Zoloft diarrhoea, does it go away? (A Complete Guide)

In this blog, we will answer the question, “Zoloft diarrhoea, does it go away?”. This blog aims to understand how zoloft induces diarrhoea, how bad your diarrhoea can get, what are the symptoms associated with it, and how to make it go away.

Does zoloft induced diarrhoea go away? 

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Zoloft induced diarrhoea gets better within a few days. Side effects of zoloft usually begin to subside within 2 to 4 weeks of treatment. 

When SSRIs increase the level of serotonin, they stimulate serotonin receptors in the GI tract as well. It results in increased serotonin activity. 

It causes an increase in firing rate of the secretomotor neurons and an increase in intestinal motility and secretion. This increased intestinal motility results in diarrhoea. 

How to treat zoloft induced diarrhoea

Your healthcare provider may suggest one of the following treatments, if needed:

Antidiarrheal agents

Your doctor may prescribe some antidiarrheal agent, which works best with zoloft, to treat your diarrhoeal symptoms. The most commonly prescribed agent is loperamide (Brand name: Imodium). 

It slows down the movement of food through your intestines, which lets your body absorb more liquid and makes your stool less watery. Other agents like Kaopectate or Pepto-Bismol (bismuth subsalicylate) are also used. 

A 2000 study suggests that loose watery stools, a common side effect associated with SSRIs, were treated with Alosetron, a medication used to treat irritable bowel syndrome (IBS) in women.

Probiotics

Probiotics should be considered a must, when dealing with meds that upset your stomach. They are actually ‘good’ bacteria which reside naturally in your gut. 

In case of diarrhoea, most of these bacteria are lost because of watery stools. The addition of probiotics will help replenish those good bacteria and bring your stomach back to its normal state. 

Natural sources of probiotics include nuts, yoghurt, asparagus, garlic, onions, leeks, banana, barley, oats, apples, cocoa, wheat bran, flaxseeds etc. Add these in your diet while being on zoloft, to strengthen your gut bacteria. 

Electrolyte replenishers

Diarrhoea is strongly associated with dehydration along with loss of electrolytes. This causes extreme weakness, sometimes up to the point where you no longer have energy to even get up from your bed. 

In this condition, it is advised to drink lots and lots of fluids. Electrolyte replenishers are also used which contain various electrolytes like sodium, potassium, chloride ions, bicarbonate ions etc, which might have been eliminated from your body along with your stools.

Oral rehydration therapy is also used. Electrolyte drinks usually contain salts of sodium or potassium, which make up for the amount of these minerals lost from the body.

Other remedies to relieve the symptoms of diarrhoea

Following are a few remedies that can help relieve the symptoms of diarrhoea:

  • Drink plenty of fluids like water, oral hydration solutions (ORS), soup etc. 
  • Consume liquid calories like milkshakes, smoothies etc. 
  • Avoid spicy foods, which can irritate your stomach and exacerbate the symptoms of diarrhoea. 
  • Eat plenty of probiotics. In case of diarrhoea, yoghurt is considered a good choice. It cools down your stomach and adds natural probiotics to replenish your lost gastrointestinal microflora. 
  • Avoid alcohol and caffeine. 

What happens in diarrhoea? 

Diarrhoea is a condition characterised by following symptoms:

  • Bloating
  • Flatulence 
  • Abdominal pain
  • Malaise 
  • Thin or loose stools
  • Watery stools
  • Nausea and vomiting
  • Inability to digest, especially solid foods
  • Electrolyte deficiency
  • Dehydration
  • Weakness 

More serious symptoms include:

  • Blood or mucus in your stool
  • Hematemesis (bloody vomiting)
  • Weight loss 
  • Chills and fever

What to eat in diarrhoea

People with diarrhoea should eat bland foods, as spicy or complex foods can irritate the bowels. Bland foods that may help with diarrhoea include:

  • Banana 
  • Applesauce
  • Softly boiled white rice
  • White bread 
  • Boiled or mashed potatoes
  • Plain crackers

Foods to avoid in diarrhoea

It is best to avoid following foods while experiencing diarrhoea

  • Dairy products
  • Fried, fatty, greasy foods
  • Spicy foods
  • Processed foods
  • Red meat like veal
  • Sardines
  • Raw vegetables
  • Rhubarb
  • Onions
  • Corn
  • Alcohol
  • Coffee
  • Soda
  • Sorbitol and other artificial sweeteners

How to relieve discomfort in the rectal area caused by diarrhoea?

Diarrhoea associated frequent bathroom visits can cause discomforts like:

  • Itching.
  • Anal fissure
  • Burning.
  • Pain during bowel movements.

If you’re experiencing any of these discomforts, there are a few things you can do that might help:

  • Take a sitz bath.
  • Patting your rectal area dry with a clean soft towel. Do not rub it. Avoid scratching it if it itches. 
  • Apply fissure cream or petroleum jelly.

Other drugs responsible for inducing diarrhoea

Following is the list of drugs, other than zoloft, which can cause diarrhoea. Make sure you are not using one of them, along with zoloft. If yes, consult your healthcare provider to make sure if it’s safe to do so:

  • Antibiotics
  • Metformin
  • Beta blockers
  • ACE inhibitors 
  • angiotensin receptor blockers (ARBS)
  • Colchicine
  • Digoxin
  • Colchicine
  • Lithium
  • Levothyroxine (Synthroid)
  • Gemfibrozil (Lopid) and fenofibrate (Tricor)
  • Magnesium-containing antacids like Maalox, Mylanta, and Gaviscon
  • Vitamins like magnesium and vitamin C
  • Non steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen (Aleve)

Other side effects of zoloft

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

Some side effects require immediate medical attention. These include:

  • Skin allergy, which could include Stevens-Johnson. You might notice red, swollen, or blistered skin, with or without fever. 
  • Allergic reactions, like rash, hives are common. It also includes wheezing, difficulty in breathing, tightness in the chest, trouble breathing, swallowing, or swelling of the mouth, face, lips, tongue, or throat. Few of these symptoms indicate anaphylactic shock. 
  • It could 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 
  • Abnormal behaviour/mania 
  • Suicidal thoughts
  • Feeling guilty all the time
  • Extrapyramidal symptoms

When to call your doctor

If your diarrhoea becomes severe, with uncontrollable vomiting and watery stools, immediately contact your doctor. Such conditions might end up needing hospitalisation, especially in case of dehydration. 

Your doctor might suggest IV infusion to replenish your electrolytes. Do not wait for your diarrhoea to subside on its own, as it might not. 

Conclusion 

In this blog, we learned about zoloft induced diarrhoea. It is a condition associated with loose watery stools, nausea, vomiting, and abdominal pain. 

Usually zoloft induced side effects go away within a few weeks. Your doctor may prescribe antidiarrheal agents like Imodium. Probiotics are also considered essential in diarrhoea as they help replenish the gastrointestinal microflora. 

Electrolyte replenishers are also used because many important electrolytes like sodium, potassium, bicarbonate ions etc are lost in loose diarrheal stools. 

FAQs: Zoloft diarrhoea does it go away

Can Zoloft cause severe diarrhoea?

Yes, zoloft can indeed cause diarrhoea. When SSRIs increase the level of serotonin, they stimulate serotonin receptors in the GI tract as well. It results in increased serotonin activity. It causes an increase in firing rate of the secretomotor neurons and an increase in intestinal motility and secretion. This increased intestinal motility results in diarrhoea.

The severity of zoloft induced symptoms differ from person to person. It depends on how your body reacts to it. For some, it’s quite tolerable. Always contact your healthcare provider if you notice any unusual symptom. 

How do you stop diarrhoea from antidepressants?

Your doctor may prescribe some antidiarrheal agent, which works best with zoloft, to treat your diarrhoeal symptoms. The most commonly prescribed agent is loperamide (Brand name: Imodium). Other agents like Kaopectate or Pepto-Bismol (bismuth subsalicylate) are also used. 

How long will Zoloft upset my stomach?

Side effects associated with zoloft may last for 3 to 4 weeks. Side effects slowly begin to go away as your body becomes used to it. 

Can I take Imodium while taking Zoloft?

Yes, you can take imodium (Generic: Loperamide) to treat zoloft induced diarrhoea. Other agents like Kaopectate or Pepto-Bismol (bismuth subsalicylate) are also used. 

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.

  • 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

What medications should not be taken with Zoloft?

Do you use zoloft with any irreversible monoamine oxidase inhibitors (MAOIs). Concomitant treatment is highly contraindicated due to the risk of serotonin syndrome with symptoms like agitation, tremor and hyperthermia. 

Zoloft must not be initiated for at least 14 days after discontinuation of treatment with an irreversible MAOI. Zoloft must be discontinued for at least 7 days before starting treatment with an irreversible MAOI.

Do not use zoloft with pimozide. Combining these medications can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.

Zoloft also interacts with tryptophan, St. John’s wort, meperidine, tramadol, cimetidine and warfarin. Always contact your healthcare provider in case of polypharmacy (Concomitant use of two or more drugs for several other conditions).

Drug interactions can end up causing serious adverse effects. Make sure you rule out possible drug interactions before starting several meds together. 

References 

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