Increasing zoloft dosage from 100mg to 150mg (4 things to expect)

In this blog, we will talk about increasing zoloft dosage from 100 mg to 150 mg. Zoloft is an antidepressant, available in various strengths. This blog will help us understand why physicians increase the dose of zoloft and what one should expect when switching from lower to higher doses. 

What happens when your doctor increases your zoloft dosage from 100mg to 150mg?

Your doctor might increase your dose, if lower doses are not working out that well for you. Higher doses are preferred in case of severe conditions, where lower doses fail to relieve your symptoms. 

When the dose is increased, it is expected to be:

• More reliable to treat your depression symptoms. 
• More effective in increasing the amount of serotonin. 
• More efficient in treating your OCD, PTSD or social anxiety symptoms. 
• More effective in reducing the frequency of panic attacks. 

Whenever the dose is increased, it is expected to provide more pronounced results as you’re taking more. But, more medicine sometimes means more side effects, especially for people who do not tolerate zoloft well. 

This is why it’s always preferred to start your treatment from the lowest effective dose. The dose is increased only if you can tolerate the active ingredient (sertraline) well. In case of intolerance, your healthcare provider may prescribe another antidepressant. 

Before switching antidepressant, it is always preferred to taper off the current med in order to avoid symptoms associated with discontinuation or withdrawal syndrome. 

Although, one study shows that there is not much of a relationship between sertraline dose and its antidepressant effects. 

The results from the study suggest that for most patients, a 50mg dose of sertraline produced similar effects compared to the effects produced when dose was increased from 50 mg to 150 mg after 3 weeks of treatment. 

While some patients clearly benefit from higher doses, the results of the current study do not show any evidence relating to a dose-response curve with sertraline in the treatment of depression. 

What if you can’t tolerate a higher dose? 

Whenever the dosage is increased, your doctor asks you to closely monitor your symptoms, especially in the first two weeks. Studies have shown that some people can not tolerate higher doses of zoloft that well. 

If lower doses fail to provide adequate therapeutic response and higher doses are hard to tolerate, your doctor might stop treatment with zoloft and prescribe you another antidepressant. 

Side effects to expect when switching from lower to higher dose of zoloft

Common side effects include:

• Loss of appetite
• Tiredness
• Feeling angry or agitated
• Weight gain
• Inability to digest food
• Nausea
• Diarrhoea
• Loss of libido
• Sweating/Night sweats
• Tremors or shaking
• Insomnia
• Decreased sex drive
• Impotence
• Inability to ejaculate

Higher doses of zoloft, if not tolerated well, can cause serious side effects. These include: 

• Skin allergy, which could include Stevens-Johnson. You might notice red, swollen, or blistered skin, with or without fever. 
• It also includes wheezing, difficulty in breathing, tightness in the chest, trouble breathing, swallowing, or swelling of the mouth, face, lips, tongue, or throat.
• It can cause low sodium levels which can result in psychological symptoms like confusion, agitation, inability to understand surroundings, memory loss etc.
• It can cause elongation of QT interval, causing increased heartbeat or arrhythmia
• Convulsions 
• The inability to have an erection
• Hypothyroidism (low thyroid gland function)
• Bone marrow failure associated with low blood counts
• Thrombocytopenia
• Neutropenia 

Make sure you immediately report these side effects to your healthcare provider. Your doctor might lower the dose if you’re unable to tolerate higher doses. 

Factors to consider before deciding appropriate dose

The dosing of a medicine depends upon several factors. Zoloft is available in various strengths, but which one is best for you? 

The process of setting the dose is not as simple as you think. A lot of factors are considered by your healthcare provider, before recommending you an appropriate dose. These include:

Medication history 

It is important to consider medication history before choosing a proper medication. It is important to rule out any possible drug interactions between zoloft and any other medication, even over-the-counter drugs. 

Paediatric population

It is crucial to determine appropriate dose for the paediatric population as there are various factors to consider in this situation, including the availability of liver enzymes, proper kidney function and immunity. 

Geriatric population

Elderly patients are more likely to have hyponatremia (low sodium in the blood), age-related kidney, liver, or heart problems. For them, dose adjustment is required.

Breastfeeding 

Several studies suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Severity of your condition

It is also an important factor to consider. You are supposed to take the dose which suits your condition and its severity. If you’re mildly depressed, I would not suggest you directly for 100mg zoloft, it would be unethical. 

The severity of your symptoms sets your dose. If you’re highly depressed and you are talking 25 mg, tell me, would it work? Nope! It will not. It doesn’t suit your condition. The amount of zoloft in your body would be too low, low enough to mess you up even more. 

Medical conditions which don’t get along with zoloft.

• Bipolar disorder

Taking zoloft might trigger mania in people with bipolar disorder. If you have this condition, talk to your doctor before using this med. 

• Kidney problems

If your kidney function is compromised you may not be able to clear this drug out. When the drug is not properly eliminated, it starts getting accumulated in the blood which, in simple words, means more side effects.

• Seizures

The use of this drug increases your risk of having seizures. Consult your healthcare provider to make sure if the use of zoloft is safe for you in this condition or not.

• Glaucoma

Zoloft may trigger a glaucoma attack. If you have glaucoma, consult your doctor before taking this medicine. 

• Liver problems 

If your liver function is compromised, your body might not metabolise this drug effectively. This increases the level zoloft in your body and causes more side effects

Recommended doses of zoloft

Zoloft is recommended, as per condition, in the following doses:

Depression:

• For adults: 50 mg once a day. Take it as advised by your doctor, either in the morning or at night. Do not exceed 200 mg.
• For children: Dose is suggested by the doctor according to the condition and body weight.

Obsessive-compulsive disorder:

• Adults and teenagers: 50 mg once a day. Take it as advised by your doctor, either in the morning or at night. Some cases might need dose adjustment. Do not exceed 200 mg.
  
• For children 6-12 years old: 25 mg once a day, taken as advised by the doctor.

Panic disorder, posttraumatic stress disorder, or social anxiety disorder:

• For adults: 25 mg once a day is considered an initial dose. Take it as advised by your doctor, either in the morning or at night. Some cases might need dose adjustment. Do not exceed 200 mg.
  
• For children: Dose is suggested by the doctor according to the condition and body weight.

Premenstrual dysphoric disorder:

• For adults: 50 mg per day is considered as an initial treatment. It is taken daily throughout your periods. Your doctor might adjust your dose according to your symptoms. Dose should not be more than 150 mg per day.
  
• For children: Dose is suggested by the doctor according to the condition and body weight.

Drug interactions 

Drug interactions are always a threat for patients who suffer from multiple illnesses, for which multiple medications are prescribed. 

Such polypharmacy is more common with elderly patients, or people with chronic conditions like hypertension, diabetes, chronic obstructive pulmonary disease (COPD), asthma etc. 

Following are a few drugs (out of many) that can possibly interact with zoloft:

• Cisapride
• Linezolid
• Bepridil
• Dronedarone
• Bromopride
• Clorgyline
• Eliglustat
• Methylene Blue
• Furazolidone
• Metoclopramide
• Iproniazid
• Isocarboxazid
• Nialamide
• Mesoridazine
• Moclobemide

It is crucial to rule out any drug interaction before you start taking zoloft with any other prescription medicine. Some medications are just not meant to be taken together. 

They can change the entire chemical composition of one another, which can result in life threatening side effects. 

Conclusion 

Zoloft, an antidepressant, is available in various strengths: 25mg, 50mg, 150mg and 200mg. Your healthcare provider usually starts your treatment from the lowest effective dose. 

Oftentimes, the low dose does not work and fails to reach up to your expectations. In such conditions, your doctor increases your dose, aiming for better results. 

In this blog we discussed what to expect when your doctor increases your zoloft dose from 100mg to 150mg. 

FAQs: increasing zoloft dosage from 100 to 150

Increasing Zoloft dosage from 100 to 150 side effects? 

Common side effects of Zoloft include:

• Loss of appetite
• Tiredness
• Feeling angry or agitated
• Weight gain
• Inability to digest food
• Nausea
• Diarrhoea
• Loss of libido
• Sweating/Night sweats
• Tremors or shaking
• Insomnia
• Decreased sex drive
• Impotence
• Inability to ejaculate

Zoloft, sometimes, causes serious side effects. Consult your healthcare provider as soon as you can if these symptoms occur:

• Seizure/convulsions
• Eye pain with vision problems
• Headache
• Confusion
• Agitation
• Memory problems/Dementia 
• Severe weakness and inability to move

When to increase Zoloft dosage? 

Your doctor might increase your dose if lower doses are not working for you. Higher doses are preferred in case of severe conditions, where lower doses fail to relieve your symptoms. 

When the dose is increased, it is expected to be:

• More reliable to treat your depression symptoms. 
• More effective in increasing the amount of serotonin. 
• More efficient in treating your OCD, PTSD or social anxiety symptoms. 
• More effective in reducing the frequency of panic attacks. 

What is considered a high dose of Zoloft? 

150mg to 200mg is considered a high dose of zoloft. It is preferred not to take more than 200mg of zoloft per day. 200mg is prescribed ONLY if the patient tolerates sertraline well and gains benefits from it. 

What is the maximum dose of zoloft? 

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 and it is well tolerated by the majority of people. 

Is 100mg Zoloft a high dose? 

100mg zoloft is moderately high. It is higher than the most effective dose, that is 50mg. The highest dose of zoloft is 200mg per day. 

References 

• Zoloft tablets, for oral use; Zoloft (sertraline hydrochloride) oral solution (2021). https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=fe9e8b7d-61ea-409d-84aa-3ebd79a046b5&type=display
• ZOLOFT Side Effects by Likelihood and Severity https://www.webmd.com/drugs/2/drug-35/zoloft-oral/details/list-sideeffects
• Sertraline https://www.mskcc.org/cancer-care/patient-education/sertraline-0
• Sertraline – oral use https://www.mayoclinic.org/drugs-supplements/sertraline-oral-route/side-effects/drg-20065940?p=1
• E Schweizer et al. Int Clin Psychopharmacol. 2001 – The antidepressant effect of sertraline is not enhanced by dose titration: results from an outpatient clinical trial https://pubmed.ncbi.nlm.nih.gov/11354235/