sertraline
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI). It's used to treat different mental health conditions, including depression and certain types of anxiety disorder, such as panic disorder. It's typically taken by mouth once per day. This medication is available as both a tablet and liquid. Common side effects of sertraline (Zoloft) include nausea, diarrhea, and dry mouth. It's best to avoid alcohol while taking sertraline (Zoloft) because this combination can worsen side effects of sertraline (Zoloft).
What is Sertraline (Zoloft)?
What is Sertraline (Zoloft) used for?
How Sertraline (Zoloft) works
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI). It works by raising the levels of serotonin, an important chemical in your brain that's involved with regulating your mood and anxiety.
Drug facts
Side effects of Sertraline (Zoloft)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (26%)
- Diarrhea (20%)
- Difficulty sleeping (20%)
- Dry mouth (14%)
- Sleepiness (12%)
Less Common Side Effects
- Irregular heartbeat
- Loss of appetite
- Changes in vision
- Tremor
- Sexual side effects (ejaculation problems, erectile dysfunction, low sex drive)
- Sweating
Sertraline (Zoloft) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Suicidal thoughts or behaviors
- Serotonin syndrome: fast heart rate, dizziness, sweating, flushing, tremor (shakiness), muscle stiffness, muscle twitching or spasms, uncoordinated movement, distress, seizures, distress, hallucinations, coma
- Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint or lightheaded
- Severe bleeding: bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums
- Low blood sodium levels: nausea, fatigue, headache, confusion, disoriented, hallucinations (seeing things that aren't real), seizures, unconsciousness
More on Sertraline (Zoloft) side effects
The following Sertraline (Zoloft) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Decreased sexual desire or ability
failure to discharge semen (in men)
Less common or rare
Aggressive reaction
breast tenderness or enlargement
confusion
convulsions
drowsiness
dryness of the mouth
fast talking and excited feelings or actions that are out of control
inability to sit still
increase in body movements
increased sweating
increased thirst
lack of energy
loss of bladder control
mood or behavior changes
muscle spasm or jerking of all extremities
nosebleeds
overactive reflexes
racing heartbeat
red or purple spots on the skin
restlessness
shivering
sudden loss of consciousness
unusual or sudden body or facial movements or postures
unusual secretion of milk (in females)
Incidence not known
Abdominal or stomach pain
bleeding gums
blindness
blistering, peeling, or loosening of the skin
blood in the urine
bloody, black, or tarry stools
blue-yellow color blindness
blurred vision
chest pain or discomfort
chills
clay-colored stools
cough or hoarseness
darkened urine
decreased urine output
decreased vision
depressed mood
difficulty with breathing
difficulty with speaking
difficulty with swallowing
dry skin and hair
fainting
feeling cold
feeling of discomfort
feeling, seeing, or hearing things that are not there
general feeling of discomfort, illness, tiredness, or weakness
high fever
high or low blood pressure
hoarseness or husky voice
hostility
increased clotting times
indigestion
inflamed joints
irritability
joint or muscle pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
lethargy
lightheadedness
loss of appetite
loss of balance control
loss of bladder control
lower back or side pain
muscle aches
muscle cramps and stiffness
muscle trembling, jerking, or stiffness
muscle twitching
painful or difficult urination
pains in the stomach, side, or abdomen, possibly radiating to the back
pale skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rapid weight gain
rash
red, irritated eyes
red, sore, or itching skin
right upper stomach pain and fullness
severe mood or mental changes
severe muscle stiffness
shuffling walk
sores, ulcers, or white spots in the mouth or on the lips
sores, welting, or blisters
stiffness of the limbs
sweating
swelling of the face, ankles, or hands
swollen or painful glands
talking or acting with excitement you cannot control
tightness in the chest
troubled breathing
twisting movements of the body
twitching
uncontrolled movements, especially of the face, neck, and back
unexplained bleeding or bruising
unpleasant breath odor
unusual behavior
unusual tiredness or weakness
vomiting of blood
yellow eyes and skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
belching
decreased appetite or weight loss
diarrhea or loose stools
sleepiness or unusual drowsiness
stomach or abdominal cramps, gas, or pain
trouble sleeping
Less common
Agitation, anxiety, or nervousness
bladder pain
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
changes in vision
cloudy urine
difficult, burning, or painful urination
flushing or redness of the skin, with feeling of warmth or heat
frequent urge to urinate
increased appetite
pain or tenderness around the eyes and cheekbones
stuffy or runny nose
Incidence not known
Flushed, dry skin
fruit-like breath odor
increased hunger
increased urination
redness or other discoloration of the skin
severe sunburn
swelling of the breasts (in women)
unexplained weight loss
unusual secretion of milk (in women)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Sertraline (Zoloft)
Pros
- Taken by mouth once daily
- A possible option during pregnancy and breastfeeding
- Fewer interactions compared to other SSRIs
- Less likely to cause weight gain compared to paroxetine (Paxil)
- Available as a generic
Cons
- Can take up to 2 months before you feel the full benefits
- More likely to cause diarrhea compared to other SSRIs
- Might make it more difficult for you to fall asleep
- Can cause withdrawal symptoms if you suddenly stop taking it
- The liquid form contains alcohol
Pharmacist tips for Sertraline (Zoloft)
- You can take sertraline (Zoloft) with or without food, but if it upsets your stomach, try taking it with food to help.
- Sertraline (Zoloft) can cause nausea. But it should get better as you continue taking the medication. If it doesn't, let your psychiatrist know. They might need to lower your dose of sertraline (Zoloft) or have you consider lifestyle or medication options to control nausea.
- SSRIs, like sertraline (Zoloft), can cause sexual side effects, such as low sex drive and erectile dysfunction. If this is bothersome for you, talk with your psychiatrist. They might need to lower your dose of sertraline (Zoloft) or ask you to take it at a different time of the day.
- Sertraline (Zoloft) can make some people feel sleepy or tired. Don't drive or do anything requiring concentration until you know how this medication affects you.
- Avoid drinking alcohol while taking sertraline (Zoloft) because it can worsen some side effects (e.g., drowsiness, dizziness) as well as worsen your depression or anxiety symptoms.
- Don't change your dose or suddenly stop taking sertraline (Zoloft) without talking to your psychiatrist first. Doing so can cause bothersome withdrawal symptoms like nausea, headache, and sleeping problems. Follow your psychiatrist's instructions to lower your dose slowly over a period of time to stop the medication completely.
- Antidepressant medications, like sertraline (Zoloft), can raise the risk of suicidal thoughts. Contact your psychiatrist right away if you or your loved ones notice any new or worsening changes in your behavior or mood while taking the medication.
- Sertraline (Zoloft) can cause false-positive results for benzodiazepine in drug tests. Make sure to report that you're taking sertraline (Zoloft) if you're asked to complete a drug test for work or school.
More tips for sertraline (Zoloft) liquid:
- You must dilute the sertraline (Zoloft) liquid solution right before taking it. You can use 4 ounces (1/2 cup) of water, ginger ale, lemon/lime soda, lemonade, or orange juice. Don't use any other types of liquid, and don't mix it in advance to take later. It's normal if the mixture looks cloudy or hazy after mixing.
- A dropper dispenser comes with sertraline (Zoloft) to measure out your dose. The dropper dispenser contains dry natural rubber, which can be a problem for people with a latex allergy. If you have a latex allergy and can't use the dropper, ask the pharmacy for an oral syringe or medication dosing cup to measure out your dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
- Store the liquid at room temperature in the original bottle it came in from the pharmacy.
More on Sertraline (Zoloft) tips
Common questions about Sertraline
Yes, Zoloft is an selective serotonin reuptake inhibitor (SSRI).
How long it takes for Zoloft to work might differ depending on your medical condition. For example, if you're being treated for depression, you might notice improvements to your mood 2 weeks after you start taking Zoloft. But, it can take about 1 to 2 months before you feel its full effects. You might feel certain side effects of Zoloft, such as nausea and diarrhea, before noticing improvement in your mental health. Talk with your healthcare team if you're not sure if Zoloft is working.
Zoloft isn't FDA-approved for generalized anxiety disorder (GAD). But, it's one of the first-choice options for GAD (off-label use). It's also approved to help with certain anxiety disorders, such as social anxiety disorder (SAD) and panic disorder. Talk with your psychiatrist if you've more questions about Zoloft and anxiety.
Yes, it's possible to gain weight from taking Zoloft.
Does Zoloft make you feel tired?
How long until Zoloft side effects go away?
How long does Zoloft stay in your system?
Is Zoloft a controlled substance?
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Risks and warnings for Sertraline (Zoloft)
Sertraline (Zoloft) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening depression, suicidal thoughts, and unusual behavior
- Risk factors: Age under 24 years old | History of depression or other mental health conditions
Taking sertraline (Zoloft) can make your depression worse and cause you to have thoughts of suicide or harming yourself. The risk is highest if you're 24 years of age or younger, within the first few months of taking the medication, and when your dose changes. If you or anyone around you notice that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking sertraline (Zoloft), get medical help right away.
Serotonin syndrome
- Risk factors: Taking other medications that raise serotonin levels in your brain
Some people taking sertraline (Zoloft) have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome is higher if you use sertraline (Zoloft) with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications. Let your psychiatrist know about all the medications you take before starting sertraline (Zoloft). Also, don't start any new medications without talking to your psychiatrist first. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.
Risk of bleeding
- Risk factors: Taking blood-thinners or other medications that raise your risk of bleeding
Sertraline (Zoloft) can raise your risk of severe bleeding or bruising, especially if you're also taking antiplatelets (e.g., aspirin, clopidogrel (Plavix)) or anticoagulants (e.g., warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto)). Get medical help if you get bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums.
Not for use alone in bipolar disorder
Depression can be the first sign of bipolar disorder. If you're at risk for bipolar disorder, taking antidepressants, like sertraline (Zoloft), by themselves can trigger a bipolar manic episode. Before starting sertraline (Zoloft), your psychiatrist will check to see if you have or are at risk for bipolar disorder. Sertraline (Zoloft) isn't used to treat bipolar depression. Talk to your psychiatrist right away if you or your loved ones notice unusual changes in your behavior, such as racing thoughts, restlessness, getting easily distracted, or unusual talkativeness.
Glaucoma
- Risk factors: History of angle-closure glaucoma
Sertraline (Zoloft) can lead to or worsen angle-closure glaucoma. You might need to see your optometrist regularly and get eye exams to check your eyes and make sure your vision isn't worsening. Contact your psychiatrist or optometrist if you notice changes in your vision after starting sertraline (Zoloft).
Life-threatening abnormal heart rhythm (QT prolongation)
- Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation
Sertraline (Zoloft) can affect your heart rhythm, which can be serious and life-threatening. One example includes lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation. Your risk is higher if you have certain factors, including abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone) and ciprofloxacin (Cipro), among others. To lower your risk, your psychiatrist or primary care provider might periodically monitor your heart and perform electrocardiograms (EKGs) to make sure your heart rhythm is normal. If you feel your chest pounding, have shortness of breath, have chest pain, or feel faint or lightheaded while taking sertraline (Zoloft), call 911 right away.
Low blood sodium levels
- Risk factors: Older people | Taking diuretic medications
Sertraline (Zoloft) can cause low sodium levels in your blood. Your psychiatrist might closely monitor your blood sodium levels before and during treatment with sertraline (Zoloft). Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.
More on Sertraline (Zoloft) warnings
Sertraline (Zoloft) dosage
Typical dosage for Sertraline (Zoloft)
Adults
- Depression, PD, OCD, PTSD, SAD: The typical starting dose ranges from 25 mg to 50 mg by mouth daily. The typical maintenance dose ranges from 50 mg to 200 mg daily, depending on your condition.
- PMDD: The typical starting dose is 50 mg by mouth daily. Your psychiatrist might ask you to take this medication daily throughout your menstrual cycle (up to 150 mg daily), or to only take it daily starting 2 weeks before your period begins and stopping when your period ends (up to 100 mg daily).
Children (age 6 years and older)
- OCD: The typical starting dose ranges from 25 mg to 50 mg by mouth daily, depending on your child's age. The typical maintenance dose ranges from 50 mg to 200 mg daily.
Your psychiatrist will determine your dose based on your age and medical condition. Your dose might be different if you have liver problems.
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Interactions between Sertraline (Zoloft) and other drugs
More on Sertraline (Zoloft) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Bepridil
- Bromopride
- Cisapride
- Clorgyline
- Dronedarone
- Eliglustat
- Furazolidone
- Iproniazid
- Isocarboxazid
- Linezolid
- Mesoridazine
- Methylene Blue
- Metoclopramide
- Moclobemide
- Nialamide
- Pargyline
- Phenelzine
- Pimozide
- Piperaquine
- Procarbazine
- Rasagiline
- Saquinavir
- Selegiline
- Sparfloxacin
- Terfenadine
- Thioridazine
- Toloxatone
- Tranylcypromine
- Ziprasidone
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Alfentanil
- Alfuzosin
- Almotriptan
- Amineptine
- Amiodarone
- Amisulpride
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amphetamine
- Amtolmetin Guacil
- Anagrelide
- Ancrod
- Anileridine
- Anisindione
- Antithrombin III Human
- Apixaban
- Apomorphine
- Ardeparin
- Aripiprazole
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Asenapine
- Aspirin
- Astemizole
- Atazanavir
- Azithromycin
- Bedaquiline
- Bemiparin
- Benzhydrocodone
- Benzphetamine
- Bivalirudin
- Bromfenac
- Brompheniramine
- Bufexamac
- Buprenorphine
- Bupropion
- Buserelin
- Buspirone
- Butorphanol
- Cangrelor
- Carbamazepine
- Celecoxib
- Ceritinib
- Certoparin
- Chloroquine
- Chlorpromazine
- Choline Salicylate
- Cilostazol
- Ciprofloxacin
- Citalopram
- Clarithromycin
- Clofazimine
- Clomipramine
- Clonixin
- Clopidogrel
- Clozapine
- Cocaine
- Codeine
- Crizotinib
- Cyclobenzaprine
- Dabrafenib
- Dalteparin
- Danaparoid
- Dasatinib
- Defibrotide
- Degarelix
- Delamanid
- Dermatan Sulfate
- Desipramine
- Desirudin
- Deslorelin
- Desmopressin
- Desvenlafaxine
- Deutetrabenazine
- Dexfenfluramine
- Dexibuprofen
- Dexketoprofen
- Dextroamphetamine
- Dextromethorphan
- Dibenzepin
- Diclofenac
- Dicumarol
- Difenoxin
- Diflunisal
- Dihydrocodeine
- Diphenoxylate
- Dipyridamole
- Dipyrone
- Disopyramide
- Dofetilide
- Dolasetron
- Domperidone
- Donepezil
- Dothiepin
- Doxepin
- Droperidol
- Droxicam
- Duloxetine
- Ebastine
- Edoxaban
- Efavirenz
- Eletriptan
- Encorafenib
- Enoxaparin
- Entrectinib
- Epoprostenol
- Eptifibatide
- Eribulin
- Erythromycin
- Escitalopram
- Ethylmorphine
- Etodolac
- Etofenamate
- Etoricoxib
- Famotidine
- Felbamate
- Felbinac
- Fenfluramine
- Fenoprofen
- Fentanyl
- Fepradinol
- Feprazone
- Fingolimod
- Flecainide
- Floctafenine
- Fluconazole
- Flufenamic Acid
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Formoterol
- Foscarnet
- Fosphenytoin
- Fostemsavir
- Frovatriptan
- Galantamine
- Gatifloxacin
- Gemifloxacin
- Glasdegib
- Gonadorelin
- Goserelin
- Granisetron
- Halofantrine
- Haloperidol
- Heparin
- Histrelin
- Hydrocodone
- Hydromorphone
- Hydroquinidine
- Hydroxychloroquine
- Hydroxytryptophan
- Hydroxyzine
- Ibuprofen
- Ibutilide
- Iloperidone
- Iloprost
- Imipramine
- Indomethacin
- Inotuzumab Ozogamicin
- Iobenguane I 123
- Iobenguane I 131
- Itraconazole
- Ivabradine
- Ivosidenib
- Ketobemidone
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lapatinib
- Lasmiditan
- Lefamulin
- Lenvatinib
- Leuprolide
- Levofloxacin
- Levomilnacipran
- Levorphanol
- Lisdexamfetamine
- Lithium
- Lofepramine
- Lofexidine
- Lorcaserin
- Lornoxicam
- Loxoprofen
- Lumefantrine
- Lumiracoxib
- Meclofenamate
- Mefenamic Acid
- Mefloquine
- Melitracen
- Meloxicam
- Meperidine
- Metaxalone
- Methadone
- Methamphetamine
- Methotrimeprazine
- Metronidazole
- Mifepristone
- Milnacipran
- Mirtazapine
- Mizolastine
- Moricizine
- Morniflumate
- Morphine
- Morphine Sulfate Liposome
- Moxifloxacin
- Nabumetone
- Nadroparin
- Nafarelin
- Nalbuphine
- Naproxen
- Naratriptan
- Nebivolol
- Nefazodone
- Nelfinavir
- Nepafenac
- Nicomorphine
- Niflumic Acid
- Nilotinib
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Ondansetron
- Opipramol
- Opium
- Opium Alkaloids
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxaprozin
- Oxcarbazepine
- Oxycodone
- Oxymorphone
- Oxyphenbutazone
- Ozanimod
- Paliperidone
- Palonosetron
- Panobinostat
- Papaveretum
- Papaverine
- Parecoxib
- Paregoric
- Parnaparin
- Paroxetine
- Pasireotide
- Pazopanib
- Pentamidine
- Pentazocine
- Pentosan Polysulfate Sodium
- Perphenazine
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Phenytoin
- Piketoprofen
- Pimavanserin
- Pipamperone
- Piritramide
- Piroxicam
- Pitolisant
- Ponesimod
- Posaconazole
- Pranoprofen
- Prasugrel
- Probucol
- Procainamide
- Prochlorperazine
- Proglumetacin
- Promethazine
- Propafenone
- Propyphenazone
- Proquazone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Remifentanil
- Reviparin
- Ribociclib
- Risperidone
- Ritonavir
- Rivaroxaban
- Rizatriptan
- Rofecoxib
- Safinamide
- Salicylic Acid
- Salsalate
- Selexipag
- Selpercatinib
- Sertindole
- Sevoflurane
- Sibutramine
- Siponimod
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
- Sodium Salicylate
- Solifenacin
- Sorafenib
- Sotalol
- St John's Wort
- Sufentanil
- Sulfinpyrazone
- Sulindac
- Sulpiride
- Sultopride
- Sumatriptan
- Sunitinib
- Tacrolimus
- Tamoxifen
- Tapentadol
- Telaprevir
- Telavancin
- Telithromycin
- Tenoxicam
- Tetrabenazine
- Tianeptine
- Tiaprofenic Acid
- Ticagrelor
- Ticlopidine
- Tilidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Tolterodine
- Toremifene
- Tramadol
- Trazodone
- Treprostinil
- Triclabendazole
- Trimipramine
- Triptorelin
- Tryptophan
- Valdecoxib
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Vilanterol
- Vilazodone
- Vinflunine
- Voclosporin
- Vorapaxar
- Voriconazole
- Vorinostat
- Vortioxetine
- Warfarin
- Zolmitriptan
- Zotepine
- Zuclopenthixol
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Sertraline (Zoloft) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sertraline (Zoloft) will not be safe for you to take.
- Currently take or have taken a monoamine oxidase inhibitor (MAOI), linezolid (Zyvox), or methylene blue (ProvayBlue) in the last 14 days
- Taking pimozide
- Taking disulfiram (for sertraline (Zoloft) liquid only)
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