How do you know if your Zoloft dose is too high? 

The following article brings you important information about how to know if your Zoloft dose is too high. In addition, it explains some important signs and symptoms in case of toxicity.

How do you know if your Zoloft dose is too high? 

There are a few signs that may indicate that your Zoloft dose is too high. These include:

• You feel anxious and agitated 
• You have symptoms related to serotonin syndrome 
• Commonly expected side effects seem to be too intense 
• You sometimes feel detached from reality 
• You’re either sleeping too much or not sleeping at all

You feel anxious and agitated 

If your Zoloft dose is too high, you’re bound to feel anxious and agitated. This is because Zoloft inhibits the reuptake of serotonin, leaving an increased amount of this excitatory chemical in your brain (1). 

This high serotonergic activity makes you anxious. Anxiety is also considered the most common initial side effect of Zoloft and other SSRIs as well. 

If you are new to this medication and your dose is too high for you to adjust well, you may feel extremely anxious and agitated. 

You have symptoms related to serotonin syndrome 

Taking a high dose of Zoloft consistently can significantly increase the amount of serotonin in your brain. Too much serotonergic activity can give rise to several disturbing symptoms associated with serotonin syndrome. 

You may not get sick, but temporary high serotonergic activity can surely induce the symptoms. 

If high-dose administration remains constant, this can lead to Serotonin Syndrome – which is a condition associated with too much serotonin in your brain (2,3). Some of the signs and symptoms include:

• Excessive sweating 
• Fever with chills
• confusion
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Metallic taste 
• Diarrhoea
• Bradycardia
• Tremors
• Abnormal muscle twitching 
• Shivering and goosebumps

Commonly expected side effects seem to be too intense 

Zoloft is commonly associated with a number of side effects and almost every person using this antidepressant goes through some tough days. These side effects usually stay as long as your body takes to adjust to this antidepressant. 

However, if you’re taking a high dose of this antidepressant, you may feel common side effects much more prominently. Some common early side effects of Zoloft include (4):

• Loss of appetite
• Tiredness
• Acid reflux
• Feeling angry or agitated
• Weight gain
• Insomnia – which can lead to dark circles
• Inability to digest food
• Nausea
• Diarrhoea
• Metallic taste 
• Loss of libido
• Jaw clenching
• Sweating/Night sweats
• Blurry vision
• Eye twitching
• Muscle tension
• Joint pain – bone loss in severe and chronic cases
• Decreased sex drive
• Frequent urination
• Inability to ejaculate or achieve climax.
• Postural hypotension
• Numbness
• Brain fog

Long-term use of a high dose of Zoloft can cause some rare side effects, like tremors, and tardive dyskinesia (very rare), and can affect your cognition. Some Sertraline-induced side effects can resemble the natural process of ageing.

Long-term use of high doses of Zoloft can also strain your vital organs, including your liver, kidneys, heart, pancreas, etc. So, make sure that your dose is adjusted according to your needs.

You sometimes feel detached from reality 

If you’re taking a high dose of Zoloft, you may start to feel detached from reality or start to see yourself as a different person – something we call ‘Depersonalisation’. 

Zoloft and other antidepressants can affect your brain and cause some psychological disturbances, but they could be dose-dependent. If you feel numb or can’t bring yourself to feel anything, either good or bad, your Zoloft dose might be a little too high. 

You’re either sleeping too much or not sleeping at all

Zoloft is known to cause sleep disturbances. It causes insomnia in some people and extreme sedation in others. No matter which type of sleep disturbance it causes, if it’s severe and affects the quality of your life, your dose might be the one to blame. 

Most people on higher doses of Zoloft tend to feel sedated and tired all the time. However, these disturbances do get better when you switch to a lower dose. 

What to do if your Zoloft dose is too high? 

If your Zoloft dose is too high, the first and the most basic thing you should do is consult your healthcare provider. Your doctor will evaluate your side effects and decrease your dose for a week or two. 

Once your body is adjusted to the lower dose with minimal side effects, that’s when your dose will be increased to deal with your mental health condition in a better way. 

It is also important to make sure that you do not pair Zoloft with anything that increases its effectiveness like certain foods can interact with Zoloft and prolong its mechanism of action.

This can make you susceptible to Zoloft-induced side effects even if you’re not taking a high dose. Just make sure you don’t stop using the medication if you’re subjected to side effects.

Zoloft may also cause pronounced side effects when combined with other antidepressants, like Fluoxetine, Escitalopram, Amitriptyline, etc.

Do not combine any medication with Zoloft on your own. Furthermore, it should never be used with a monoaminoxidase inhibitor (MAOI), which is an entirely different class of antidepressants and should never be paired with other antidepressants.

Just head out to your doctor, who’ll guide you in the best possible way. Stopping Zoloft abruptly can cause more harm than good, as doing so can trigger withdrawal symptoms.

However, it is also important to note that persistent use of high doses of Zoloft can affect the quality of life and may shorten life span in some individuals, by causing disturbing side effects.

What is the correct dose of Zoloft?

The appropriate dosage of Zoloft varies depending on the specific treatment and the condition being treated. The doctor is the one who determines the best dosage for each patient based on their individual needs and medical condition (5).

In certain cases, the usual dosage may need to be adjusted for individuals with special conditions, such as liver disease. These adjustments ensure that the medication is safe and effective for those individuals (5).

What can affect the intensity of the side effects of Zoloft?

Physical exercise can influence the intensity of side effects caused by Zoloft. Engaging in regular physical activity has been shown to have antidepressant-like effects by affecting various mechanisms associated with depression. 

Therefore, incorporating exercise into your routine can be beneficial when taking Zoloft. It may enhance the antidepressant effects of the medication and help reduce any adverse effects experienced (6).

Food can play a supportive role in the treatment of depression and can help minimize the adverse effects of Zoloft. Including nutrient-rich foods in your diet, along with supplements and certain medicinal herbs, has shown to be beneficial in conjunction with antidepressant medications (7).

References