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Long-term side effects of antidepressants like Zoloft can include emotional numbing, sexual problems, weight gain, decreased positive feelings, and suicidal thoughts. Nevertheless, antidepressants such as Zoloft are often prescribed for long-term use. When your healthcare provider determines that the benefits outweigh the risks.
Although this class of medication is named after a single medical condition, antidepressants are also used to treat many other illnesses, including:
- Bulimia
- Bipolar disorder
- Bulimia
- Child enuresis
- Fibromyalgia
- Generalized Anxiety Disorder and Social Anxiety Disorder
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
- Neuropathy (pain due to nerve damage, including diabetic neuropathy)
- Obsessive-Compulsive Disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Premenstrual syndrome (PMS)
Researchers are only just beginning to learn about the long-term side effects of antidepressants. Because long-term studies are rarely done before a drug is approved, the drug may be used for a long time before a consistent side-effect profile emerges.
Before we dig into the research, let's look at how antidepressants work. Antidepressants come in several forms:
- Monoamine oxidase inhibitors (MAOIs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
In the brain, information, including emotions, travels from one neuron (brain cell) to another via chemical messengers called neurotransmitters. Think of neurotransmitters as keys to a mailbox: each neurotransmitter unlocks a specific receptor (the chemical “lock”) that keeps messages flowing.
Many of these symptoms and diseases are caused by some abnormality in the brain's neurotransmitters (usually serotonin, norepinephrine, dopamine, etc.). In some cases, you may be deficient in one or more of the neurotransmitters, your brain may not be using them efficiently, or there may be a problem with the receptors.You may either have missing keys, or your keys may not be used properly, or your keys may be broken.
Whatever the cause of the problem, the result is the same: neurotransmitter dysregulation. Your messages are not delivered because your email doesn't reach the correct mailbox.
Zoloft and other antidepressants change how your neurotransmitters work, making more of them available so they can properly transmit messages when they come in. They do this by slowing down a process called reuptake, which is basically the cleaning up or recycling process.
When messages flow properly, the brain works better and symptoms associated with slowing down are reduced or eliminated.
Each neurotransmitter has a different role, and while increasing their availability may have desirable effects, such as easing depression, reducing neuropathic pain, and improving thought processes, it may also have undesirable effects.
The potential side effects of Zoloft and other antidepressants are numerous and range from mild discomfort to debilitating and even life-threatening. What's more, antidepressants tend to become less effective over time.
As we increasingly understand the long-term effects of antidepressants such as Zoloft, the most concerning concerns relate to weight gain and diabetes, but many other side effects can also persist and negatively impact quality of life.
Patient preferences and adherence We published a paper looking at how people who have been taking antidepressants for a long time feel about the side effects they experience. Overall, medications have helped people feel less depressed and improve their quality of life, but about 30% of people say they still suffer from moderate or severe depression.
The main side effects are:
- Sexual problems (72%), including inability to reach orgasm (65%)
- Weight gain (65%)
- Feeling emotionally numb (65%)
- I don't feel like myself (54%)
- Decreased positive emotions (46%)
- Feeling dependent (43%)
- Not caring much about others (36%)
- Having suicidal thoughts (36%)
Many participants wanted more information about the long-term risks of the medication. Around 74% also mentioned withdrawal symptoms and said they needed more information and support about stopping taking antidepressants.
Some noted that they had to try several antidepressants before finding one that worked well for them and was tolerable, but more than two-thirds of those questioned said that medication helped them to cope with life.
About a fifth of participants said that antidepressants helped them function better, but some said they would not have started taking the medication if they had known about the possible side effects and withdrawal symptoms.
Do not suddenly stop taking your antidepressant medication. Talk to your doctor about the appropriate way to stop taking it.
Before taking Zoloft or any other antidepressant, make sure you understand the possible long-term side effects. You may need to try several medications before you find the one that works best for you.
While taking this medication, be aware of side effects and weigh their severity against the effectiveness of the medication.
Any decision about using antidepressants should be discussed with your doctor, but only you can decide whether the benefits of taking medication outweigh the drawbacks.
Weight gain is one of the potential long-term side effects that Zoloft and other antidepressants can have on the body.
Research published in 2015 Journal of Clinical Psychiatry These findings suggest that the long-term risk of weight gain from antidepressants that alter serotonin receptors may be substantially higher in women than in men because of differences in how serotonin is used.
A 2015 Australian study found that people taking antidepressants tend to gain more than 3% of their body weight each year. Over time, that gain can be substantial.
Weight gain can have a negative impact on your health as well as your self-esteem. To avoid gaining extra pounds, talk to your doctor about ways to improve your diet and increase your exercise.
Some studies have pointed to a possible link between antidepressant use and problems with blood sugar regulation, including type 2 diabetes.
A systematic review published in the 2013 edition of the journal Diabetes Care Researchers investigated this relationship to better understand what's going on. They looked at 22 studies, including two with more than 4,000 participants. Here are some of the findings that prompted the study:
- Antidepressants can cause significant weight gain, which can worsen blood sugar control.
- SSRIs and Pamelor (nortriptyline) have been reported to worsen glycemic control in patients with diabetes.
- Tricyclic antidepressants cause hyperglycemia (high blood sugar levels) in humans.
- In mice, tricyclic antidepressants cause a condition called hyperinsulinemia, in which the body produces too much insulin compared to the amount of sugar in the blood.
The aim of this study was to find out whether antidepressants increase the risk of diabetes, even in people who did not have diabetes when they started taking them. The researchers concluded that some antidepressants affect blood sugar regulation and may be a risk factor for diabetes. However, the larger and more recent studies they looked at suggested that the risk is small.
But higher doses appear to be linked to an increased risk, the researchers say. And some people who developed type 2 diabetes while taking antidepressants reported that the disease went away when they stopped taking the medication. The researchers also note that people who are diagnosed with diabetes are more likely to be prescribed antidepressants, although the relationship is unclear.
If you have diabetes, your doctor may adjust your diabetes medication to keep your blood sugar levels in a healthy range while you take an antidepressant.
Also, there may need to be more emphasis on weight loss and exercise, as these are linked to diabetes and antidepressants may contribute to weight gain.
If you're worried about your risk of diabetes or have type 2 diabetes, you may want to talk to your doctor to find an antidepressant that's less associated with blood sugar problems. You may also want to test your blood sugar more frequently.
If your antidepressant is no longer working as well as it did when you first started taking it, you may be developing a tolerance to the medication. Some people call this an antidepressant “poop-out,” but the medical term is tachyphylaxis. It's unclear how many people taking antidepressants experience this phenomenon, but studies have shown that the rate ranges from 9% to 57%.
No one is sure why this decline in effectiveness occurs, but one theory is that it's because receptors in the brain become less sensitive to the drug. Other reasons could include:
- Year
- Alcohol and drug abuse
- Alternative or coexisting psychiatric diagnoses
- Drug interactions
- stress
If you think you've developed a tolerance to antidepressants, talk to your doctor. He or she may suggest:
- Increase dosage
- Add another drug
- Switching to a different type of antidepressant
- Adding psychotherapy or counseling to your treatment plan
- Making lifestyle changes to relieve symptoms of depression
Approximately 10% to 30% of people never respond to antidepressant treatment, which may be due to treatment-resistant depression (TRD).Although there is no standard definition, TRD is often defined as failure to respond to two or more treatment attempts despite adequate dosage, duration, and adherence. TRD can lead to decreased social functioning, medical comorbidities, and increased mortality.
The cause of TRD is still unknown, but genetics,Metabolic disorders,Misdiagnosis is also often the cause.
If your doctor diagnoses TRD, they may try one or more of the following treatments:
If you take an antidepressant long-term and notice any of the side effects mentioned above (or any additional ones), be sure to tell your doctor right away. In some cases, your doctor may change your dosage or switch you to a different antidepressant altogether.
Do not stop taking antidepressants on your own, as this may lead to relapse or withdrawal symptoms such as agitation or suicidal thoughts.
Many people undergo therapy while taking antidepressants. Treatments such as cognitive behavioral therapy can help people closely monitor behavioral changes and other side effects caused by taking antidepressants.
Your therapist may also consult with your prescribing doctor or GP to monitor your health whilst you are taking antidepressants.
In some cases, depression can return even while you are taking an antidepressant. A relapse of depression is when symptoms return after a period of recovery. Tell your doctor if you experience any new or worsening symptoms of depression, such as:
- Experiencing a loss of interest in activities
- Feeling sad or anxious
- Have suicidal thoughts
- Sleeping too long or too short
- Moving away from family and friends
Like all medications, Zoloft and other antidepressants have long-term side effects. Treatment is a balancing act, where you and your doctor weigh the pros and cons and decide on your next course of action. Be sure to be informed about the potential long-term side effects of Zoloft and other antidepressants and discuss them with your healthcare provider.