5 Foods and Drinks to Avoid If You’re Taking Sertraline (Zoloft)

Sertraline (Zoloft) is an antidepressant medication that’s FDA-approved to treat conditions like major depressive disorder, panic disorder, premenstrual dysphoric disorder (PMDD) and obsessive-compulsive disorder (OCD). 

Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) and generally causes fewer side effects than other types of antidepressants. The most common side effects people report while taking Zoloft include: 

• Nausea

• Loose stools

• Upset stomach

• Tremor

• Increased sweating

• Decreased libido

• Delayed ejaculation 

Like many medications, sertraline can interact with other medications and supplements. Some interactions can lead to a rare but potentially life-threatening condition called serotonin syndrome. Luckily, sertraline doesn’t interact with many foods or drinks. But there are some you should avoid while taking sertraline. Avoiding these certain things can lower your risk of developing side effects. Here are five foods and drinks to avoid.

1. Grapefruit

Grapefruit is a citrus fruit that’s high in antioxidants, vitamins, and minerals. Grapefruit juice is a popular breakfast drink and can help cut down bitter pill aftertastes. But you should stay away from grapefruit and grapefruit juice if you take sertraline. 

Grapefruit blocks an enzyme called CYP3A4. This enzyme is found in the small intestine (gut), which helps break down many medications, including sertraline. When this enzyme is blocked, sertraline levels can build up in your body. This increases the chance of side effects like:

• Increased heart rate and blood pressure

• Headaches

• Dizziness

• Stomach upset

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2. High-fat foods

High-fat foods don’t change how your body absorbs sertraline. But fried and greasy foods, like pizza and potato chips, can cause stomach upset. Sertraline can also cause similar side effects such as indigestion, nausea, and diarrhea. The combination of sertraline and high-fat foods can increase your risk of developing one or more of these side effects. 

High-fat foods also pass more slowly through the stomach into the intestines and take longer to digest. This means they have more time to hang around and worsen potential sertraline side effects. Some high-fat foods you may want to avoid while taking sertraline include:

• Fried foods

• Chips

• Pizza

• Burgers

• Donuts

• Ice cream

• Cream

• Butter

3. Caffeine

Caffeine is a naturally occurring stimulant found in coffee and some teas. It’s also a main ingredient in energy drinks. Caffeine doesn’t interact with sertraline directly. But caffeine can affect your gut. You may be more likely to experience stomach upset or other gastrointestinal side effects from sertraline if you’re also consuming a lot of caffeine.

People at risk for prolonged QT syndrome, a potentially life-threatening condition that affects heart rhythm, may need to avoid caffeine while taking sertraline. People at risk for QT prolongation have developed serious arrhythmias while taking sertraline. High levels of caffeine have also been known to trigger changes in heart rhythm in people at risk for prolonged QT syndrome. Combining the two could increase your risk of developing an arrhythmia. 

Keep in mind that most people aren’t at risk for developing prolonged QT syndrome. Your healthcare team can help you determine whether you’re at risk. 

4. Alcohol

Alcohol can impact your mind and body. In the short term, it can also make you drowsy and affect your judgment and reaction time. Sertraline can also cause drowsiness. Combining alcohol with sertraline can impair your ability to think and operate a vehicle. Experts recommend avoiding alcohol if you’re taking sertraline (or any SSRI). 

Alcohol also directly affects the lining of the stomach, which can lead to inflammation, indigestion, and discomfort. This can aggravate or heighten the risk of developing gut-side effects while taking sertraline.

5. St. John’s wort (and other supplements)

Many herbs and supplements can interact with prescription medications. 

St. John’s wort is a supplement that can be used to treat depression. But it can also interact with many antidepressant medications, including sertraline. That’s because both St. John’s wort and sertraline increase the levels of serotonin in your body. Combining the two can increase the risk of developing a rare but potentially life-threatening condition called serotonin syndrome. 

Sertraline may also increase the risk of bleeding, especially in people taking blood thinners. People taking blood thinners and sertraline should also avoid any supplements that can raise your risk of bleeding. Your healthcare team can help you determine whether you need to avoid certain supplements and vitamins if you’re taking blood thinners and sertraline. 

What else can you do to help sertraline (Zoloft) work better?

Take your medication at the same time every day. This will help you avoid skipping doses or accidentally doubling your dose. Taking sertraline with food can also help lower your risk of developing nausea and stomach upset. 

It can also help to start taking sertraline at a low dose and increasing your dose gradually to give your body a chance to adjust to the medication. This may lower your chances of developing side effects. Your healthcare team can help you decide whether you should start off on a low dose and gradually work your way up. 

Why trust our experts?

Written by:

Eunice Kang, MD, CPH

Dr. Kang practiced internal medicine, mostly hospital-based, for 12 years before transitioning to clinical research in 2021. She began her clinical career as a hospitalist clinician educator and became an associate program director of the internal medicine residency program at Norwalk Hospital in Norwalk, Connecticut, in 2015.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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