At a glance
- It will take at least a few weeks until you begin to notice the antidepressant effects of Zoloft, an SSRI (selective serotonin reuptake inhibitor).
- The side effects of SSRI drugs are well-documented and are reported to occur in over 20% of people taking them. They include nausea, sexual problems, weight gain and insomnia. Most of these side effects will get better over time, likely within a few weeks from starting the medication.
Introduction
SSRIs (selective serotonin reuptake inhibitors) are the most commonly prescribed class of antidepressants in the United States and include several well-known drugs including:
- Prozac (Fluoxetine)
- Lexapro (Escitalopram)
- Zoloft (Sertraline)
- Paxil (Paroxetine)
- Celexa (Citalopram)
For how often they are prescribed, it’s not uncommon to get that first fill from your pharmacy and not be exactly clear to expect when starting out. You’re not alone!
While you want to be sure to discuss any questions and concerns with your doctor or pharmacist, here are two things you need to know about Zoloft (and SSRIs in general) to get you started.
Fact #1: Give It Time!
Perhaps the most important thing to know about starting on Zoloft is that it isn’t going to feel like it is working right away.
In fact, it isn’t uncommon for Zoloft (and all SSRIs for that matter) to take at least 1 to 2 weeks to start having a noticeable effect…and even longer until a full response is seen. Why is this? Why don’t antidepressants like Zoloft work right away when countless other meds don’t share this problem? The answer, which you probably have guessed, is somewhat complicated and a full discussion on the matter isn’t likely to awaken the passion of many of your friends.
The truth is, we actually don’t fully understand the exact mechanism behind how SSRIs work. We do know, at least initially, that they increase the availability of the neurotransmitter serotonin in the central nervous system by blocking its reuptake (i.e. reabsorption) into neurons. This reuptake blockage leaves substantially more serotonin to interact with its receptors.
However, this clearly can’t be the entire story due to the well-known delay in response to them. It appears that the long-term effect of SSRIs has more to do with the fact that they seem to change the balance of serotonin receptors themselves over time. For those so inclined, you can certainly delve deeper into the precise mechanism of SSRIs, but the moral of the story is that you need to give a drug like Zoloft time to work.
Don’t get discouraged if you don’t see any changes after only a few days of taking it…it doesn’t work that way. You do want to be sure to keep in close communication with your doctor during your first few weeks of therapy. It is important that your progress is monitored so adjustments can be made if you and your doctor deem them necessary. They also can help you monitor for side effects, which is what is discussed in the next section.
Fact #2: The Side Effects Will Get Better
Just as it is important to be patient for Zoloft to start working, time is an important factor as it concerns side effects.
It’s an unfortunate fact that you are likely to experience at least some sort of side effect when you first start taking the drug. The good news is that most of these side effects will significantly decrease in severity, or altogether, over time.
For example, nausea and other related gastrointestinal side effects (like cramping and diarrhea) are reported to occur in over 20% of people starting out on the drug! After a few weeks though, studies show that they often reduce to the point where they occur at the same rate as those taking a placebo. The same is true for the other side effects that can occur with Zoloft. Below are the most commonly reported:
- Nausea/GI
- Insomnia
- Sexual (e.g. decreased libido, loss of orgasm, etc.)
- Migraines/Headaches
- Weight gain
All of these side effects have been shown to, in general, be short-lived and are likely to improve within the first few weeks of starting. Nevertheless, there are times where they can linger and if you do continue to experience side effects that you feel are associated with Zoloft for more than a few weeks, it is important to talk to your doctor about them.
There are many strategies they may suggest to help mitigate them, which could include adjusting your dose or even switching to another antidepressant not associated with what you are experiencing. Again, be sure to let your doctor know of any problems you are having.
Final Words
Zoloft is an effective SSRI drug in treating a number of conditions, notably depression. If you take away one thing from this article, it's that you have to give it time...time for it start working and time for your body to adjust to it!
As always, if you have any questions for us, be sure to drop us a line and we will answer it promptly. Good luck!
References
- Clinical Practice Guidelines for the management of Depression. PubMed
- PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder. Psychiatry Online
- Zoloft Prescribing Information. Pfizer
- SSRI Antidepressant Medications: Adverse Effects and TolerabilityPubMed