Medication Guide
Sertraline (Zoloft) Side Effects and Uses
A plain-language guide to Sertraline, an SSRI antidepressant. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Sertraline (Zoloft) is an SSRI antidepressant. Common sertraline side effects include nausea or upset stomach, diarrhea or loose stools, headache and trouble sleeping or feeling sleepy. The rare but serious ones, and when to get help, are listed under sertraline side effects below. Never stop or change your dose on your own.
How Sertraline Can Help You
Sertraline (Zoloft) is a selective serotonin reuptake inhibitor, or SSRI. It slowly raises the amount of serotonin the brain can use. Serotonin is a chemical messenger tied to mood, worry and stress. Over time, this can quiet worry and lift low mood. It can also ease the unwanted thoughts of OCD and PTSD.
Many people say they feel more like themselves again. They feel less weighed down and less on edge. Daily life is easier to enjoy. Sertraline does not change who you are. It eases the symptoms that were in the way.
Change comes slowly. Some people notice better sleep, appetite or energy within one to two weeks. The full effect usually builds over four to eight weeks of daily use. Your prescriber checks in during this time. Once you feel well, you decide together how long to stay on it.
Uses for Sertraline
- Major depressive disorder
- Obsessive-compulsive disorder (OCD), including in children 6 and older
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder
- Premenstrual dysphoric disorder (PMDD)
- Generalized anxiety disorder (off-label)
How to Take Sertraline
Your prescriber decides your dose and any changes to it. The dose depends on the condition, your age and your response. Most people take sertraline once a day. Many choose the morning. If it makes you sleepy, your prescriber may suggest the evening. You can take it with or without food, and food can ease early nausea.
Take it at about the same time each day. Missed a dose? Take it when you remember, unless the next dose is close. In that case, skip the missed one and never double up. Do not stop sertraline on your own. Stopping suddenly can bring dizziness, irritability and flu-like feelings, so your prescriber plans any change.
Sertraline Side Effects
Common Side Effects
- Nausea or upset stomach
- Diarrhea or loose stools
- Headache
- Trouble sleeping or feeling sleepy
- Dry mouth
- More sweating
- Sexual side effects, such as lower desire or delayed orgasm
- Shakiness or jittery feelings early on
Serious: Get Medical Help Promptly
- New or worse suicidal thoughts, mostly in people under 25 (boxed warning)
- Serotonin syndrome, with agitation, fever, fast heartbeat or stiff muscles
- Unusual bleeding or bruising, more likely with blood thinners or NSAIDs
- Low sodium (hyponatremia), with confusion, weakness or headache, mostly in older adults
- Mania, with a very high mood, racing thoughts or little need for sleep
- Severe allergic reaction, with rash, swelling or trouble breathing
When Is Zoloft Prescribed?
Zoloft is the brand name, and sertraline is the generic name. It has a long track record. So it is often a first choice for depression and anxiety. In adults, the FDA has approved it for depression, OCD, panic disorder and PTSD. It is also approved for social anxiety disorder and PMDD.
For children and teens, the only FDA approval is for OCD in ages 6 and older. Other uses in young people are off-label and need close follow-up. Families can learn about child and adolescent psychiatry by telehealth from anywhere in California.
How Should Zoloft Be Taken?
Sertraline comes as tablets and an oral liquid concentrate. Swallow the tablets with water. Mix the liquid just before use with a small amount of drink. Use water, ginger ale, lemon-lime soda, lemonade or orange juice. Do not mix it with other drinks, and use the dropper that comes with it.
The liquid contains alcohol, so it must not be used with disulfiram. Sertraline has a half-life of about 26 hours. That is why once a day keeps levels steady. Read the medication guide from your pharmacy. Ask your prescriber about any step that is unclear.
Feeling Restless or Hyper on Zoloft
In the first weeks, or after a dose change, some people feel restless, jittery or irritable. Some cannot sleep. This is sometimes called activation. Report it even when it is mild, because your prescriber can adjust the plan.
A different pattern needs a call right away. Watch for very high energy, little need for sleep, racing thoughts or risky behavior. These can be signs of mania or hypomania. This is more likely with bipolar disorder, so share any personal or family history. If you are thinking about harming yourself, call or text 988, or call 911.
Zoloft Precautions and Interactions
Sertraline must never be taken with an MAOI antidepressant, linezolid, IV methylene blue or pimozide. Other drugs that raise serotonin, such as triptans, tramadol and St. John's wort, raise the risk of serotonin syndrome. Aspirin, NSAIDs and blood thinners raise bleeding risk.
Tell your prescriber about liver disease, seizures, glaucoma, bleeding problems and low sodium. Like all antidepressants, sertraline has a boxed warning. It covers suicidal thoughts in children, teens and young adults. If you are pregnant, planning a pregnancy or breastfeeding, talk it through with your prescriber.
Is Sertraline Right for You?
Only a full evaluation with a prescriber can tell you if Sertraline fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
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Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Paroxetine (Paxil), SSRI antidepressant
- Trazodone (Desyrel), Serotonin modulator (SARI) antidepressant
- Venlafaxine (Effexor XR), SNRI antidepressant
- Vilazodone (Viibryd), SSRI and serotonin partial agonist antidepressant
- Vortioxetine (Trintellix), Serotonin modulator antidepressant
- Amitriptyline (Elavil), Tricyclic antidepressant (TCA)
FAQ
Questions About Sertraline
What is Zoloft used for?
In adults, Zoloft is FDA approved for depression, OCD, panic disorder, PTSD, social anxiety disorder and PMDD. In children and teens 6 and older, it is approved for OCD. Prescribers sometimes use it off-label for other conditions when there is a good reason.
How long does sertraline take to work?
Some people notice better sleep, appetite or energy within one to two weeks. The fuller effect on mood and anxiety usually takes four to eight weeks of daily use. Your prescriber follows up during this time and adjusts the plan if needed.
Can Zoloft cause hyperactivity?
Some people feel restless, jittery or unable to sleep when they start sertraline or after a dose change. Very high energy with little need for sleep can be a sign of mania and needs a prompt call to your prescriber. Report any big change in energy or mood.
What if I feel worse when I first start?
A short rise in jitters or anxiety in the first week or two is common and often fades. If it is strong, tell your prescriber, who may slow the start or change the plan. If you are thinking about harming yourself, call or text 988, or call 911.
Can children take Zoloft?
Sertraline is FDA approved for OCD in children 6 and older. Other uses in children are off-label. Young people on any antidepressant need close follow-up because of the boxed warning about suicidal thoughts.
Will I gain weight on sertraline?
For most people, sertraline has little effect on weight. Small changes up or down can happen over long-term use. If you notice a real change, bring it up with your prescriber, since there are often simple ways to help.
Can I drink alcohol while taking sertraline?
It is best to limit or avoid alcohol. Alcohol can make depression and anxiety worse, and it may add to drowsiness. Talk with your prescriber about what is reasonable for you.
Can I take Zoloft with ibuprofen or aspirin?
Taking sertraline with ibuprofen, naproxen or aspirin raises the risk of bleeding. Ask your prescriber or pharmacist before you combine them, especially for regular use. Report unusual bruising, nosebleeds or dark stools right away.
Is sertraline addictive?
No. Sertraline is not habit-forming and does not cause cravings. Your body does adjust to it, though, so stopping suddenly can cause uncomfortable symptoms. Your prescriber plans a slow taper when it is time to stop.
How long does Zoloft stay in your system?
Sertraline has a half-life of about 26 hours. After the last dose, most of it leaves the body within about a week. Stopping should still follow a taper planned with your prescriber.