Zoloft (Sertraline) Oral: Uses, Side Effects, Dosages - Verywell Health
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What Is Zoloft?
Zoloft (sertraline) is a prescription medication used to treat mental health conditions such as depression, obsessive-compulsive disorder (OCD), panic attacks, and others. It belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs).
Serotonin is a natural substance in your brain that helps regulate mood. As an SSRI, Zoloft works in the brain to increase serotonin, which helps improve symptoms of depression or anxiety. Low serotonin levels are linked to mood disorders like depression.
Zoloft is available as an oral tablet as well as an oral solution.
Drug Facts
Generic Name: Sertraline
Brand Name(s): Zoloft
Drug Availability: Prescription
Administration Route: Oral
Therapeutic Classification: Antidepressant
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Sertraline hydrochloride
Dosage Form(s): Tablet, solution
What Is Zoloft Used For?
The Food and Drug Administration (FDA) approved Zoloft to treat:
Verywell / Dennis Madamba
How to Take Zoloft
Your healthcare provider will either prescribe you Zoloft to take as a tablet or solution (liquid), meant to be taken by mouth. How often you take it depends on what condition you are treating and how your body reacts to the medication. It is usually taken once daily in the morning or evening. You can take this medication with or without food.
If taking the oral solution, remember the following:
- Dilute the solution right before use.
- Use the dropper supplied with your medicine to grab the dose of the solution and mix with 4 ounces (or 1/2 cup) of water ginger ale, lemon/lime soda, lemonade, or orange juice.
- After mixing, the solution may appear slightly hazy. This is normal.
- Take the dose immediately after mixing.
Storage
Keep the tablets and solution at room temperature (between 68 and 77 degrees F). Make sure the bottle containing the medication is closed tightly.
Off-Label Uses
Healthcare providers may prescribe Zoloft for off-label uses, meaning for conditions not specifically indicated by the FDA. Studies have shown that Zoloft may be beneficial for other mental health conditions, such as:
- Binge-eating disorder
- Bulimia nervosa
- Generalized anxiety disorder
How Long Does Zoloft Take to Work?
How long it takes before feeling symptom improvement will depend on each person and their symptoms. It can take anywhere from a few weeks to a few months. In studies, Zoloft has been found to reduce anxiety and lead to self-reported mental health improvements.
What Are the Side Effects of Zoloft?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
The most common side effects of Zoloft include:
- Drowsiness
- Insomnia
- Nausea
- Loss of appetite
- Increased sweating
- Sexual problems, including ejaculation failure or decreased sex drive
- Tremor
- Agitation
Side effects may appear differently in children. Children taking Zoloft may experience:
- Nose bleed
- More frequent urination
- Aggressiveness
- Heavy menstrual periods
- Weight change
Talk to your healthcare provider or pharmacist If any of these side effects don't go away or become more severe.
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you're having a medical emergency. Serious side effects and their symptoms can include the following:
- Suicidal thoughts or suicide attempts
- Severe allergic reactions: Symptoms may include trouble breathing, hives, or swelling of the tongue, lips, mouth, or throat
- Aggressive or violent behavior
- New or worse depression or anxiety
- Serotonin syndrome: Symptoms may include hallucinations, loss of consciousness, fast heart rate, muscle stiffness, coma, shakiness, sweating, nausea, or vomiting
- Seizures
- Abnormal bleeding
- Changes in appetite or weight
- Blurred vision
- Low sodium levels: Symptoms may include headache, weakness, and confusion
Zoloft contains a boxed warning, the FDA's strictest warning label, because of the heightened risk of suicidal thoughts or behaviors in young people, especially in the first few months of therapy and during dosage changes. Immediately contact your prescribing healthcare provider if you start to have worsening depression symptoms or thoughts about suicide.
If you are a caregiver, watch for signs of worsening depression or sudden changes in mood or behavior.
Report Side Effects
Zoloft may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Dosage: How Much Zoloft Should I Take?
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage forms (solution or tablets):
- For depression:
- Adults—At first, 50 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
- Children—Use and dose must be determined by your doctor.
- For obsessive-compulsive disorder:
- Adults and teenagers—At first, 50 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
- Children 6 to 12 years of age—At first, 25 mg once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
- Children younger than 6 years of age—Use and dose must be determined by your doctor.
- For panic disorder, posttraumatic stress disorder, or social anxiety disorder:
- Adults—At first, 25 milligrams (mg) once a day, taken either in the morning or evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 200 mg per day.
- Children—Use and dose must be determined by your doctor.
- For premenstrual dysphoric disorder:
- Adults—At first, 50 milligrams (mg) once a day throughout your menstrual cycle or just during the premenstrual time. Your doctor may adjust your dose as needed. However, the dose is usually not more than 150 mg per day throughout your menstrual cycle or 100 mg per day if you are only taking it during your premenstrual time.
- Children—Use and dose must be determined by your doctor.
- For depression:
Modifications
For Zoloft, dosage adjustments may be necessary based on other health conditions, age, and pregnancy status.
Other Health Conditions
If you have mild liver problems, your healthcare provider may prescribe you a reduced dosage of Zoloft. However, Zoloft is not recommended for use in people with more moderate to advanced liver problems because the medication is metabolized in the liver. No dosage changes are needed for kidney problems.
Age
Dosing for adults older than 65 may be more conservative, as this population is more likely to have other medical conditions that may affect treatment. Additionally, SSRIs, including Zoloft, have been associated with hyponatremia (low sodium levels) in older people.
Additionally, people aged 24 and younger should be wary of increased suicidal thinking or behavior with Zoloft use, especially early in treatment or when the dosage is adjusted. If you suspect this is a problem for you, contact your healthcare provider. You may be able to change to a different medication. Zoloft's safety and effectiveness have not yet been established in children, except for those being treated for OCD.
Pregnancy
Because Zoloft oral solution contains 12% alcohol, this formulation is not recommended for use during pregnancy. In general, Zoloft has been associated with some pregnancy complications, including increased risk of persistent pulmonary hypertension (high blood pressure) and withdrawal in the newborn infant when used in the third trimester.
However, untreated mental health conditions during pregnancy can also lead to complications. Talk to your healthcare provider to weigh the benefits of staying on Zoloft vs. the potential risks. Together, you can decide the best option for you and your health.
Zoloft is generally considered safe to use while breastfeeding, though.
Missed Dose
If you miss a dose of Zoloft, you should take the missed dose as soon as you remember. But if it is almost time for the next scheduled dose, you should skip the dose you missed. Do not take extra to make up for the missed dose. Doing so can increase your risk for side effects.
Overdose: What Happens If I Take Too Much Zoloft?
If you take too much Zoloft, you may begin to experience:
- Fast heart rate
- Tiredness
- Nausea or vomiting
- Dizziness
- Tremors
- Agitation
- Seizures
- Hypertension
- Altered mental status
People taking other serotonergic drugs are also at a higher risk of serotonin syndrome with an overdose. Serotonin syndrome symptoms can range from mild to potentially life-threatening.
What Happens If I Overdose on Zoloft?
If you think you or someone else may have overdosed on Zoloft, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Zoloft, call 911 immediately.
Precautions
It is very important that your doctor check your or your child's progress at regular visits. This is to allow for changes in your dose and to help reduce any side effects. Blood tests may be needed to check for unwanted effects.
Do not take sertraline with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking sertraline during the 14 days after you stop a MAO inhibitor and wait 14 days after stopping sertraline before you start taking a MAO inhibitor. If you take them together or do not wait 14 days, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.
Do not use pimozide (Orap®) while you are taking this medicine. Do not use the oral liquid form of sertraline if you are also using disulfiram (Antabuse®). Using these medicines together can cause serious problems.
Sertraline may cause a serious condition called serotonin syndrome if taken together with some medicines. Do not use sertraline with buspirone (Buspar®), fentanyl (Abstral®, Duragesic®), linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), methylene blue injection, tryptophan, St John's wort, or some pain or migraine medicines (eg, rizatriptan, sumatriptan, tramadol, Frova®, Imitrex®, Maxalt®, Relpax®, Ultram®, Zomig®). Check with your doctor first before taking any other medicines with sertraline.
For some children, teenagers, and young adults, this medicine can increase thoughts of suicide. Tell your doctor right away if you or your child start to feel more depressed and have thoughts about hurting yourselves. Report any unusual thoughts or behaviors that trouble you or your child, especially if they are new or get worse quickly. Make sure the doctor knows if you or your child have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you or your child have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let the doctor know if you, your child, or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
Sertraline may increase your risk for bleeding problems. Make sure your doctor knows if you or your child are also using other medicines that thin the blood, such as aspirin, NSAID pain or arthritis medicines (eg, diclofenac, ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, Voltaren®), or warfarin (Coumadin®, Jantoven®).
This medicine may cause hyponatremia (low sodium in the blood). This is more common in elderly patients, those who are taking diuretic medicines for high blood pressure, or those who have decreased amounts of fluid in the body due to severe diarrhea or vomiting. Check with your doctor right away if you or your child have headache, trouble concentrating, memory problems, confusion, weakness, or unsteadiness.
Check with your doctor right away if you have chest pain or discomfort, fainting, irregular or slow heart rate, or trouble breathing. These may be symptoms of heart rhythm problems, including QT prolongation and torsades de pointes.
Check with your doctor right away if you have decreased interest in sexual intercourse, delayed or inability to have and orgasm in women, inability to have or keep an erection in men, or loss in sexual ability, desire, drive, or performance. These could be symptoms of sexual dysfunction.
This medicine may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, talk with your doctor.
The use of alcohol is not recommended in patients who are taking sertraline. .
This medicine may cause some people to become drowsy, to have trouble thinking, or to have problems with movement. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert or well-coordinated.
The dropper dispenser for the oral liquid contains dry natural rubber (a derivative of latex). This may cause allergic reactions in people who are sensitive to latex. Tell your doctor if you or your child have a latex allergy before you start using this medicine.
Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. This is to decrease the chance of having side effects such as agitation, anxiety, dizziness, a feeling of constant movement of self or surroundings, headache, increased sweating, nausea, trembling or shaking, trouble with sleeping or walking, or unusual tiredness when you stop the medicine.
Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
What Are Reasons I Shouldn't Take Zoloft?
There are a few reasons why your healthcare provider may not choose Zoloft as part of your treatment plan.
Allergy
A person should not take Zoloft if they are allergic to the ingredients.
Alcohol
Drinking alcohol while you take Zoloft can increase the risk of sleepiness. It is best to speak with your healthcare provider if you drink alcohol.
Pregnancy
Zoloft should only be used during pregnancy if the benefits outweigh the risks. It is best to talk to your prescribing healthcare provider if you are pregnant or plan to become pregnant, so they can help you decide the best option for you.
Children
Sertraline has only been studied for the treatment of obsessive-compulsive disorder in children. It should not be used in someone younger than 6.
Other health conditions
In certain individuals, the body may handle Zoloft differently. Talk to your healthcare provider if you have:
What Other Medications Interact With Zoloft?
There are a few medications that can interact with Zoloft.
Drugs you should not take with sertraline include:
- Pimozide
- Phenelzine, isocarboxazid, or other monoamine oxidase inhibitors (MAOIs)
- Zyvox (linezolid)
Drug interactions that can increase side effects if taken with Zoloft include:
This list does not include all drugs that can interact with Zoloft. Before taking this medication, be sure to tell your healthcare provider about all the prescription medications, over-the-counter (OTC) medications, vitamins, supplements, or herbs you are taking. This will help you avoid potential interactions. If you have any questions about drug interactions, speak with your healthcare provider or pharmacist.
What Medications Are Similar?
Zoloft is a medication known as a selective serotonin reuptake inhibitor (SSRIs). A few other commonly prescribed SSRIs include:
Prozac
Fluoxetine is available as a tablet, capsule, or solution. It is often prescribed to treat different types of depression, panic attacks, bulimia nervosa, or obsessive-compulsive disorder. The most common side effects include strange dreams, decreased appetite, decreased sex drive, or sleepiness. Compared with other SSRIs, fluoxetine is sometimes associated with higher rates of weight loss, agitation, and anxiety.
Celexa
Celexa is available as an oral tablet and solution. It is often prescribed to treat depression. Common side effects include sexual problems, sleepiness, anxiousness, or constipation. Celexa is more often associated with QT prolongation than other SSRIs, which appear to depend on the dose.
Lexapro
Escitalopram is available as an oral tablet and solution. It is often prescribed to treat depression and generalized anxiety disorder. Common side effects include sexual problems, sleepiness, anxiousness, or lack of hunger. Along with citalopram, escitalopram is associated with a higher risk of QT prolongation.
This list is a list of drugs from similar medication classes as Zoloft. It is not a list of medicines recommended to take with Zoloft. Ask your pharmacist or healthcare provider if you have any questions.
How Can I Stay Healthy While Taking Zoloft?
Zoloft is a safe and effective medication when used correctly. This drug is often used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, and premenstrual dysphoric disorder.
While Zoloft does have the potential for serious side effects, the most common side effects may be milder. Those tend to include drowsiness, sexual problems (e.g., ejaculation failure or decreased sex drive), or nausea. If you start to experience any side effects, don't immediately panic. Talk to your healthcare provider about your options. Immediately reach out to your healthcare provider if you find that your depression is worsening or you have suicidal thoughts.
It is important to inform your healthcare provider of your other health conditions and any prescription medications, OTC medications, vitamins, supplements, or herbs you are taking. This way your healthcare provider is able to make the best decision about what medication and what dose work best for you.
Medical Disclaimer
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
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