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Q. I am unable to handle the withdrawal effect of Zoloft. What should I do?

Answered by
Dr. Aditya Gupta
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on Jul 17, 2019 and last reviewed on: Jul 20, 2019

Hello doctor,

I have been on Zoloft for 14 years. I am on the maximum dose of 200 mg. I have been struggling with anxiety due to menopause. My general doctor thought it might be a good idea to switch my medication. She recommended that I go down to 100 mg a week on the Zoloft and then go to Pristiq. The problem is that the with drawl is so bad at the 100 mg I cannot handle it. So I started over going down to 175 mg and then to 150, and it was awful. I was in such bad shape I could not do it. Can I go from taking a select to write into the new prescription?

Dr. Aditya Gupta

Psychiatry Sexology


Welcome to

As you are having severe withdrawals and discontinuation symptoms even after lowering the dose to 175 mg, I would suggest you consult a psychiatrist in person for evaluation, and then you can discuss with him or her regarding the following, As the reason for the change of medicine is anxiety during menopause, i.e., a new issue besides one for which you were taking Zoloft (Sertraline) (and it was working fine), instead of cross tapering you can go for augmentation.

Mirtazapine or Celexa (Citalopram) is a few options to go with adding a short term Benzodiazepine like Ativan to help you with withdrawal symptoms. Also, do practice relaxation techniques like breath relaxation exercises daily as it will help you relax and eases your anxiety. Checking your thyroid status is also necessary. I hope this solves your query. Feel free to ask if you have any further questions.

Investigations to be done:

TFT (thyroid function test).

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Thank you doctor,

What is augmentation?

Dr. Aditya Gupta

Psychiatry Sexology


Welcome back to

Augmentation means adding a second medicine to enhance the work of first one. Like what you are currently doing is cross tappering i.e decreasing Zoloft and at the same time introducing Prestiq once you came to 100 mg of Zoloft. While in augmentation there is no need to decrease Zoloft, instead we add another medicines, to increase the effect of first one or in your case to improve the symptoms of anxiety. I hope you got my point now. Feel free to ask if you have any further queries.

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