Zoloft for Depression: Important Things to Know Before Taking This Antidepressant

If you’re feeling down, not motivated, or like nothing interests you, early signs of depression may be setting in. Depression is a mood disorder that affects how you feel, think and behave. Thankfully, there are many effective treatment options available to treat it.

Therapy is one option. Cognitive behavioral therapy (CBT), psychodynamic therapy, and group therapy can all make a positive difference. What’s more, many medications are FDA approved to treat depression. First-choice medication options include selective serotonin reuptake inhibitors (SSRIs), such as Zoloft (sertraline), Lexapro (escitalopram), and Prozac (fluoxetine). 

Of these, Zoloft is commonly prescribed to treat anxiety, depression, and several other mental health conditions. But there are many important factors to consider before starting this medication.

What is Zoloft, and how does it treat depression?

Zoloft is an SSRI antidepressant that was initially FDA approved in 1991. It works by raising the levels of serotonin in your brain, a chemical messenger in your body that seems to play a role in mood, sleep, and anxiety.

Zoloft is available as an oral pill and liquid. These formulations are usually taken once daily, with or without food. One common side effect of Zoloft is nausea, but taking it with food can help reduce this side effect.

What else can Zoloft treat besides depression?

Zoloft is commonly used to treat depression. Aside from depression, Zoloft is also used for:

• Obsessive-compulsive disorder (OCD). OCD is a mental health condition that can cause unwanted, intrusive thoughts (obsessions) and certain actions and behaviors (compulsions).

• Panic disorder (PD). PD is a type of anxiety disorder where you have panic attacks. Panic attacks have many symptoms, including sweating, fear, and shortness of breath. 

• Post-traumatic stress disorder (PTSD). PTSD is a mental health condition that happens after directly or indirectly experiencing a traumatic event. Symptoms may include nightmares, flashbacks, and mood changes.

• Premenstrual dysphoric disorder (PMDD). PMDD is a more severe form of premenstrual syndrome (PMS). Symptoms may include fatigue, irritability, and mood swings. Keep in mind that there are different ways that Zoloft is used for PMDD. Some people take it every day, while others only take it during the days or weeks when they have a lot of symptoms.

• Social anxiety disorder (SAD). Also known as social phobia, SAD is when someone feels extremely anxious in social situations and worries about being judged by others. One example of SAD is performance anxiety. 

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How will Zoloft make me feel at first? 

Zoloft doesn’t provide immediate relief. It’s designed to manage symptoms of depression and anxiety over time — not right away. It may even make some people feel worse before they start feeling better. 

You may experience some temporary side effects before you notice any improvements. Over time, side effects should lessen and positive mood changes should begin to take their place. Improvements in depression and anxiety tend to appear after a couple weeks to months.

Will Zoloft start working immediately?

No. Zoloft won’t make you feel better right away. Some improvements in mood may appear within 1 to 2 weeks, but Zoloft can take about 4 to 8 weeks to fully kick in. It’s important you continue taking the medication even if you don’t see any changes for the first few weeks. 

However, if you’ve taken Zoloft for more than 4 weeks and haven’t noticed any positive changes, speak with your healthcare provider to discuss your options. They may want to change your dose or give you a different medication.

What are the common side effects of Zoloft?

Like any medication, Zoloft has side effects you may experience. Some common Zoloft side effects include:

• Nausea

• Diarrhea

• Dry mouth

• Insomnia

• Tiredness

• Trouble sleeping

• Sexual side effects, such as low sex drive, problems having an orgasm, or erectile dysfunction (ED)

• Weight gain

If you’re experiencing these types of side effects, hang in there. For many people, side effects will get better with time.

And keep in mind: Don’t stop taking Zoloft without talking to a healthcare provider first. If Zoloft is stopped abruptly, it’s possible to develop antidepressant discontinuation syndrome — especially if you’ve taken Zoloft for a long period of time.

What are the most serious side effects of Zoloft?

Rare but serious side effects are possible while taking Zoloft. Side effects that may require medical attention — if experienced — can include:

• Serotonin syndrome. This is a rare but potentially life-threatening condition that can happen when your body has too much serotonin. Symptoms may include hallucinations, a rapid heartbeat, and seizures. This is more likely to happen when Zoloft is combined with other serotonin-affecting medications.

• Bleeding. SSRIs like Zoloft can increase your risk of easy bleeding and bruising. The risk of bleeding is higher if you’re taking other medications that can cause bleeding, such as non-steroidal anti-inflammatory drugs (NSAIDs) or anticoagulants.

• Low sodium levels. Zoloft can lower the amount of sodium in your body. If sodium levels get too low, possible symptoms may include trouble with concentration, confusion, and fainting.

• Thoughts of suicide. In people younger than age of 25, Zoloft can increase thoughts of suicide and self-harm — especially when first starting the medication or after a dose change. If you or someone you know is having thoughts of suicide, contact your healthcare provider as soon as possible or call the National Suicide Prevention Lifeline at 988.

• Eye problems. In rare cases, SSRIs like Zoloft are associated with glaucoma and cataracts, especially in people who have a family history of these health problems. 

If you experience signs of any of these serious side effects, talk to your healthcare provider right away.

Zoloft side effects week by week

Zoloft’s side effects can change with time. You may experience some side effects in the early weeks of taking it, but they often lighten up later on.

Week one of taking Zoloft

During the first week of taking Zoloft, you may notice some side effects creep in. This is normal — your body is adjusting to the medication’s effects. The most common side effects to expect within the first week are:

• Headache

• Dizziness

• Fatigue

• Trouble sleeping

• Upset stomach

• Loss of appetite

• Sexual problems

• Restlessness

• Dry mouth

Most of these side effects lessen — or go away completely — within the first 2 weeks of starting the medication. However, some side effects, like sexual side effects, may linger on as you keep taking Zoloft (or after a dose increase).

Week two of taking Zoloft

You’ll likely experience similar side effects during your second week of taking Zoloft. Thankfully, reports show that common side effects tend to go away after week two. 

If you continue to experience occasional but tolerable side effects, try to keep taking Zoloft as prescribed by your healthcare provider. Patience is key when it comes to taking antidepressants like Zoloft. But if you’re concerned with any of these side effects or they aren’t getting better, it’s important to loop in your provider.

Is it better to take Zoloft in the morning or at night?

It depends on the person. Zoloft’s effectiveness doesn’t depend on the time of day it’s taken, but your sleep schedule may be better if you take it at a certain time of day.

For some people, Zoloft can make you feel tired and sleepy. For others, it can cause insomnia or difficulty sleeping. But, thankfully, it tends to cause less drowsiness than other antidepressants.

If Zoloft makes you feel tired or sleepy, try taking it in the evening before bed. If Zoloft makes it harder for you to fall asleep, try taking it in the morning after waking up. 

Is there anyone who shouldn’t take Zoloft?

Most people are eligible to take Zoloft. But, like with all medications, there are a few people who shouldn’t use it.

Age is one factor. Children younger than 6 years old should not take Zoloft. There isn’t much information available that says if it’s safe and effective. Zoloft is better suited for older children, adolescents, and adults.

If you have any of the following medical conditions, it’s important to consult your healthcare provider before starting this medication:

• Kidney or liver disease

• Active bleeding problems 

• Low sodium levels or hyponatremia

• Bipolar disorder

If you’re pregnant or breastfeeding, or trying to conceive, you should also talk to your doctor about whether Zoloft is the right medication for you. 

Zoloft can also interact with certain medicationsand worsen side effects. If you’re taking any of the following medications, your healthcare provider may lower the dosage of Zoloft or prescribe a different medication: 

• Serotonin and norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta)

• Tricyclic antidepressants (TCAs) like nortriptyline (Pamelor)

• Monoamine oxidase inhibitors like selegiline (Zelapar, Emsam)

• Antipsychotics like ziprasidone (Geodon)

• Triptan migraine medications like sumatriptan (Imitrex)

• Blood thinners like warfarin (Coumadin, Jantoven)

• Antiseizure medications like phenytoin (Dilantin, Phenytek)

• Certain opioids like tramadol (Ultram)

• Linezolid (Zyvox)

Can I take Zoloft and drink alcohol?

It’s best to avoid drinking alcohol when taking Zoloft. Alcohol can actually make depression and anxiety worse. And drinking alcohol can also worsen side effects like:

• Nausea

• Dry mouth

• Diarrhea

• Dizziness

• Drowsiness

• Sexual problems like ED

• Suicidal thoughts

Why trust our experts?

Written by:

Nidhi Gandhi-Patel, PharmD, BS

Nidhi Gandhi-Patel, PharmD, is a licensed pharmacist in Illinois. She has worked in the pharmacy profession for more than 6 years and currently is the interim Co-Director of the AACP Transformation Center at the American Association of Colleges of Pharmacy (AACP).

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

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If you or someone you know is struggling with depression or has had thoughts of harming themselves or taking their own life, know that help is available. The National Suicide Prevention Lifeline (988) provides 24/7, free, confidential support for people in distress, as well as best practices for professionals and resources to aid in prevention and crises.