Increased zoloft side effects

What to expect in the first week of taking Zoloft

During your first week on Zoloft expect headache, nausea, fatigue, constipation, and more

Living with mental health conditions like anxiety or depression can make daily life stressful. An estimated 31% of all adults will experience an anxiety disorder at some point in their life, and statistics show that 264 million adults around the globe have anxiety. Luckily, there are many treatment options available for people who seek relief from anxiety or depression. Zoloft is a prescription medication used to reduce symptoms of anxiety and depression, and when taken properly, it can make daily life more manageable. Let’s take a more in-depth look at how to take Zoloft, what side effects to look out for in the first week, and what else to expect when you first start this medication.

RELATED: What is Zoloft?

What is Zoloft prescribed for?

Zoloft is the brand name of a generic medication called sertraline, which belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). SSRIs like Zoloft are antidepressants that work by increasing levels of serotonin in the brain. Zoloft is approved by the Food and Drug Administration (FDA) to treat the following conditions:

Major depressive disorder
Obsessive-compulsive disorder (OCD)
Post-traumatic stress disorder (PTSD)
Panic disorder
Social anxiety disorder
Premenstrual dysphoric disorder (PMDD)

Off-label uses for Zoloft include:

Anxiety
Binge eating disorder
Body dysmorphic disorder
Bulimia nervosa
Premature ejaculation
Hot flashes due to menopause

Starting Zoloft

Just like with any medication, knowing as much as possible about the drug you’ll be taking is essential to making sure you maximize its potential benefits. Knowing how to take Zoloft properly is important to make sure it works as effectively as possible. When taken correctly, Zoloft can make people feel less anxious or fearful, and it can reduce the urge to perform repeated tasks. It can improve sleep quality, appetite, energy levels, restore interest in daily life, and reduce unwanted thoughts and panic attacks.

Zoloft is available in tablet form in dosage strengths of 25 mg, 50 mg, or 100 mg. It’s also available as an oral solution, which must be diluted into four ounces of water, orange juice, lemonade, ginger ale, or lemon/lime soda before consumption.

The standard dose of Zoloft for anxiety is 25 mg or 50 mg per day. These are the starting doses of Zoloft for other disorders:

It’s important to talk with your doctor about what dosage is right for you because the exact amount of medication you’ll need will vary based on your specific condition, how severe your symptoms are, and whether or not you have any other health problems.

Zoloft is typically given once per day. The manufacturer of Zoloft does not specify that it should be taken in the morning or evening, just that it should be taken at the same time each day. There is some data from initial trials for Zoloft that suggests it can cause somnolence for some individuals. If you notice that it causes somnolence when you take it, it may be best to take it every day in the evening. Your healthcare professional may make a recommendation to change your dosage time to alleviate other side effects as well.

How long does it take for Zoloft to work?

Once you start taking Zoloft in the right amount as prescribed by your doctor, you can expect it to start working in about two to six weeks. Zoloft isn’t the type of medication that will start working on the first day, so you’ll need a little bit of patience while you wait for it to start relieving your symptoms.

According to the National Alliance on Mental Illness, some of the earliest signs that Zoloft is working are improvements in sleep, energy, or appetite. These improvements could happen as soon as one to two weeks into taking the medication. More significant changes like feeling less depressed or regaining interest in daily life may take six to eight weeks to show up.

Remember to be patient while assessing any positive impacts Zoloft may be having on your depression or anxiety. Most prescribers will require a follow up at 4, 6, or 8 weeks to assess how it is working for you. They may utilize a type of questionnaire to measure your symptoms more objectively and compare them to where you were before starting Zoloft. If you begin to get frustrated because you are not feeling the results you expected with Zoloft, make sure to speak to your healthcare provider first before discontinuing the medication. Zoloft should not be discontinued abruptly as it can cause worsened anxiety, agitation, confusion, headache, and insomnia. Your doctor may ask you to give the drug more time, or they may suggest transitioning to a different drug. This is a decision you should make with your doctor.

When you first start taking Zoloft, you may begin to notice a few side effects. One of the best ways to avoid side effects is to take the medication exactly as prescribed by your doctor. Your doctor will prescribe you a certain dose for a reason, and taking more Zoloft because you want it to work faster isn’t safe. Let’s take a look at some of the most common side effects of Zoloft you’ll want to be aware of when you start taking it.

Related: Zoloft for anxiety

Zoloft side effects to expect in the first week

During the first few days on Zoloft, you may experience some initial side effects even if you’re taking the medication exactly as prescribed by your doctor. This happens because it takes time for the body to become used to the medication. Some of the most common side effects that people have during their first week of taking Zoloft include:

Headache
Nausea
Fatigue
Constipation
Dry mouth
Sleepiness
Nervousness
Drowsiness
Trouble sleeping
Restlessness
Decreased sex drive
Weight gain
Dizziness
Loss of appetite
Increased sweating

Up to two-thirds of patients discontinue antidepressant therapy in the first 90 days of treatment due to side effects. It is important to know what to expect as therapy begins and have an open dialogue with your prescriber about your concerns. Do not abruptly stop treatment without speaking to your prescriber.

For some of these side effects, men and women may experience them at a different rates or intensity. For example, a study evaluating SSRI-induced sexual dysfunction found that men suffer from sexual dysfunction related to this class of drugs more often than women, but when women do, it is more intense. Sexual dysfunction can be characterized by decreased libido, delayed orgasm, delayed or inability to ejaculate, and impotence.

Women also have to be concerned with the effects of Zoloft on their unborn child if they take this medication during pregnancy. Zoloft has been linked to cardiac defects as well as defects in the formation of the baby’s skull. Zoloft is not recommended during pregnancy unless the benefits clearly outweigh the risks, especially in the last trimester.

Can Zoloft make you feel worse at first?

Zoloft does not provide immediate relief of symptoms, and for some, it may leave you wondering if what you are feeling is actually worse than before you started the medication. Depending on what primary condition you are treating, you may have a different response and a different timeline for improvement than others. There is data to suggest that Zoloft begins helping with anxiety symptoms in the first few weeks after you start treatment. Relief from depressive symptoms may not come until closer to the 12-week mark. While depression and anxiety are often hand-in-hand, the delay in the improvement of depression may leave you feeling “worse” than you did initially.

Zoloft is known to increase suicidal thoughts in teens and young adults, and this is especially true when anxiety and depression are uncontrolled. It is important to monitor this group of patients closely as their risk for these thoughts is highest until their anxiety and depression are better controlled.

How long do Zoloft side effects last?

Taking Zoloft may make you feel uncomfortable or weird at first as your body starts to process the medication. After a week or two these side effects will go away for most people as their bodies get used to the medication. It’s possible to experience some of these side effects sporadically throughout the duration that you’re taking Zoloft, especially if your doctor increases your dose. If your doctor increases the dose, it will take a couple of weeks for your body to fully appreciate the new dose. From there, it can be several more weeks before you may see an improvement in symptoms. Most healthcare professionals will allow for 4-8 weeks between dose adjustments to make sure the full effect of the new dose is realized.

You may be wondering if you should discuss your drug therapy with those around you. Your family and friends have likely noticed the impact depression and anxiety can have on you, but the decision to share your treatment choice is absolutely up to you. Yes, some of the side effects of drug therapy may also be noticeable. Like untreated anxiety and depression, the effects of drug therapy can also impact your daily functioning. Speak to your healthcare professional about the best way to handle any potential impacts to your job or performance of daily activities. While your boss at work should not hold against you that you are seeking treatment for your disorder, you may not feel comfortable sharing this information. Your doctor will be able to walk you through your best options of treating your disorder while maintaining performance expectations along with your privacy.

Serious side effects of Zoloft

Although it’s rare, Zoloft can cause more serious side effects like:

Unusual weight loss
Low sodium levels
An increased risk of bleeding
Eye pain that indicates angle-closure glaucoma
Sexual dysfunction such as delayed ejaculation
Manic episodes for people with undiagnosed bipolar disorder
Allergic reactions
Seizures

Black box warning: Zoloft and suicidal thoughts

Zoloft also comes with a box warning for suicidal thoughts and behaviors. Short-term studies have shown that antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to a placebo. If you’re taking Zoloft and start to have extreme mood changes and/or suicidal thoughts or behaviors, you should seek medical advice right away. You can also reach out to the National Suicide Prevention Lifeline at 1-800-273-8255.

Precautions to take when starting Zoloft

You should not take Zoloft if you have a history of an allergic reaction to sertraline or one of its other ingredients. Zoloft therapy is also contraindicated in patients receiving treatment with a class of drugs known as monoamine oxidase inhibitors (MAOIs). Examples of MAOIs include isocarboxazid, selegiline, and phenelzine. If you are taking one of these drugs, you must notify your doctor.

Do not abruptly stop Zoloft or any SSRI without first consulting your prescriber. This can lead to sleep and sensory disturbances, anxiety, and agitation.

Suicidal thoughts and ideation may occur in adolescents, teens, and young adults who take Zoloft. This may be worse during the initial few months of therapy or after dose changes. Caregivers and loved ones should monitor this population closely during this time for unusual changes in behavior and irritability.

Tell your doctor if you have a history of seizure disorders (epilepsy) or cardiac disorders such as QT prolongation as Zoloft therapy could make these worse.

If you have liver disease, your dose may need to be adjusted by your prescriber.

You should take your first dose while you are home and do not need to drive. Zoloft has been known to cause somnolence in some patients, and you should avoid driving after taking Zoloft until you know how it affects you.

Zoloft has been linked to birth defects, especially when taken late in pregnancy. Zoloft should only be taken in pregnancy if the benefits clearly outweigh the risks.

Drug interactions

Another thing to consider when taking Zoloft is that it shouldn’t be taken with certain medications. Giving a list of all the medications and over-the-counter supplements you’re taking to your doctor will help reduce your chances of experiencing more serious side effects from interactions with Zoloft. Here’s a list of medications that shouldn’t be taken at the same time as Zoloft:

Medications that increase serotonin
Triptans (migraine agents)
Tricyclic antidepressants
Blood thinners such as warfarin
Nonsteroidal anti-inflammatory drugs (NSAIDs)
St. John’s Wort
Lithium
Ultram (tramadol)
Nardil (phenelzine)
Parnate (tranylcypromine)
Marplan (isocarboxazid)
Azilect (rasagiline)
Emsam (selegiline)
Orap (pimozide)

Zoloft shouldn’t be taken at the same time as MAOIs because this could lead to serotonin syndrome, which causes hallucinations, seizures, comas, tremors, delirium, and other serious side effects. This list of drug interactions is not exhaustive, so it’s so important to tell your doctor about all the medications you’re taking or thinking about taking.

Foods to avoid while taking Zoloft

Like with many other drugs, grapefruit and grapefruit juice can interact with Zoloft absorption. It can slow the metabolism of Zoloft, therefore increasing blood levels of available Zoloft. This is typically only a problem if intake of grapefruit products is inconsistent. If you are going to ingest grapefruit products, it is best to ingest a consistent amount daily.

RELATED: Can you drink coffee while taking Zoloft?

Missed dose of Zoloft

Nobody is perfect, and missing a dose of Zoloft is bound to happen at one point or another. Taking your medication consistently as prescribed by your doctor is important, but missing a dose isn’t the end of the world if you know what to do when it happens.

“Take your dose as soon as you remember,” says Brian Wind, Ph.D., a clinical psychologist, and the chief clinical officer of JourneyPure. “If it is nearly time to take the next dose, don’t take an extra dose to make up for the one you missed. Simply take the next dose. You can experience side effects and an increased risk of relapse if you suddenly stop your medication.”

The side effects you might experience if you stop or miss a dose of your medication are mild withdrawal symptoms that happen because of something called antidepressant discontinuation syndrome. According to American Family Physician, antidepressant discontinuation syndrome occurs in about 20% of patients who abruptly discontinue an antidepressant after taking one consistently for at least six weeks. Missing a dose of Zoloft may cause you to have flu-like symptoms, nausea, insomnia, imbalance, or hyperarousal.

The best thing you can do if you miss a dose, just as Dr. Wind says, is to take your next dose as soon as you remember. If you’ve been experiencing any symptoms because of your missed dose, they should go away once you start taking Zoloft consistently again. It may also be a good idea to contact your doctor if you miss a dose, just to check in and make sure you don’t need to do anything else.

Zoloft overdose

Overdosing on Zoloft is more serious than missing a dose. There are no reported cases of fatal Zoloft overdoses, but taking too much medication can cause serious side effects or health complications. Accidentally or purposefully taking two or more doses of Zoloft could cause:

Nausea
Vomiting
Dizziness
Agitation
Confusion
Fever
Fainting
Hallucinations
Changes in blood pressure
Rapid heartbeat
Tremors
Seizures

In rare cases, taking too much Zoloft can also cause serotonin syndrome, which results in dangerously high levels of the neurotransmitter serotonin in the brain. When there’s too much serotonin in the brain this can cause confusion, diarrhea, and headaches. More severe symptoms may include seizures, hallucinations, muscle rigidity, and comas.

If you think you’ve overdosed on Zoloft and/or start to experience one or more of these symptoms you should seek medical attention right away or call the Poison Control hotline at 1-800-222-1222. The Poison Control hotline is free for anyone to use and offers callers expert and confidential advice.

When to see a doctor for Zoloft side effects

Zoloft can be a great medication to treat symptoms of anxiety and depression if it’s taken properly. Being prepared to experience potential side effects is an important part of taking any medication, and knowing what to expect can remove some of the anxiety that often comes from taking a new medication.

If you start taking Zoloft and have some mild side effects it’s important to remember that that’s normal. It’s also important to remember at what point you should see your doctor because of the side effects you’re having. As mentioned throughout this article, more serious side effects like confusion, hallucinations, allergic reactions, seizures, and vomiting require medical attention. If you start to experience worsening depression or anxiety, suicidal thoughts, panic attacks, severe irritability or aggression, then you should seek immediate medical help.

Side effects of stopping Zoloft

If it is determined by your healthcare professional that discontinuing Zoloft is best for you, you should do so gradually with dose tapering. This will decrease the likelihood of unwanted side effects of abrupt discontinuation such as dizziness, nausea, vomiting, insomnia, irritability, and agitation. If you abruptly stop Zoloft, it will be completely eliminated in a little over 5 days, even if you have taken it for a long time. Do not discontinue Zoloft without the direct advice of your prescriber. Long-term treatment with Zoloft is safe, but your prescriber may choose to reevaluate your drug choice if your symptomology changes or your side effects are bothersome. Sleep disturbances and weight gain are some of the most common adverse events associated with long-term therapy.

Zoloft alternatives

Zoloft isn’t the only antidepressant that can treat anxiety and depression. Zoloft can be very effective, but if it doesn’t work for you or if it causes too many side effects, then an alternative antidepressant may be needed. Clinical trials have shown that depression symptoms will completely go away for about 1 out of every 3 people who take SSRIs, but more research still needs to be done on why SSRIs work for some people and not for others.

If you’re experiencing too many side effects from Zoloft, then you might consider talking with your healthcare provider about other options. Here are some of the most popular alternatives to Zoloft:

Celexa (citalopram): Celexa is an SSRI that’s FDA-approved to treat depression, and even though it’s mainly prescribed for depression, doctors can sometimes prescribe it to help alleviate symptoms of anxiety.
Effexor XR (venlafaxine hcl er): Effexor is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can treat depression, improve moods, and improve energy levels.
Lexapro (escitalopram): Lexapro is an SSRI used to treat generalized anxiety disorder and major depressive disorder.
Paxil (paroxetine): Paxil is an SSRI used to treat depression and other psychological conditions.
Prozac (fluoxetine): Prozac is an SSRI used to treat major depressive disorder, OCD, bulimia nervosa, and panic disorder.
Xanax (alprazolam): Xanax is a benzodiazepine that relieves anxiety in the short-term. Xanax is a controlled substance because of its potential for abuse/dependence.

RELATED: A beginner’s guide to antidepressant side effects

Bottom line: Is Zoloft safe?

Side effects, some potentially dangerous, are possible with Zoloft. However, for most people, Zoloft is a very safe and effective treatment for depression and anxiety. Studies have shown that while Zoloft may cause more adverse events than Lexapro or Prozac in the same class, it has fewer safety concerns than drugs in related classes.

The potential to experience side effects from medication shouldn’t keep you from getting the treatment you need for your anxiety or depression. Talking with your healthcare provider is the best way to come up with a treatment plan that will work best for you and cause the least amount of side effects for you on your journey to find relief from your symptoms.

Side Effects, Dosage, Uses & More

Important warnings

This drug has a boxed warning. These are the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.

This drug may increase suicidal thoughts or behavior in some children, teenagers, or young adults. The risk of this is greatest within the first few months of treatment or when the dosage is changed. Call your doctor right away if you have any new or sudden changes in your mood, behavior, actions, thoughts, or feelings, especially if they are severe. Pay extra close attention when you start taking this drug or when your dosage is changed.

Sertraline oral tablet is a prescription drug that’s available as the brand-name drug Zoloft. It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version. This drug is also available as an oral solution.

Why it’s used

Sertraline is used to treat major depressive disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and premenstrual dysphoric disorder.

This drug may be used as part of combination therapy. This means you may need to take it with other medications.

How it works

Sertraline belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

This drug works by increasing the amount of serotonin, a natural substance in your brain, that helps maintain mental health balance. This can improve the symptoms of depression and anxiety.

Sertraline oral tablet may cause drowsiness, insomnia, or both. It may also cause other side effects.

More common side effects

The adult side effects of this drug are slightly different from the side effects for children. Side effects for adults and children can include:

nausea, loss of appetite, diarrhea, and indigestion
change in sleep habits, including increased sleepiness and insomnia
increased sweating
sexual problems, including decreased sex drive and ejaculation failure
tremor or shaking
tiredness and fatigue
agitation

Additional side effects for children can include:

abnormal increase in muscle movement or agitation
nose bleed
more frequent urination
urine leakage
aggressiveness
heavy menstrual periods
slowed growth rate and weight change. You should closely watch your child’s height and weight while they take this drug.

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor 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:

Suicide attempts
Acting on dangerous impulses
Aggressive or violent behavior
Thoughts about suicide or dying
New or worse depression
New or worse anxiety or panic attacks
Agitation, restlessness, anger, or irritability
Trouble sleeping
An increase in activity or talking more than usual
Serotonin syndrome. This condition can be life threatening. Symptoms can include:
- hallucinations and delusions
- agitation
- loss of consciousness
- seizures
- coma
- fast heart rate
- changes in blood pressure
- muscle tremor or stiff muscles
- dizziness
- shakiness
- sweating
- nausea
- vomiting
- muscle rigidity
Severe allergic reactions. Symptoms can include:
- trouble breathing
- swelling of your face, tongue, eyes, or mouth
- rash, itchy welts (hives) or blisters, alone or with fever or joint pain
Abnormal bleeding
Seizures or convulsions
Manic episodes. Symptoms can include:
- greatly increased energy
- severe trouble sleeping
- racing thoughts
- reckless behavior
- unusually grand ideas
- excessive happiness or irritability
- talking more or faster than usual
Changes in appetite or weight. You should check the weight and height of children and adolescents often while they take this drug.
Low sodium levels. Seniors may be at greater risk for this. Symptoms can include:
- headache
- weakness or unsteadiness
- confusion, problems concentrating or thinking, or memory problems
Eye pain
Changes in vision, including blurred and double vision
Swelling or redness in or around your eyes

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Sertraline oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

Drugs you should not use with sertraline

Do not take these drugs with sertraline. When they are used with sertraline, they can cause dangerous effects on your body. These drugs include:

Pimozide. Taking this drug with sertraline can cause serious heart problems.
Monoamine oxidase inhibitors (MAOIs) such as isocarboxazid, phenelzine, and tranylcypromine. Taking these drugs with sertraline increases your risk for serotonin syndrome. You must also wait 14 days between taking these drugs and taking sertraline.
Linezolid, intravenous methylene blue. Taking this drug with sertraline increases your risk for serotonin syndrome.

Interactions that increase the risk of side effects

Taking certain medications with sertraline may result in increased side effects. These drugs include:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, aspirin and warfarin. Taking these drugs with sertraline increases your risk of bleeding or bruising.
Triptans such as sumatriptan. Your risk for serotonin syndrome is increased when you take these drugs with sertraline. Your doctor should watch you closely if you take these drugs together.
Lithium. Taking this drug with lithium increases your risk for serotonin syndrome.
Serotonergic medications such as fentanyl, tramadol, and St John’s wort. Taking these drugs with sertraline increases your risk for serotonin syndrome.
Cimetidine. Taking cimetidine with sertraline may cause a buildup of sertraline in your body. Your dose of sertraline might need to be lowered if you take it with cimetidine.
Tricyclic antidepressants such as amitriptyline, desipramine, and imipramine. Taking sertraline with these drugs may cause these drugs to build up in your body. Your doctor may need to adjust your dosage of tricyclic antidepressants while you take sertraline.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Sertraline oral tablet comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms can include:

trouble breathing
swelling of your face, tongue, eyes, or mouth
rash, itchy welts (hives) or blisters, alone or with fever or joint pain

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction

Drinking alcohol while you take sertraline can increase your risk of sleepiness. It can also affect your ability to make decisions, think clearly, or react quickly. If you drink alcohol, talk with your doctor.

Warnings for people with certain health conditions

For people with glaucoma: Taking this drug may trigger a glaucoma attack. If you have glaucoma, talk with your doctor before taking this drug.

For people with bipolar disorder: Taking this drug may trigger a manic episode. If you have a history of mania or bipolar disorder, talk with your doctor before using this drug.

For people with seizures: Taking this drug increases your risk for seizures. If you already have seizures, talk with your doctor before taking this drug. If you have a seizure while using this drug, you should stop taking it.

For people with kidney problems: If you have kidney problems or a history of kidney disease, you may not be able to clear this drug from your body well. This may increase the levels of this drug in your body and cause more side effects. This drug may also decrease your kidney function, making your kidney disease worse.

For people with liver problems: If you have liver problems or a history of liver disease, your body may not be able to process this drug as well. This may increase the levels of this drug in your body and cause more side effects.

Warnings for other groups

For pregnant people: You should talk with your doctor if you’re pregnant or planning to become pregnant. Research in animals has shown adverse effects on the fetus if you take sertraline. There haven’t been enough studies on humans to be certain of how it might affect the fetus. You should only take these drugs if the potential benefit justifies the potential risk.

For women who are nursing: This drug may pass into breast milk and may cause side effects in a child you are nursing. Talk with your doctor as you may need to decide whether to stop nursing or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk for side effects. If you are over the age of 65 years, you may be at higher risk for developing muscle problems while taking this drug, including low salt levels in the blood (known as hyponatremia).

For children: This medication has not been studied in children as a treatment for major depressive disorder, panic disorder, post-traumatic disorder, social anxiety disorder, and premenstrual dysphoric disorder. It should not be used for these disorders in people younger than 18 years.

This medication has only been studied in children with obsessive-compulsive disorder. For treatment of obsessive-compulsive disorder, it should not be used in people younger than 6 years.

This dosage information is for sertraline oral tablet. All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

your age
the condition being treated
how severe your condition is
other medical conditions you have
how you react to the first dose

Forms and strengths

Generic: sertraline

Form: Oral tablet
Strengths: 25 mg, 50 mg, 100 mg

Form: Oral solution
Strengths: 20 mg/mL

Brand: Zoloft

Form: Oral tablet
Strengths: 25 mg, 50 mg, 100 mg

Form: Oral solution
Strengths: 20 mg/mL

Dosage for major depressive disorder

Adult dosage (ages 18–64 years)

The typical starting dose is 50 mg per day.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 0–17 years)

The use of this drug to treat children with this condition has not been studied. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk for side effects. Your doctor may start you on a lowered dose or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Dosage for obsessive-compulsive disorder

Adult dosage (ages 18–64 years)

The typical starting dose is 50 mg per day.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 0–5 years)

The use of this drug to treat this condition in children hasn’t been studied. It shouldn’t be used in people younger than 6 years.

Child dosage (ages 6–12 years)

The typical starting dose is 25 mg per day.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 13–17)

The typical starting dose is 50 mg per day.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Senior dosage (ages 65 years and older)

Dosage for panic disorder

Adult dosage (ages 18–64 years)

The typical starting dose is 25 mg per day. This is usually increased to 50 mg per day after 1 week.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 0–17 years)

The use of this drug to treat children with this condition has not been studied. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Dosage for post-traumatic stress disorder

Adult dosage (ages 18–64 years)

The typical starting dose is 25–50 mg per day. This is usually increased in increments of 25–50 mg after 1 week depending on your response and how you tolerate it.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 0–17 years)

The use of this drug to treat children with this condition has not been studied. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Dosage for social anxiety disorder

Adult dosage (ages 18–64 years)

The typical starting dose is 25–50 mg per day. This is usually increased by 25–50 mg after 6 weeks depending on how you tolerate the dosage.
Your doctor will slowly increase your dose every week, as needed.
The maximum dose is 200 mg per day.

Child dosage (ages 0–17 years)

The use of this drug to treat children with this condition has not been studied. It should not be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

Dosage for premenstrual dysphoric disorder

Adult dosage (ages 18–64 years)

A doctor will typically prescribe sertraline in two ways:

Continuous: The typical starting dose is 50 mg per day throughout your menstrual cycle. The dose may increase in the next cycles up to a maximum of 150 mg/day as needed.
Luteal: The typical starting dose is 50 mg daily in the first two weeks before and up to the start of your anticipated period. Each cycle the dose may increase a bit up to a maximum of 100 mg/day.

Child dosage (ages 0–17 years)

The use of this drug to treat children with this condition has not been studied. It should not be used by people younger than 18 years.

Senior dosage (ages 65 years and older)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Sertraline oral tablet is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all: Your depression will not get better. It may even get worse. Do not stop taking this drug without first talking with your healthcare professional. Stopping your drug too quickly may cause serious symptoms, including:

anxiety, irritability, high or low mood, restlessness, and changes in your sleep habits
headache, sweating, nausea, and dizziness
electric shock-like sensations, shaking, and confusion

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

tiredness
vomiting
fast heart rate
nausea
dizziness
agitation
tremors

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You will know that this drug is working if you notice that your depression symptoms are less severe or happen less often. This may take up to 4 weeks. When you do start to feel better, don’t stop taking it. Continue to take it as your doctor told you.

Keep these considerations in mind if your doctor prescribes sertraline oral tablet for you.

General

You can take this drug with or without food.
You can cut or crush the tablet.
Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.

Storage

Store this drug at room temperature between 59°F and 86°F (15°C and 30°C). Keep it away from light.
Don’t store this medication in moist or damp areas, such as bathrooms.
Keep the bottle closed tightly.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

Always carry your drugs with you when you travel.

When flying, never put it into a checked bag. Keep it in your carry-on bag.
Don’t worry about airport X-ray machines. They can’t hurt your medication.
You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor you for certain health issues. This is done to make sure you stay safe while you take this drug. Your doctor will check:

Your mental health and symptoms of depression. Your doctor will monitor your symptoms of depression to make sure that this drug is working and that you’re not having suicidal thoughts. They’ll watch you closely during the first few months after you start taking this drug or if you have had dose changes.
Sodium levels. Your doctor may check the amount of sodium in your body. Your doctor may do this when you start using this drug and at other times while you are taking it.
Eye pressure. Your doctor may check the pressure of your eyes regularly while you take this drug. Your doctor will do this if you have a history of increased eye pressure or are at risk for certain types of glaucoma.
Cholesterol levels. This drug can increase your cholesterol. Your doctor will check your cholesterol levels to make sure that they are not getting too high.
Liver function. Your doctor will check how well your liver is working while you take this drug. If your liver isn’t working well, your doctor may decide to lower your dose of this drug.

Insurance

Many insurance companies require prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Zoloft instructions for use: Side effects, analogs, contraindications

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POSSIBLE SIDE EFFECTS. A SPECIALIST'S CONSULTATION IS REQUIRED.

Author of the article

Khokhrina Kristina Sergeevna,

pharmacist

All authors

Content of the article

Zoloft: active ingredient
Zoloft: side effects
Zoloft: Contraindications
Zoloft and alcohol
Zoloft: overdose
Zoloft: How to stop drinking it
Zoloft: Anges
Summary
Ask the expert on Article

on the STO from the Deposit estimates of the WHO from the deposits .8% of the total population, which is 280 million people. Among them, 5% of adults and 5.7% of persons over 60 years of age. More than 700,000 people die each year from suicide due to depression. Depression is treatable with medication. nine0003

Doctors prescribe antidepressants. Zoloft is one of them. We asked pharmacist Kristina Khokhrina to tell us in more detail: what side effects it can cause, what active ingredient, contraindications, overdose, is the drug compatible with alcohol and how to stop drinking it.

All products Zoloft

27 reviews

Zoloft: active ingredient

Zoloft contains the active ingredient - sertraline in the form of hydrochloride. It is produced in tablets with a dosage of 50 mg and 100 mg. Zoloft is an antidepressant. It is used to treat and prevent depression caused by various causes. And also when: nine0003

obsessive-compulsive disorders
panic disorders
post-traumatic stress disorder
social phobias

How Zoloft works

Zoloft helps to eliminate depressive manifestations:

relieves anxiety
normalizes sleep
reduces somatic manifestations: palpitations, disruption of the gastrointestinal tract, increased excitability. nine0024

Zoloft does not cause dependence on the drug and does not lead to weight gain in humans.

Zoloft side effects

Watch your condition carefully while using the medicine. If you experience side effects that are not described or if symptoms worsen, contact your doctor immediately.

Zoloft: side effects

flatulence, nausea, vomiting, diarrhea, constipation, abdominal pain, dry mouth
increased heart rate, increased blood pressure nine0024
arthralgia, muscle cramps
gait disturbance, teeth grinding, drowsiness, syncope, headache, migraine, tremor, insomnia, anxiety, hallucinations, psychosis, nightmares, decreased libido, suicide, coma
yawning, bronchospasm
bedwetting, urinary retention during the day
hepatitis, jaundice
decrease in potency, disruption of the reproductive system, menstrual cycle disorders in women
visual impairment
thyroid disorder
urticaria, pruritus, anaphylactic shock
flushing, tinnitus, loss of appetite and others

Zoloft: contraindications

hypersensitivity to any component of the preparation
concomitant use of monoamine oxidase inhibitors and pimozide
pregnancy and lactation
children under 6 years of age nine0024

Caution must be taken in: mental retardation, epilepsy, renal and/or hepatic insufficiency, marked reduced body weight.

Zoloft and alcohol

Alcohol is not recommended to be taken with the medicine. Its action can increase side effects and lead to overdose.

Learn how to recognize depression in the article "The Beck Test for Depression"

Zoloft: overdose

Zoloft overdose occurs when used simultaneously with alcohol or other incompatible drugs. With such combinations, severe poisoning can occur, up to coma and death. Overdose symptoms are: nine0003

nausea
vomiting
drowsiness
increased heart rate
dizziness
psychomotor agitation
diarrhea
excessive sweating

Hospital observation and constant monitoring of vital signs will be required. When first aid is not recommended to induce vomiting, it is better to give activated charcoal.

Zoloft: how to stop drinking it

"Withdrawal" syndrome is rare. Nevertheless, it is necessary to discuss with the doctor a decrease in the dosage of the drug. Since the termination of treatment is possible: nine0003

symptoms of depression
hallucinations
aggression
anxiety
psychosis

Particular attention should be paid to the fact that after the end of the use of Zoloft, within 14 days, you should not take drugs related to monoamine oxidase inhibitors.

Zoloft: analogues

Zoloft has about 10 names of analogues of the active substance. All medicines are prescribed and prescribed by a doctor. Therefore, to choose a remedy or replace your own, consult your doctor first. nine0003

Zoloft and Atarax: compatibility

The combination of these drugs increases the side effects. This manifests itself in the form of dizziness, drowsiness and confusion. Elderly people have difficulty in thinking and coordinating movements.

Do you want to understand analogues of drugs in order to skillfully select drugs for your budget? Our manual from expert pharmacists "Analogues of popular drugs" will help you with this! nine0014 Getting a training manual is easy: subscribe to our social networks and write “analogues” in the messages.

Megapharmacy in social networks: VKontakte, Telegram, OK

Summary

Zoloft is an antidepressant that is taken to prevent and treat depression and other disorders.

Zoloft may have a significant number of side effects.

The active substance is sertraline, dosage in tablets of 50 mg or 100 mg.

Zoloft has contraindications that should be taken into account when prescribing it. nine0024
It is not recommended to use alcohol together with Zoloft to avoid overdose symptoms.

An overdose of the drug occurs when used simultaneously with certain drugs and alcohol.

Zoloft is not usually addictive, but you should consult your doctor before stopping it.

Zoloft has several analogues, but only a doctor can replace them.

Ask an expert about the topic of the article

Still have questions? Ask them in the comments below and our experts will answer you. There you can also share your experience with other readers of Megasovets. nine0003
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SERTRALINE

nine0002 Rec.INN WHO registered
drug interaction
Included in preparations: list

Pharmacological action

Antidepressant, naphthylamine derivative. Selective blocker of neuronal reuptake of serotonin in the brain. Neuronal uptake of norepinephrine and dopamine is practically not affected. It does not have specific affinity for adreno- and m-cholinergic receptors, GABA receptors, dopamine, histamine, serotonin or benzodiazepine receptors. Does not inhibit MAO. Causes anorexia, effective in obsessive states. nine0003
Pharmacokinetics

When administered orally sertraline in doses of 50-200 mg 1 time / day for 14 days C _max in blood plasma is reached after 4.5-8.4 hours. Average T _1/2 in young and elderly men and women is 22-36 hours. According to the half-life, approximately two-fold accumulation of the active substance is observed until an equilibrium state is reached after 1 week of treatment. Plasma protein binding is about 98%, V _d - 20 l / kg. Intensively metabolized during the first passage through the liver. The main metabolite found in plasma, N-desmethylsertraline, has weak pharmacological activity. nine0003
T _1/2 N-desmethylsertraline varies within 62-104 hours. It is excreted mainly through the intestines and in the urine in equal amounts as metabolites, less than 0.2% is excreted in the urine unchanged.

Indications of the active substance SERTRALINE

Treatment of depressive conditions of various origins in patients with mono- and bipolar affective disorders. Prevention of recurrence of episodes of depression. nine0003
Open list of ICD-10 codes

F31 Bipolar affective disorder

F32 Depressive episode

F33 Recurrent depressive disorder

F41.2 Mixed anxiety and depressive disorder

Dosing regimen

Inside - 50 mg 1 time / day, if necessary, the dose can be increased to 200 mg / day for several weeks. The effect appears 7 days after the start of treatment, reaching a maximum after 2-3 weeks.

Side effects

From the side of the central nervous system: dizziness, drowsiness, headache, insomnia, fatigue, weakness, tremor; rarely - manic or hypomanic state, anxiety, restlessness, visual disturbances. nine0003
From the side of the cardiovascular system: rarely - reddening of the skin with a feeling of heat or warmth, palpitations.

From the digestive system: decreased appetite, diarrhea, dry mouth, nausea, stomach or intestinal cramps, flatulence; rarely - constipation, vomiting.

From the side of metabolism: increased sweating.

On the part of the reproductive system: rarely - decreased potency.

Allergic reactions: rarely - fever, skin rash, urticaria or itching.

Contraindications for use

Simultaneous use with MAO inhibitors, hypersensitivity to sertraline.

Use in pregnancy and lactation

Adequate and well-controlled studies of the safety of sertraline during pregnancy have not been conducted, therefore, use is possible only in cases where the expected benefit to the mother outweighs the possible risk to the fetus. nine0003
It is not known if sertraline is excreted in breast milk, so use during lactation is not recommended. Separate studies have shown that in infants whose mothers received sertraline during the feeding period, its plasma levels are negligible or not detectable, while concentrations in breast milk exceed concentrations in the mother's blood.

Women of childbearing age should use reliable methods of contraception during treatment with sertraline.

In experimental studies no teratogenic and mutagenic effects of sertraline were detected. However, at doses approximately 2.5-10 times the maximum daily clinical dose, sertraline caused a delay in fetal bone ossification, possibly as a result of maternal exposure. With the introduction of sertraline at doses approximately 5 times the maximum clinical dose, a decrease in neonatal survival was observed.

Use in hepatic dysfunction

Use with caution in hepatic dysfunction.

Use in impaired renal function

Use with caution in impaired renal function.

Pediatric use

Pediatric safety has not been established.

Precautions

Use with caution in cases of history of drug abuse or dependence, liver dysfunction, kidney dysfunction, epileptic seizures, weight loss. nine0003
Should not be used in patients undergoing electroshock therapy. The use of sertraline is possible no earlier than 14 days after the abolition of MAO inhibitors.

Do not drink alcohol during treatment.

Pediatric safety has not been established.

Influence on the ability to drive vehicles and mechanisms

During the treatment period, activities requiring increased attention and high speed of psychomotor reactions should be avoided. nine0003
Drug interactions

Simultaneous use of coumarin derivatives with anticoagulants significantly increases prothrombin time.

Co-administration of sertraline may displace other drugs from plasma protein binding, resulting in an increase in plasma concentration of the corresponding active substance and an increased risk of side effects.
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