Zoloft acid reflux (11 tips to manage your acidity)

In this blog post, we will talk about zoloft induced acid reflux and what factors can contribute to it. We will also learn about ways which can help you in keeping your acidity at bay and how many over-the-counter medications are available to provide relief from heartburn or acid reflux.

Zoloft induced acid reflux

Zoloft induced acid reflux is one of the most commonly reported side effects induced by zoloft. One reason that could contribute to zoloft induced acidity is the nature of its formulation. 

Let me give you a little insight into the factors which are considered while formulating a medicine. 

Many drug moieties can not produce therapeutic response when taken in their pure forms. These chemicals can not get past the dissolution process on their own. 

A medicine can not reach its target receptors if it is not absorbed in your blood and in order to get absorbed, your med needs to get dissolved first. 

In order to overcome this problem, pharmaceutical companies, according to the guidelines, change these pure active compounds into their salts. The salt form makes it much easier for your drug to get absorbed into your gastric fluid.

As sertraline, generic name for zoloft, has the same solubility issue, so it is formulated as ‘Sertraline Hydrochloride’ in order to get dissolved easily in your stomach fluid. 

The thing with this hydrochloride is, that once it comes in contact with water present in your stomach, it is converted into hydrochloric acid. Now this freshly formed acid can contribute to your increased acidity or acid reflux. 

There’s one more question you need to ask yourself, “What am I eating?”. Your diet plays a huge role in the amount of acid your stomach makes. You need to have a healthy diet if you wish to stay away from this acid reflux. 

Avoid taking zoloft on an empty stomach. Make sure you have eaten something before you take it. You can also try taking your med in between your lunch. This can prevent you from experiencing heartburn. 

11 tips to manage your acidity

Following are a few tips which can help you manage your acid levels. These include:

Eat dinner earlier 

Studies suggest that you should be done with dinner at least 3 hours before you go to bed. When you lie down on bed, the process of digestion gets slower. So you need to digest your food before you go to sleep. 

According to one study, eating a late-night meal can increase acid exposure when lying down by 5%, compared with eating earlier in the evening.

Eat smaller portions 

Do not fill your plate up. It puts a burden on your stomach to digest large amounts of food at one time. Instead, try to eat in smaller, more frequent meals. 

Maintain a healthy weight

Maintaining a moderate body weight can help reduce acid reflux in the long term. Some studies suggest that people who have excess belly fat are more likely to suffer from gastric acid reflux. 

Follow a low carb diet

Some researchers suspected that undigested carbs may cause bacterial overgrowth and increased pressure inside the abdomen, which could contribute to acid reflux. Having high amounts of undigested carbs in your stomach can cause flatulence and bloating. 

Don’t drink too much alcohol 

Alcohol can exacerbate your acid reflux and heartburn. It’s best to avoid drinking too much alcohol, as it affects you negatively in more ways than you can imagine.

Limit your caffeine intake

Caffeine is often found associated with acid reflux. Studies suggest that high caffeine intake can cause gastrointestinal problems like acid reflux, diarrhoea, gastroesophageal reflux disease (GERD) etc. 

It can also exacerbate the symptoms in those who already have GERD or peptic ulcer.

Limit the intake of carbonated beverages 

Studies have observed that regular consumption of carbonated or fizzy beverages, including soft drinks, club soda, and seltzer, could be linked to a higher risk of acid reflux. 

One study found that carbonated soft drinks can worsen certain acid reflux symptoms, like heartburn, fullness, and burping. This is because carbonated beverages make your burp more, that can increase the amount of acid escaping your stomach and irritating your oesophagus, throat and mouth. 

Don’t go heavy on citric juices

All citrus fruits contain ascorbic acid, also known as vitamin C, which could cause indigestion if you consume them in large amounts. Grapefruit juice and orange juice are considered the most common triggers for heartburn and acid reflux. 

Walk a mile after dinner

Studies suggest that going for a short walk after dinner can help your body to produce more digestive enzymes and makes your stomach absorb the nutrients from your food. 

It improves your digestion and reduces bloating, acid reflux, constipation and provides relaxation from several other gastrointestinal problems. 

Add milk and yoghurt in your diet

Milk and yoghurt are well known to provide relief from gastric acidity. Yoghurt also contains lactobacillus, which is a probiotic, also known as ‘good bacteria’. This good bacteria can improve your digestion and can manage excessive acid secretion in your stomach. 

Avoid spicy foods

Yes, food can taste pretty bland without spice and your favourite seasonings, but spicy food can mess up your stomach and is the most common cause of acid reflux in people who add high amounts of spices in their foods. Make sure you cut back on spicy food, at least for a while. 

Over-the-counter medications for acid reflux

Following are the OTC medications for the treatment of heartburn.

Antacids 

Antacids are widely used to relieve heartburn. They are alkaline in nature and once inside your stomach, they neutralise gastric acid. Common OTC antacids include:

• Magnesium hydroxide, also called milk of magnesia.
• Aluminium hydroxide gel (Alternagel)
• Calcium carbonate (Alka-Seltzer)
• Gaviscon
• Pepto-Bismol

Histamine-2 (H2) blockers

Histamine-2-blockers are also used to relieve heartburn. These OTC meds inhibit the production of gastric acid. They can prevent acid reflux and heartburn for up to several hours.

H2 blockers can interact with other medications, so make sure you ask your healthcare provider before using them. These include:

• Cimetidine 
• Famotidine (Pepcid AC)
• Rimantadine
• Zantac 360
• Nizatidine

Proton pump inhibitors (PPIs)

Proton pump inhibitors or PPIs are also used to inhibit stomach acid secretion. These meds are used worldwide to treat heartburn and indigestion. They are also given in combination with antacids for better results. 

These include:

• Lansoprazole (Prevacid)
• Esomeprazole (Nexium)
• Omeprazole (Risek)

So Which Works Best for Heartburn?

All of these over-the-counter medicines can relieve the symptoms of heartburn. If you have more severe heartburn symptoms that won’t go away after 2-3 weeks of using zoloft.

If they are not relieved even after the use of above-mentioned OTC medications, you need to consult your healthcare provider. It could also mean that it’s time to switch to another antidepressant.

Tips to ensure proper use of zoloft

• Administer once daily either morning or evening, as directed by your healthcare provider.
• Consult your healthcare provider, if your mood worsens or you experience a serious side effect.
• Contact your healthcare provider immediately if you feel symptoms of serotonin syndrome, like chills, fever, nausea, diarrhoea, confusion etc. 
• Do not stop zoloft abruptly. If it’s time for you to stop zoloft, your doctor will simply make a taper schedule for you, which should be followed vigilantly if you wish to keep withdrawal symptoms at bay. 
• Report any problems with bleeding or bruising to your doctor. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider. 
• Dilute Zoloft oral liquid before use with water. You can also dilute it in ginger ale, lemon soda, lemonade, or orange juice. Take immediately after mixing. Do not let it sit for a long time.

Conclusion

In this blog, we learned that zoloft induced acid reflux is one of the most common side effects experienced. The nature of its formulation can also have an impact on its tendency to cause heartburn. The excessive acid secretion can damage your gastric mucosa lining. 

It also damages the protective mucosa of the oesophagus and can cause blisters in your mouth. Make sure you watch what you eat and avoid foods that can exacerbate your acid reflux like citrus fruits and spicy foods. 

There are a few OTC drugs, which are most commonly used, to provide relief from your acid reflux. Make sure you discuss your symptoms with your healthcare provider and ways to manage them.

FAQs: Zoloft acid reflux

Is acid reflux A side effect of sertraline?

Yes, acid reflux is one of the symptoms of sertraline. 

Can I take an antacid with Zoloft?

Yes, over-the-counter antacids are considered safe to use with zoloft. Though, it is advised to always talk to your healthcare provider about your symptoms before you start taking any med for their relief.

What foods should I avoid while taking sertraline?

Zoloft interacts with the following foods and drink:

• Grapefruit Juice

Grapefruit juice increases the level of zoloft in your body by inhibiting its metabolism. Be aware of using these two together. You might find more pronounced effects of zoloft, including adverse effects, as it will not convert into its inactive metabolite.

• Green Tea

The combination of green tea and zoloft may increase the risk of bleeding

• Cannabis

Do not use cannabis while you’re on zoloft. It will cause symptoms like confusion, panic attacks, seizures, anxiety, nervousness etc.

• Tyramine rich foods

Tyramine is an amino acid. The combination of zoloft with tyramine rich foods, like cheese, milk, chicken liver, beef, avocados, bananas, canned figs, soy beans etc, can cause sudden and dangerous increase in your blood pressure.

• Alcohol

Concomitant use of zoloft and alcohol may cause much more pronounced symptoms of depression and anxiety

Why do SSRIs cause stomach problems?

Zoloft is associated with side effects that upset gastrointestinal tract, abbreviated as GIT. These include heartburn, nausea, gastric acid reflux and diarrhoea, as it increases intestinal motility. 

These are the probable causes of stomach pain in zoloft users. It happens because the increased amount of serotonin stimulates serotonin receptors in the GI tract as well as the brain.

Do the side effects of Zoloft go away?

The side effects of zoloft stay until your body gets used to the medication. Once it adapts to the presence of zoloft, the side effects begin to fade away. It usually takes 2 to 4 weeks, depending on how your body reacts to the med. 

Do SSRIs affect gut serotonin?

Serotonin has receptors (to which it binds and produces its effects) in your brain as well as in your gut. SSRIs increase the amount of serotonin by inhibiting its reuptake. So, this serotonin also binds to its receptors present in your gut. 

References

• Nancy C Brahm, Merry C Kelly-Rehm – Antidepressant-mediated gastroesophageal reflux disease https://pubmed.ncbi.nlm.nih.gov/21486738/
• Which OTC Meds Treat Heartburn? https://www.webmd.com/heartburn-gerd/guide/treating-heartburn-over-counter-medicine
• Food and Drug Administration US – Over-The-Counter (OTC) Heartburn Treatment https://www.fda.gov/drugs/information-consumers-and-patients-drugs/over-counter-otc-heartburn-treatment
• Jen Uscher – 10 Tips for When Your Meds Trigger Heartburn https://www.webmd.com/heartburn-gerd/features/10-tips-ease-heartburn-triggered-medications