about him and now we are left with a kid who has social phobia and general anxiety with some depression. He has recently tapered off Zoloft and a few other meds because of severe reactions. If the panic attacks are drug induced how can we fix this?
    I am not in a position to offer individual advice but maybe the page on anxiety can offer some help that he can review with his psychiatrist.