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Ask Dr Ivan

In the second of a regular column, Dr Ivan Goldberg,MD, Director, N.Y. Psychopharmacologic Institute, New York, NY, answers a few of the many questions that arrive in our mailbox. We are sorry, but Dr Goldberg cannot enter into individual correspondence.

Q

My wife changed from Prozac to Zoloft 50 mg in February. Since then she appears increasingly to take offense at everything I say to her. She is also under great stress, having just started a new business.

Everything I have read about Zoloft indicates that this is not a major side effect, but I would appreciate confirmation of that fact, since a PDR does not seem to be available on line.

It sounds as if your wife has become increasingly irritable. Irritability is a very nonspecific symptom and has many causes. Among those causes are depression, mania or hypomania, and being "stressed out." If your wife's irritability continues to worsen, she should be evaluated by her psychiatrist. As Zoloft uncovers a manic state in some people, it may be playing some role in the etiology of irritability.

Q

Over the few weeks, I have been gradually decreasing my dose of Zoloft (under my doctor's supervision, of course). For the past 8 days, I have not taken any at all. I was wondering two things. How long does it take for this dizziness (lightheadedness) that I feel to go away completely? It's not bad, mind you, but I hate out-of-control feelings of any sort, so I really don't like this at all.

When one stops Zoloft too rapidly a withdrawal syndrome may develop. Among the symptoms that may be experienced are nausea, tremors, lightheadedness, muscle pains, weakness, insomnia, and anxiety. While most people coming off Zoloft have none of these symptoms, some people do have one or more. The withdrawal symptoms usually last 1-2 weeks but in some instances they have gradually decreased over the period of a month.

Q

How long does any trace of Zoloft stay in your system?

Zoloft has a half-life of about one day. That means that for every day that passes without taking the medication the level in the blood falls by 50%. After one day the level is reduced to 50% of the original level, after two days to 25%, after three days to 12.5%, and so on.

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