Key takeaways:
Sertraline doesn't interact with many foods, but grapefruit, alcohol, and St. John's wort can increase the risk of side effects or serious drug interactions.
High-fat foods and too much caffeine can make common sertraline side effects — like nausea, diarrhea, and stomach upset — more noticeable.
Taking sertraline at the same time every day and with food may help reduce stomach side effects and help your treatment work as intended.
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Sertraline (Zoloft) is a medication that’s FDA approved to treat conditions like major depressive disorder, panic disorder, and obsessive-compulsive disorder (OCD), as well as premenstrual dysphoric disorder (PMDD).
Sertraline 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 sertraline include:
Nausea
Loose stools
Upset stomach
Tremor
Increased sweating
Decreased libido
Delayed ejaculation
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Sertraline doesn’t interact with many foods or drinks. But avoiding certain ones while taking sertraline can lower your risk of developing common 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
2. High-fat foods
Fatty 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 doesn’t interact with sertraline directly. But caffeine can affect your gut. You may be more likely to experience stomach upset or other gastrointestinal (GI) 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)
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.
Frequently asked questions
Yes, you can eat bananas if you’re taking sertraline. Potassium-rich foods can interact with older antidepressant medications called monoamine oxidase inhibitors (MAOIs). But they don’t interact with sertraline (Zoloft).
You can take sertraline at night. In fact, you can take sertraline any time of the day. Sertraline makes some people feel tired, but it makes others feel more awake. If it makes you feel more alert, taking it in the morning may help prevent trouble sleeping at night.
Yes, you can eat bananas if you’re taking sertraline. Potassium-rich foods can interact with older antidepressant medications called monoamine oxidase inhibitors (MAOIs). But they don’t interact with sertraline (Zoloft).
You can take sertraline at night. In fact, you can take sertraline any time of the day. Sertraline makes some people feel tired, but it makes others feel more awake. If it makes you feel more alert, taking it in the morning may help prevent trouble sleeping at night.
The bottom line
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) that can treat depression and other mood disorders. It’s helpful to be aware of certain foods and drinks that may worsen side effects of sertraline or make it less effective. You should avoid grapefruit juice, alcohol, and fatty foods, as well as St. John’s wort. People at risk for bleeding or prolonged QT syndrome may need to avoid additional things — like caffeine and certain supplements — while taking sertraline.
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References
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Cappelletti, S., et al. (2015). Caffeine: Cognitive and physical performance enhancer or psychoactive drug? Current Neuropharmacology.
Foundation for Inherited arrhythmias. (n.d.). Every rare heartbeat detected, protected, and heard.
Funk, K. A., et al. (2013). A comparison of the risk of QT prolongation among SSRIs. The Annals of Pharmacotherapy.
National Center for Complementary and Integrative Health. (2017). St. John’s wort and depression: In depth.
National Health Service. (2025). Sertraline.
Peterson, B., et al. (2023). St. John’s Wort. StatPearls.
Poison Control. (n.d.). What you should know about sertraline (Zoloft).
