For how long does Sertraline increase anxiety?

For how long does Sertraline increase anxiety?

Sertraline increases anxiety levels during the early course of the treatment, usually for 2-4 weeks. Early anxiety is one of the most common side effects of Sertraline and other SSRIs, and it could become quite nerve-racking for some people. 

However, this is most likely to happen because when your body is newly exposed to Sertraline, it doesn’t accept it right away. It takes time to adjust to the antidepressant and the changes it makes in your body. Once your body is fully adjusted, the anxiety begins to fade away. 

Why does Sertraline cause early anxiety? 

Sertraline causes anxiety as an early side effect because of the way it works. It is a selective serotonin reuptake inhibitor (SSRI) which actively inhibits the reuptake of serotonin by blocking serotonin transporters (SERT) (1,2). 

This increases the availability of serotonin in your brain and manages the symptoms associated with depression and other mental health conditions. 

This spike in serotonin levels is not well-received by your body at first and you begin to feel jittery (3). Once your body gets used to Sertraline, your anxiety begins to subside. 

What to do if you suffer from Sertraline-induced anxiety? 

If you’re experiencing severe anxiety during the early course of your treatment, talk to your healthcare provider. I can totally understand how overwhelming this anxiety becomes and not everyone can deal with it. 

This is why your doctor needs to know about it. Oftentimes, the initial antidepressant dose is a bit high for a new user and higher doses can cause intense anxiety symptoms. 

If that’s the case with you, your doctor will most likely decrease your dose and give you some time to adjust to a lower dose first. Once you start to function well with a new dose, your doctor will gradually increase it till you reach an appropriate Sertraline dose. 

If your anxiety still persists, your doctor may prescribe you a benzodiazepine, like Xanax, Klonopin, or Ativan, for a month or two, or till your Sertraline kicks in. Benzodiazepines can actively control the early anxiety and insomnia triggered by Zoloft (4). 

Furthermore, Sertraline may also be prescribed with antipsychotics to manage depression comorbid with psychosis, which can also trigger anxiety or panic attacks. However, Zoloft can interact with typical antipsychotics like Haloperidol.

The most important point:

Do not stop using Sertraline abruptly. If you are experiencing side effects, talk to your healthcare provider but don’t stop the medication on your own. Sertraline is one of those medications which makes your body dependent on it. 

If you take away the med too quickly, it responds in the worst of ways and you begin to experience a number of symptoms, commonly known as Sertraline withdrawal symptoms (5). 

If your doctor thinks there’s another antidepressant that may be more suitable for you, he or she will suggest the best way to withdraw from Sertraline, according to your current dose and the duration of your treatment with this antidepressant.

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References

1.-

Singh HK, Saadabadi A. Sertraline. 2023 Feb 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 31613469. https://www.ncbi.nlm.nih.gov/books/NBK547689

2.-

Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. 2023 May 1. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32119293. https://www.ncbi.nlm.nih.gov/books/NBK554406

3.-

Edinoff AN, Akuly HA, Hanna TA, Ochoa CO, Patti SJ, Ghaffar YA, Kaye AD, Viswanath O, Urits I, Boyer AG, Cornett EM, Kaye AM. Selective Serotonin Reuptake Inhibitors and Adverse Effects: A Narrative Review. Neurol Int. 2021 Aug 5;13(3):387-401. doi: 10.3390/neurolint13030038. PMID: 34449705; PMCID: PMC8395812. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8395812/

4.-

Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression: a review. Prim Care Companion J Clin Psychiatry. 2008;10(3):222-8. doi: 10.4088/pcc.v10n0307. PMID: 18615162; PMCID: PMC2446479. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446479/

5.-

Haddad P. The SSRI discontinuation syndrome. J Psychopharmacol. 1998;12(3):305-13. doi: 10.1177/026988119801200311. PMID: 10958258. https://pubmed.ncbi.nlm.nih.gov/10958258/

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