Drugs Q & A

Is 25mg Of Zoloft Enough For Anxiety?

What is anxiety?

Anxiety is a feeling of fear, dread, and uneasiness. The cause of anxiety is unknown. Factors such as genetics, brain biology and chemistry, stress, and your environment may play a role.

Anxiety might cause you to sweat, feel restless and tense, and have a rapid heartbeat. It can be a normal reaction to stress. For example, you might feel anxious when faced with a difficult problem at work, before taking a test, or before making an important decision. It can help you to cope. The anxiety may give you a boost of energy or help you focus. But for people with anxiety disorders, the fear is not temporary and can be overwhelming.

What are anxiety disorders?

Anxiety disorders are conditions in which you have anxiety that does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, schoolwork, and relationships.

What are the types of anxiety disorders?

There are several types of anxiety disorders, including:

Generalized anxiety disorder (GAD). People with GAD worry about ordinary issues such as health, money, work, and family. But their worries are excessive, and they have them almost every day for at least 6 months.

Panic disorder. People with panic disorder have panic attacks. These are sudden, repeated periods of intense fear when there is no danger. The attacks come on quickly and can last several minutes or more.

Phobias. People with phobias have an intense fear of something that poses little or no actual danger. Their fear may be about spiders, flying, going to crowded places, or being in social situations (known as social anxiety).

What is Zoloft?

Zoloft is a brand of sertraline a medication used to treat depression, obsessive-compulsive disorder (bothersome thoughts that won’t go away and the need to perform certain actions over and over), panic attacks (sudden, unexpected attacks of extreme fear and worry about these attacks), posttraumatic stress disorder (disturbing psychological symptoms that develop after a frightening experience), and social anxiety disorder (extreme fear of interacting with others or performing in front of others that interferes with normal life). It is also used to relieve the symptoms of premenstrual dysphoric disorder, including mood swings, irritability, bloating, and breast tenderness.

How Zoloft works

Sertraline the active ingredient in Zoloft is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amounts of serotonin, a natural substance in the brain that helps maintain mental balance.

How should Zoloft be used?

Sertraline comes as a tablet and a concentrate (liquid) to take by mouth. It is usually taken once daily in the morning or evening. Take sertraline at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sertraline exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Sertraline concentrate must be diluted before use. Immediately before taking it, use the provided dropper to remove the amount of concentrate your doctor has told you to take. Mix the concentrate with 4 ounces (1/2 cup [120 milliliters]) of water, ginger ale, lemon or lime soda, lemonade, or orange juice. After mixing, the diluted solution may be hazy; this is normal. Do not mix the concentrate with any liquids other than the ones listed. Drink the diluted solution immediately.

Your doctor may start you on a low dose of sertraline and gradually increase your dose, not more than once a week.

It may take a few weeks or longer before you feel the full benefit of sertraline. Continue to take sertraline even if you feel well. Do not stop taking sertraline without talking to your doctor. If you suddenly stop taking sertraline, you may experience withdrawal symptoms such as nausea, sweating, depression, mood changes, frenzied or abnormally excited mood, irritability, anxiety, confusion, dizziness, headache, tiredness, seizures, ringing in the ears, numbness, or tingling in the arms, legs, hands, or feet, difficulty falling asleep or staying asleep.

Is 25mg Of Zoloft Enough For Anxiety?

According to Singlecare, the right dosage of Zoloft for anxiety varies by the severity of anxiety and whether the patient has other medical conditions. In general, though, the initial therapeutic dosage of Zoloft for anxiety is 25 mg or 50 mg per day. 

Zoloft tablets are available in three dosage strengths: 25 mg, 50 mg, and 100 mg. The maximum dose of Zoloft is 200 mg per day (which can be taken as two 100 mg tablets).  

Most studies suggest that the most effective dose of Zoloft is 50 mg per day. This dose is proven to be the most effective and tolerable dose for most patients. People who don’t respond to 50 mg per day may be advised by their doctor to increase their dose of Zoloft by 50 mg per day at weekly intervals to a maximum of 200 mg per day. For example, a doctor might recommend taking 50 mg daily for one week, then 100 mg daily for one week, etc.

Zoloft is also available in liquid form as an oral solution. The oral solution comes as a clear, colorless solution with a menthol scent that contains 20 mg of sertraline per mL, at 12% alcohol. It comes in a 60 mL bottle with a calibrated dropper with 25 mg and 50 mg graduation marks. Zoloft oral solution must be mixed (just before taking) into 4 ounces of water, orange juice, lemonade, ginger ale, or lemon or lime soda before consumption.     

When does Zoloft start working for anxiety?

Zoloft doesn’t work immediately, so don’t stop taking Zoloft if your symptoms don’t improve right away. It takes two to six weeks to start reducing anxiety symptoms. Some people may feel a reduction in their anxiety symptoms within the first week of taking Zoloft, but this shouldn’t be expected for everyone.

How does Zoloft make you feel?

According to the National Alliance on Mental Illness, some of the earliest signs that Zoloft is working are improvements in sleep, energy, or appetite. These improvements could happen one to two weeks into taking the medication.

More significant changes, like feeling less depressed or regaining interest in daily life, may take six to eight weeks to occur. Over time, many people will notice a substantial difference in their anxiety symptoms, and some people may eventually have no symptoms at all.

What Are Side Effects of Zoloft?

Common side effects of Zoloft include:

•          sleepiness

•          drowsiness

•          tired feeling

•          nervousness

•          sleep problems (insomnia)

•          dizziness

•          nausea

•          skin rash

•          headache

•          diarrhea

•          constipation

•          upset stomach

•          stomach pain

•          dry mouth

•          changes in appetite

•          abnormal ejaculation

•          impotence

•          decreased sex drive

•          difficulty having an orgasm

•          dry mouth, and

•          weight loss.

Tell your doctor if you have serious side effects of Zoloft including:

•          very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, feeling like you might pass out;

•          agitation, hallucinations, fever, overactive reflexes, tremors;

•          nausea, vomiting, loss of appetite, feeling unsteady, loss of coordination;

•          trouble concentrating, memory problems, weakness, fainting, seizure, shallow breathing, or breathing that stops.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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