What side effects are common when the dose of Zoloft is increased from 50 mg to 100 mg?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
What side effects are common when the dose of Zoloft is increased from 50 mg to 100 mg?
Some of the commonly reported side effects when the dose of Zoloft is increased from 50 mg to 100 mg include:
- Behavioural or mood-related side effects
- Gastrointestinal side effects
- New side effects that were not observed at a 50 mg dose
Behavioural or mood-related side effects
When your Zoloft dosage is increased from 50 to 100 mg, the most commonly reported side effects are mood-related (1). People tend to feel even more anxious and moody when their dose is increased. Some become extremely irritated and angry and avoid interacting with people.
The incidence of these behavioural side effects is quite common and 90-95% of people go through them. The intensities, however, are different for different people. Several studies have reported that Zoloft can also make you feel depressed when the dose goes high.
This is because your body does not understand how to deal with the higher dose quite yet and it needs some time to adjust to the newly increased dose. After 3 to 4 weeks, these side effects begin to subside slowly.
However, studies have shown that Zoloft can induce suicidal behaviour in users younger than 24 years of age and this effect can become quite prominent when the dose is increased. This is why you should keep a close eye on such people taking Zoloft.
Gastrointestinal side effects
Zoloft is well known for its stomach-upsetting properties. The med can significantly increase the production of your stomach acid and can cause side effects like acid reflux and heartburn.
When the dose of this antidepressant is increased, these gastrointestinal side effects become quite problematic. Some people have reported extreme pain and burning sensation in their stomach, oesophagus, and throat after taking the increased dose of Zoloft.
However, experts have suggested taking Zoloft in between your meals and not on an empty stomach to avoid these gastrointestinal side effects. This way, the lining of your stomach will be protected from the corrosive action of stomach acid.
New side effects that were not observed at a 50 mg dose
A huge number of case studies and surveys have revealed that people start to experience new types of side effects that they did not observe when they were taking 50 mg of Zoloft (2).
This is probably because their body was able to tolerate the 50 mg dose well, but the new increased dose is a little too much for them, especially at the beginning of the treatment.
Some people start to develop sexual side effects like loss of libido when their dose is escalated from 50 mg to 100 mg. Some people begin to experience some psychological side effects like insomnia, drowsiness, mood disturbances, photosensitivity, flushing, etc.
What to do if you can’t tolerate Zoloft well when your dose is increased from 50 mg to 100 mg?
If you can’t tolerate the newly increased dose, you should consult your healthcare provider. You need to inform your doctor why you are unable to tolerate the new dose and what side effects are disturbing you the most.
If your healthcare provider determines that your body is unable to adjust well to the new dose, your doctor may tone it down to 75 mg to help your body adjust a little. 75 mg is usually considered a good dose to try first before switching directly from 50 mg to 100 mg.
This is because Zoloft and other antidepressants are not so easy to deal with. Not everyone can bear them well, especially those people who are sensitive to medications. This is why the best way to increase your dose is to do it as slowly as possible.
This allows your body enough time to adjust to the slow rise in your dose and this way, you can be protected from the harmful effects of rapid dose escalation. Make sure you don’t stop using Zoloft without your doctor’s approval.
If you think that discontinuing your antidepressant will help you get rid of the side effects, then you could not be any more wrong. If you suddenly stop the use of Zoloft, you will be subjected to the disturbing symptoms associated with Zoloft’s abrupt withdrawal.
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References
1.-
Weintraub D, Streim JE, Datto CJ, Katz IR, DiFilippo SD, Oslin DW. Effect of increasing the dose and duration of sertraline trial in the treatment of depressed nursing home residents. J Geriatr Psychiatry Neurol. 2003 Jun;16(2):109-11. doi: 10.1177/0891988703016002008. PMID: 12801161. Available from: https://pubmed.ncbi.nlm.nih.gov/12801161/
2.-
Preskorn SH, Lane RM. Sertraline 50 mg daily: the optimal dose in the treatment of depression. Int Clin Psychopharmacol. 1995 Sep;10(3):129-41. doi: 10.1097/00004850-199510030-00001. PMID: 8675965. Available from: https://pubmed.ncbi.nlm.nih.gov/8675965/
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