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Zoloft (Sertraline) Tremor Side Effect

i began Sertraline two days ago and it has thrown me over the edge, physically. after the first night of taking 50mg Sertraline, i woke up the next morning with my upper-extremeties shaking very badly. i had read this was a possible side effect, but also read that it was a common side effect but then a serious side effect!??? it was very scary!

throughout the day the tremor lessened, but the morning was horrible! i called my doctor and made him aware of the tremor, and he told me to reduce my dose to 25mg last night, which i did. i felt fine until 10pm rolled around, and then 2am, and then before i knew it, it was 6:30am! i couldn't get to sleep for the life of me. i was shaking way too much. everytime i closed my eyes, i could feel my brain shaking (maybe it was just my head and neck moving around, but it really felt like my brain)! my eyes as well.

called my doctor again today and he said if i cannot tolerate it then it isn't the medication for me. he prescribed me Xanax to try out for a month, but he doesn't want me to rely on Xanax just to get me through the first weeks use of Sertraline, because of the risk of addiction and overuse. i discontinued my Sertraline tonight. there is no way i can live a "a few weeks" (a dreadful eternity) with a  severe tremor until the medication "kicks in". why should i be asked to suffer after already so much suffering?

i wonder if anyone else has experienced a tremor side effect and knows how and why it surfaces when taking certain medications? hope i'll find another medication that works for me, or else i'll try to combat this through therapy, exercise, eating right, herbal remedies WHATNOT...
18 Responses
366811 tn?1217426272
I don't know how much background there is to the selection of Sertraline, and the idea of "trying out" Xanax makes me nervous and I don't even TAKE any meds at all. Seems to me like the time has come for a consult with a psychiatrist who is more qualified to assess your condition and approprioate medication that the family doc. And we're not just talking about trying out meds the way you try out shoes; NO, we are talking about a thorough evaluation of YOU, because, in addition to whatever meds may be indicated, a course of therapy may be a good idea as well -which, if successful (as mine was) will mean no more drugs at all other than your brain's own feel-good juice.

So -stop messing about and get in front of that shrink. OK?
Avatar universal
Different meds affect different people different ways.  I have been on Sertraline (Zoloft) in the past and I am actually on it now.  I actually prefer it to any other SSRI, but I can share with you my personal experiences with it.  First of all, it is very common to prescribe a benzo like Xanax when starting an SSRI.  It is true that it can have a high affinity for addiction if abused.  But in my experience, taking it as prescribed for a month is what it is designed for.  I say this because when starting an SSRI like Zoloft, it can actually increase your anxiety, but I also suspect as it was with me, that when we are anxious we start to worry about the side effects of the medication and oversensitize ourselves to our symptoms; don't get me wrong, they are there and both times that I started Sertraline, it put me more on edge when I started it, but after a couple of weeks, most of the side effects 'wore off.'  Continue to express your concerns with your doctor.

Having said that, I wholeheartedly agree with JS; while I am a proponent of SSRIs and certain medications,  I only support it COMBINED with talk therapy.  There is no pill that will cure you of this.  Only by learning about where you anxiety comes from and how the panic/anxiety cycle works, will you break free of it.  Continue to use this forum and ask as many questions as you like.
480448 tn?1426952138
I just want to add that I totally agree with cj and JS 100%!

SSRI's often make you feel worse before they make you feel better, and like cj said, simply being wrought with anxiety in the first place makes us super sensitized to every little symptom and sensation.  Then, we start reading about the med...and BAM...we are convinced we have every side effect listed.

If you can TRY to tough it out...the side effects (shakiness, nervousness, etc) usually start to subside after about a week for most people (sometimes even a bit sooner).  Also, remember that you have to take it for at least 3-4 weeks to really allow it to become effective.

I think asking your doc for a psych referral is an awesome idea....they will be able to treat you as a whole...meds, therapy, coping, etc.  They also will be able to manage your meds....sometimes people require dosage adjustments...or even switching to an entirely different SSRI...but the tricky thing is...you have to give them a chance before you will know if they will work for you or not.  And, you have to be patient.

My very first SSRI was Zoloft, and like you, I also experienced a brief period of the "jitters"...and gradually that improved, and I can honestly say that Zoloft changed my life at that time....that, along with regular therapy allowed me to become "me" again and live a completely anxiety-free life for MANY many years (until I decided I didn't need it anymore...then a few years later, the anxiety reared its ugly head again).

So...my advice to you is to look into seeing a psychiatrist who will be able to treat all aspects of your anxiety, including the meds.  Give the Zoloft a chance, and continue communicating to your doc.  Taking the Xanax temporarily to help you thru some of the initial side effects is fine...just be sure to take it as prescribed.  I would say if your shaking is the worst in the am...take a Xanax first thing after you awaken.  If the shaking is keeping you up at night, and you are taking the Zoloft at night, ask your doc about switching it up to the am.  Most times Zoloft is prescribed at bedtime,. but it can be taken in the morning also.

Hang in there...and keep posting here.  It really is nice to know that you're far from alone in this...and trust me...you AREN'T alone...there are many of us out there that have done this dance before.

Good luck to you.
thank you guys i just had an anxiety flare up for the last week, waking up at random points at night heart rapidly beating blood pressure through the roof. i had to go the er twice to get calmed down , the next day my doctor prescribed me 50 mg sertraline, it had helped me through my anxiety in the past to the point where i stopped taking it a year ago. it does take a while to build barriers against the anxiety so i was prescribed .50 mg zanax for a few days until this sertraline starts making a noticable impact... for those that vape out there try vaping on cbd juice it seems to calm the anxiety thoughts and puts you in a relaxing state of mind. but for those thinking sertraline is going to help right away it does take about a week or less with some people to start making a difference. if need be dont be afraid to ask yout doctor for a small dose of zanax to help the anxiety till you notice the sertraline, for me sertraline seems to be the go to for my anxiety but you do get tremours that you do have to work through throughout the first week for some people. its all about keeping yourself in a posative state of mind.. you will get through it and there are people out there just like you and me!  
459689 tn?1276573743
kcdem here to do my weekly zoloft bashing. I hate zoloft....... it caused me horrible insomnia. if an ssri is correct i think you will have very few if any side effects and gradually feel better. 20 years ago when they first came out that was the norm. for some reason now these horrid side effects are to be tolerated and it is normal to take benzos to ride out the effects until our bodies can tolerate it. i dont buy it. i think it is lazy doctors and drug companies pushin that line. i take prozac and had NO side effects at all and gradually felt better. i was told that Zoloft was the best and tried it after 2 months of night sweats, insomnia and speed like effects i did some research and was suprised at how much more side effects zoloft has compared to other ssris.

get off of it now and try another ssri, dont put up with tremors and dont mask the side effects with xanax. that is my personal opinion.

432009 tn?1304753441
You are so right on about the Zoloft bash....I was so messed up when my Dr. tried pushing it on me....I suffered horribly....aggitated....trembling...shaking....freaking out...and the push to increase the dosage so I would feel better...and yeah, the ole xanax to quiet it all down. Thank god that my 2nd Dr. pulled me off of it, but not until I suffered for weeks, was taking 100 mgs., and couldn't leave my bed, couldn't work, had to file for medical leave...

And yes, it is the good ole drug companies doing the heavy detailing and sampling...I know first hand, because I was a pharma rep. for 3 years...and I was great at it. I used to sell Asendin - it was a tricyclic AD that was supposed to provide patients with relief as quickly as 14 days...with none of the side effects of the other tricyclics....I sold the heck out of it....psychs., internists, general practioners, OB/GYN.....we would detail the symptoms of depression to help our generalists recognize a depressed patient when they saw one. This was back in the day before SSRI's, so it was still in the early stages of the AD boom. My drug was supposed to be incredibly safe....

Fast forward....I find out that this drug ended up causing Tardive Dyskinesia in elderly female patients. Tardive Dyskinesia is a horrible neurological condition that is disfiguring and many times irreversible. The actual definition is: : A syndrome of involuntary movements, especially around the mouth, associated with long-term use of antipsychotic medication. This condition is normally caused from antipsychotic meds, not tricyclic antidepressants.

With that said, all I can say is "Caveat Emptor"...except it should read:
"Let the patient beware"...

Take good care, KC...

Avatar universal
Thanks so much!
480448 tn?1426952138
Hey guys!
480448 tn?1426952138
Woops!  Premature "enter" button hitting....lol.

Morning all!  Happy Friday!

I can totally understand where you guys are coming from with your Zoloft experiences, but in all honesty, I do not think it is quite fair to label the drug or the drug companies as the culprit.  IMO, EVERYONE reacts differently to meds...and pretty much all SSRI's are notorious for a decent amount of side effects...and some people are more sensitive to them than others.

My experience is actually the exact opposite...I had NO side effects when I started Zoloft (and I started at a fairly high dose)...but DID experience the tremors and shakiness for the first week or so of starting Lexapro.  I toughed it out...that was simply my choice of course...and it DID get better.  People have to basically weigh the overall benefits of the medications with tolerating some side effects.

Now, with that said...I would never suggest someone try to "stick it out" if they do not feel comfortable doing so...if the side effects were extreme, or if they didn't start to improve after a fair amount of time.  Keeping the lines of communication open with the doc is crucial too.

But, SOOO many people give up on these drugs soo quick and never get to see if they truly would have benefited from them or not.  And, what works for one person, may not work for the next.  Same with the side effects.....

I also don't have a huge problem with SHORT TERM benzo treatment to help someone manage these side effects to make it easier to give the meds a fair shake.  It's really a shame that these meds HAVE these side effects...as I always say...I liken it to an ulcer med causing severe heartburn...it can be very discouraging...and I understand that.  But, it's simply the nature of the beast, and how the med affects us chemically.

I've been there too...and definitely sympathize...the symptoms and side effects are not too fun...but for a lot of people...they DO get better...and for some people who have tried to hang in there...have ended up benefitting them in the long run.

I think a week (2 max) is fair enough to give a med like this a chance...if the side effects aren't noticably improving after that time...then I totally agree it is time for a different game plan...and usually a different SSRI will end up causing less symptoms for that person.  Also, IMO...another big issue I think is that docs are starting people out at higher doses than they should, which worsen the side effects.  Minimalistic is my motto.  You can ALWAYS increase a dose later.

I just really do not like "bashing" any drug...because it tends to worry people that much more.  NOTHING wrong with sharing our experiences...because that is so important...but I think we need to remember that OUR experiences will be totally different from someone else's.

Also...I think that it can't be said enough that most people would increase their chances of success with talk therapy.

Hope I didn't offend any of you, that certainly isn't my intention...I just wanted to mention these things.  I totally respect your experiences and your kindness in wanting others not to have to go through what you all did.  Just wanted to offer a counter opinion.  And, from a fellow sufferer's standpoint as well.  I wish this WHOLE process was easier for people...it is very frustrating.

Thanks for letting me babble on.  ;0)

Avatar universal
I too am on Zoloft, 25mg for anxiety almost 5 months now.  I had the same issues in the beginning and quickly learned I had to take it in the morning because it was and upper for me.  I never did up my dose to 50 like my Doc. initially prescribed because I was worried about worsening my side effects.  I hated them.... but I new it was from the Zoloft so it didn't freak me out to much.  I figured I could handle anything as long as it was temporary and committed to a month.   I know if I tried another med I may just have to go through the same thing again anyways.

All of the physical, icky side effects are gone and it has helped my anxiety.  I am glad I stuck it out, I went into it knowing it would take a period of adjustment so I wasn't too surprised.  

Not sure how long I want to continue taking it, I have always had anxiety but have never treated it with an SSRI.  It had always left on it's own.  I have a couple of issues with the Zoloft that I don't like but there is always give and take and no med is perfect.  I too, was given Xanax which I rarely took - I was too afraid of getting hooked.  Stay away from ANY caffeine until you are used to the Zoloft, it magnifies the jitters and the sleeplessness which lasted about 6 weeks for me.  Good Luck, it can feel so good to get relief from the anxiety - I hope you find some.  Erin
Avatar universal
I just started zoloft 5 days ago. I started at 50 mg. for two days and fealt so druged that I went down to 25mg. Now I suffer the anxiety I had before I started. I experience it in the morning with the jitters. I take ativan as well. I still feel some of the anxiety, so I can only imagine what it would be like without Ativan. The things ive read from the pharm. Said trembeling is a serious side effect and should be reported. Howev er, I have read so many post about the trembeling. I hope mine gets better. I must admit later in the day I do feel alittle better.
Avatar universal

Is this your first time on an SSRI?  I will tell you that when I first went on them, it was pure hell for about a month regarding all side effects.  Now, I'm adjusting to another one, and finding the same thing, though not quite as bad.  As for tremors, even my psychiatrist was surprised when I told her I got them from Zoloft. She looked it up and found that "only 11%" of the population who takes Zoloft gets tremors.  That's not a huge percentage, but it's enough.  Zoloft is the only SSRI I've been on that has given me tremors.  I didn't get them until I started 50 or 75 mg.  Give it a few weeks at your highest dose to see if they go away.  Most of the time the start-up side effects will subside within a few weeks when your body adjusts.  My tremors didn't go away until a couple weeks after I stopped taking Zoloft.
Avatar universal
i only started taking it because i had been having the odd monthly panic attack for the past couple of months, and my sister (a nurse) recommended i get on some meds before it became a problem. apart from those individual instances i was fine.

i've been on zoloft 50mg for 8 weeks now, at first i felt a bit worse, then some placebo effect helped me out. the first thing i noticed was my constant yawning.

weeks 5-6 i felt pretty bad, and stupidly upped my dose to 100mg, week 7 was literally hell, i thought i was going to die everyday, couldn't leave my bed except to rush to ER, and would have my heart racing and pounding in my ear 24/7, difficulty breathing and alot of dizziness and chest pains.

i also began getting some nasty PVC's (skipped beats), which really threw me into the abyss. luckily i've now slipped back down to 50mg just about, and while i've started getting morning anxiety, it ussually evens out by 2-3pm.

i'm jittering now more than before, but it's worrying me alot less. a couple other niggles like acid reflux and constant tingling in my fingers when i'm warm, but i've been for all the tests and i'm totally clear of anything physically wrong with me. i was even able to play football today without getting all drowsy.

all in all i think the important things to take away are don't go on a med if you think you can help it, try therapy first, because medications are a mixed bag that occationally throw a spanner in the works.

there are 2 ways to look at my situation, either i started the zoloft at the right time and its been helping limit the gradual increase of my anxiety, or it's made an occational problem into a daily one. i'm really hoping that my current status is only due to recently coming down in my dosage, and will dissapate given time.
Avatar universal
Hi all,
I know this is an old thread but, people like me, still stumble upon it.
I'm a little confused about your response in this thread Nursegirl6572 - you mentioned above that you had NO side effects when you started Zoloft, but on a different thread you wrote that you did which included tremors. So that's left me questioning the authenticity of your responses :\

That all being said, I started zoloft a little over 4 weeks ago. I'm experiencing the tremors which got worst each time I upped my dose, I'm currently on 100mg. The tremors are (thankfully) subsiding, and I'm hoping it'll lessen and disappear in a few more weeks time. I take Z for generalised anxiety disorder and I'm starting to feel the benefits now, so hopefully it'll do its magic by week 8 :)
Hi, did they go? I'm wondering weather to pack it in, only 2 weeks in but my tremors are bad
Avatar universal
Avatar universal
When you went back on it, Like I am after 3 yrs off it, did you get the shakes? I didn't get them when I was younger. I'm 70 now.
Avatar universal
Hi, I have just starting Zoloft. A very small dosage. I think its .25. What do you all consider tremors. I knows this is a dumb question. I feel like there a million bugs and electricity running thru my arms and legs. I feel like my body is going to fast for itself, but only I can feel it. It doesn't seem like anyone can actually "see" that I am dealing with this. I have been getting weird night panic attacks on this drug also. This is day 6 on it, so I haven't even been on it for a week. I have been sleeping ok, (which might be do to the help of the .25 of Xanax ive been taking) but I still wake up so tired!! Like, I am yawning all day! :( UHG. I just want to break the anxiety. It's so hard getting up every day and coming to work but I do it anyway. :(
I hope the best for everyone.
I tried Zoloft but it actually increased my  panic attacks.  After a month I told my doctor that was it.  I was already on Xanax but RARELY took it.  Well now I do take 1/4 of .5 mg and it does help.  God Bless because this Anxiety is NO joke.  I hope you find something that helps.
Avatar universal
I stopped taking Zoloft after 4 years. I started it at 16 to help with anxiety and paranoia. Tapering off the drug was easy for me because I was also taking Wellbutron and it masked some of the withdrawal effects. Three weeks after I developed a peptic ulcer and was in pain for a month. After the ulcer I continued to have stomach pain and had two upper endoscopys revealing nothing wrong. I was then diagnosed with Functional Dyspepsia. I decided to go back on Zoloft because my anxiety had gotten bad again. Also there are some studies that suggest that SSRIs might help with Functional Dyspepsia. I know this drug very well and exactly what it does to my body. I cut my 25mg tablet in half and took one. I had EXTREME jitters the next day. I had so much adrenaline  pumping through my veins that 2 Xanax and an Propranolol didnt help it. I walked two miles and and worked out to help burn some of the adrenaline. I know for me these side effects will last for over two weeks but the benefit is worth it in the end.
Avatar universal
Yes... has happened to me... sooo I started over as per doctors orders... 12.5mg of zoloft for 1 week then upped to 25mg for 2 weeks then up it slowly till you reach 50mg... I would still get sort of the restless leg syndrome and I had ativan with me which is half the life of xanax.  but definitely would take it if needed. also... I decided to take the zoloft at night vs. morning.  but I was up like clock work at 5am wired. however, I would fall asleep by 9pm or 10pm.
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