The number of prescriptions dispensed for antidepressants in the UK has almost doubled in the last 10 years. There’s two ways to interpret these numbers – it’s either more of us are depressed than ever before, it is just that more are seeking help. I can’t tell you the answer to that, but I can give you an open and candid Sertraline (Zoloft) review, one of the most commonly prescribed antidepressants there is.
How Do You Know You Need Antidepressants?
It all came to a head for me the end of 2018, but when I look back, it probably started long before this date. I had pretty much every symptom of depression, and it’d taken me probably a year to recognise what it was and to do something about it.
I visited the GP to discuss how I’d been feeling (this was the hardest part, honestly), and we actually decided to try CBT Therapy as a treatment long before we’d even talked about medication. I appreciated this suggestion and approach, as I had heard about doctors prescribing pills too easily, and it being the ‘easy’ solution – I didn’t want easy, I wanted help.
So following my GP appointment, I began 2-weekly sessions of counselling of a Tuesday evening. My therapist was a great woman, we talked about things that I’m sure helped in some places, but ultimately after 3 months, I’d noticed no change in my quality of life. Please try to remember that I am just one case, and person will react differently to therapy and medication. Don’t take my experience as a reason not to try CBT counselling, as I know people who have benefited from it.
So to wrap this up, my GP and I had a follow-up appointment and I explained how I wasn’t feeling any better. It was at that point that she decided to try me on SSRI antidepressants, and I was prescribed 50mg of Sertraline per day.
What Is Sertraline?
Sertraline, otherwise known as Zoloft to our American readers, is a selective serotonin re-uptake inhibitor (SSRIs) – mouthful right? In a nutshell, they treat depression by increasing levels of serotonin in the brain.
A 2007 study found that people with depression often have low levels of serotonin. Serotonin deficiency has also been linked to anxiety and insomnia.
Serotonin a chemical nerve and impacts multiple areas of the body. From mood to bowel movements, sleep, health and sexual function. It’s the main tool when it comes to regulating your mood naturally, and when your serotonin level is low, this can cause depression and anxiety.
There are some natural serotonin boosters like sunlight and exercise, but despite being mood lifters, these things alone are very unlikely to help much if you’re suffering from a genuine mental health condition.
The Side Effects When Starting Sertraline
I was incredibly nervous before starting on antidepressants. You read so many horror stories and I got so lost in Reddit threads about the awful side effects of certain medications, and I’d convinced myself that it was going to be the worst experience of my life. As with any medication, there’s a wide range of potential side effects and everybody is different, so I can only tell you about my personal experience. For me, the main symptoms of Sertraline in the beginning were:
- A strange taste in my mouth, like copper
- Tiredness, pretty much all the time
Honestly, I didn’t have it too bad. The metallic taste in my mouth wasn’t enjoyable, but it was manageable. The only thing really was the exhaustion, there was a period of time when it became disruptive. But once the medication set in and my body got used to it, this improved. To start feeling ‘normal’ again, I would say it took me around 6 weeks.
Increasing SSRI Dose Over Time
I began my antidepressant journey in January 2018 with a 50mg daily dose of Sertraline. As I have mentioned above, I had some mild side effects during the first 6 weeks. Within the first 6 months I began to see an improvement in my mood and my quality of life, so the medication seemed to be doing its job… until it wasn’t.
Gradually I felt myself slipping back into depression and anxiety despite the medication, and it felt as though perhaps my brain had adjusted to it. I’m no doctor, and I can’t say whether this is really a thing or not, but in some way, the 50mg stopped having an effect.
I gave it a few weeks and I visited my GP again and she increased my dose to 100mg daily. I lasted another 3 months or so and again, the 100mg was not helping with my depression. If anything, I was feeling worse from the disappointment of it all.
Long story short, I ended up on 150mg almost a year ago now, and everything has been fine since. Your doctor will always insist on starting low and increasing, as 50mg-100mg might be enough to help, but in my case it wasn’t. Taking 150mg of Sertraline per day seems to be the ‘sweet spot’ for me, as I’m now living a happier, healthier and more productive life with very few side effects.
So that said, based on my experience, you should consider increasing your dose, or consider a whole new medication entirely if you experience the following (after the initial 6-8 weeks period):
- Lower or decreasing mood and irritability
- Suicidal or erratic thoughts/behaviours
- Continuous exhaustion
- Any other disruptive or severe symptoms
The Reality of Living on Antidepressants
Now that I’ve found the dosage that’s right for me and I’ve had plenty of time to adjust, taking 150mg of Sertraline daily is just part of my everyday routine at this point. I do eventually want to take steps towards withdrawing from my medication, but for now, they are doing their job and I don’t want to rock the boat just yet.
There’s a few things to be aware of though. There will be some side effects of long-term SSRIs that will just become part of your everyday life. Again, I repeat, these side effects and their intensity is down to the individual, however the 2 biggest ‘new normals’ for me happen to be the most common of all side effects experienced with Sertraline.
In a nutshell, I find it very difficult to feel much sometimes. The interesting thing about Sertraline is that it increases your serotonin levels, but decreases your dopamine. So while you don’t feel the incredible lows of depression anymore, the things that brought you joy, comfort of happiness before your medication can also be muted.
This can have an impact on relationships as it can genuinely affect your personality, enthusiasm and romantic feelings. I think if you’re equipped with this information before starting antidepressants then you will have a better understanding of why you feel this way, and you can perhaps educate those around you of what’s going to be happening.
I dread to think how many relationships are ruined because of antidepressants and a lack of understanding from both parties. I was completely open with my partner about the possible side effects and we did a lot of research together to prepare us both – please do this.
Sexual Impacts of Sertraline
A super high sex drive became mediocre at best. This is somewhat linked to what’s mentioned above, as dopamine levels have a direct impact on libido and sexual sensations.
In my experience, Sertraline has made it very very difficult to orgasm. Don’t get me wrong, it was never easy before, but it’s now an awful lot of hard work. I get there eventually, but it takes a lot more time and also, they aren’t quite as earth-shattering as they used to be.
Again, this is something you might just have to learn to live with and adjust to. If the medication is markedly improving your overall quality of life and the alternative is depression and anxiety, then more difficult orgasms is a fair trade.
My Conclusion: The Pros and Cons of Sertraline
As with any big decision in life, I thoroughly believe in weighing up the pros and cons. Deciding to take antidepressants is a big step and you should do plenty of research so that you are well informed and can understand how the medication works and may impact your life.
Would I recommend Sertraline to somebody that’s suffering from depression or anxiety? I certainly would. Despite a rocky start, my journey with antidepressants has been an overall positive one, and I’ve come on leaps and bounds since starting them.
Just keep in mind that the first few months can be difficult, and it can take just that long before you start to shake the initial side effects and feel the benefits of what you’re taking. If not Sertraline, there’s bound to be something out there to help you, so speak to your GP.
I’ve created a quick and easy table of my personal pros and cons of Sertraline:
|Better mood||Personality changes|
|Better quality of life||Sexual impact|
|Helped with depression||Tiredness|