Sertraline lowest dosage

How and when to take sertraline

Dosage and strength

Sertraline is available as 25mg, 50mg or 100mg tablets.

The usual dose of sertraline is 50mg a day in adults. But your doctor may start you on a lower dose, then increase it gradually to a maximum dose of 200mg a day.

If you have liver problems, your doctor might give you a lower dose.

The usual dose of sertraline for children aged 6 to 12 is 25mg a day, but this may be increased to 50mg a day after a week.

The usual dose of sertraline for children aged 13 to 17 is 50mg a day.

Children aged 6 to 17 might have their dose increased up to 200mg a day, if needed.

How to take it

Take sertraline once a day. You can take it with or without food.

You can choose to take sertraline at any time, as long as you stick to the same time every day.

If you have trouble sleeping, it's best to take it in the morning.

How long to take it for

Once you're feeling better it's likely that you'll continue to take sertraline for several more months. Stopping before that time can make depression come back.

Most doctors recommend that you take antidepressants for 6 months to a year after you no longer feel depressed.

If you forget to take it

If you occasionally forget to take a dose, skip the missed dose and take your next dose the next day at the usual time.

Never take 2 doses at the same time to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

The amount of sertraline that can lead to an overdose varies from person to person.

Taking too much can cause symptoms such as:

  • being sick (vomiting)
  • shaking
  • feeling sleepy
  • feeling dizzy
  • fast heart rate
  • fits or seizures

Urgent advice: Contact 111 for advice now if:

  • you take more than your prescribed dose of sertraline

Go to or call 111

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the sertraline packet, or the leaflet inside it, plus any remaining medicine with you.

Stopping sertraline

If you have been feeling better for 6 months or more, your doctor may suggest coming off sertraline.

Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking sertraline for a long time.

This is to help prevent any withdrawal symptoms you might get as a reaction to coming off the medicine.

These can include:

  • feeling dizzy
  • feeling sick
  • numbness or tingling in the hands or feet
  • trouble sleeping
  • feeling agitated or anxious
  • headaches
  • shaking

Page last reviewed: 2 February 2022
Next review due: 2 February 2025

When Should You Increase Your Zoloft Dosage To Treat Anxiety?

  • Overview
  • What is Zoloft?
  • What is the proper Zoloft dosage for anxiety?
  • When to increase your Zoloft dose for anxiety?
  • Talk to your doctor first
  • Factors that could impact whether you need a higher dose
  • Zoloft’s effects on anxiety
  • The lowdown

If you’ve been prescribed Zoloft to treat your anxiety, but it’s not quite doing the job, you might find it tempting to increase your dosage.  

However, Zoloft is a psychiatric medicine, so it’s crucial you don’t take more or less than the dosage prescribed. However, your doctor may be able to prescribe a stronger dose if needed, if they determine that this is the right course of action.

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Zoloft, or sertraline as it is known under its generic name, is a psychiatric medicine used largely in the treatment of depression and anxiety. 

Taken orally, Zoloft belongs to a group of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. SSRIs are a commonly prescribed antidepressant that improves mood by blocking the mechanisms that absorb serotonin, allowing it to be available to the brain for longer. 

This is important because serotonin is known for its ability to induce feelings of happiness. In fact, serotonin is often referred to as the “happy hormone.” 

Starting Zoloft

The appropriate dosage of Zoloft will be determined by a doctor and is likely to differ depending on the patient and their individual needs. 

Typically, 50 milligrams once a day is a standard starting dosage for adults with depression, obsessive-compulsive disorder, and premenstrual dysphoric disorder. Some conditions tend to start with a lower dose of 25 milligrams once a day, like panic disorder. 

Maximum dose

Your Zoloft dose must stay within a safe range, so you’re unlikely to be prescribed anything higher than 150-200 milligrams per day. In the end, your dosage will depend on the condition being treated and your individual needs. 


Children can also benefit from Zoloft but will follow a different dosage regimen. This dose will be at the discretion of your doctor and is based on your child’s age, size, and therapeutic need. For instance, for children aged 6 to 12 years of age with obsessive-compulsive disorder, a standard starting dose is 25 milligrams once a day.  

If you have concerns or questions about your dosing, make sure to discuss it with your doctor before making any changes to your medication regimen. 

If you’re taking Zoloft, but aren’t feeling any improvement in your anxiety levels, it can be tempting to simply up your dose – but it’s important not to. 

Zoloft is not an instant relief medication. SSRIs do not exert instant effects like, pain relief does. Zoloft (and other SSRIs) is a little more complicated and it takes longer for its full effects to be felt. 

These medications take time for their effectiveness to peak. Zoloft works by blocking the reuptake of serotonin and it takes repetitive dosing and time for the medication to be able to exert its effects on your system. It can take around two to six weeks before you start to experience a reduction in your anxiety symptoms. 

If after this period you still haven’t seen any benefits then you may want to talk to your doctor about altering your Zoloft dose.  

While Zoloft can have a positive impact on anxiety, it can also come with some minor side effects. Zoloft can also increase your risk of serious side effects if you have an existing medical condition or are taking other medication. 

Therefore, increasing your Zoloft dose without approval from your doctor should not be done under any circumstances. This can have serious detrimental effects on your health and wellbeing and can result in coma and seizures.

Zoloft side effects and drug interactions 

The following side effects¹ and potential drug interactions² highlight why it’s important to follow your Zoloft prescription and avoid increasing your dosage without your doctor's approval.

Potential side effects of Zoloft include:

  • Nausea 

  • Loss of appetite or indigestion 

  • Diarrhea

  • Excessive sweating 

  • Tiredness or fatigue 

  • Sexual performance issues, e.g. reduced sex drive, failure to ejaculate 

  • Sleep disturbances, e. g. sleepiness or insomnia 

  • Shaking hands

  • Increased agitation and irritability

  • Suicidal ideations 

  • Impulsive and dangerous behavior 

  • Worsening of depression and/or anxiety symptoms

  • Violent behavior 

  • Seizures 

  • Manic behavior, e.g. fast-paced and racing thoughts, extreme high and low emotions, excessive energy, and talking grandiose thinking.

  • An allergic reaction (typical symptoms include trouble breathing, a rash or hives, and swelling).

  • Eye problems, e.g. blurred vision, red eyes, pain in the eyes.

  • Serotonin syndrome includes symptoms such as hallucinations, agitated behavior, loss of consciousness/coma, increased heart rate, vomiting, and rigid muscles

There are also specific side effects that can affect children taking Zoloft:

  • Nose bleeds

  • Urine problems, e.g. frequently needing to urinate or leaking urine 

  • Changes to menstruation, specifically heavier periods 

  • Agitation or fidgeting 

  • Aggressive or irritable behavior that is out of the norm 

  • Changes to physical development. You may see your child’s growth rate start to slow down and/or weight gain.

 Conditions that can increase your risk of Zoloft side effects:

  • Glaucoma: People with glaucoma can experience an increase in glaucoma attacks if they take Zoloft and should therefore talk to their doctor to determine if the SSRI is appropriate. 

  • Seizure conditions: Since seizures are already a potential side effect of Zoloft, the medication should be considered carefully in people with a seizure condition lest it increases their frequency or severity³. 

  • Liver issues: Patients with liver problems should take care when starting Zoloft as they can experience stronger effects than normal, due to their liver’s inability to break down the medication. 

  • Bipolar disorder: Bipolar disorder is a possible contraindication for Zoloft as you may experience a higher risk of manic symptoms. 

  • Kidney issues: Much like the liver, if your kidneys aren’t functioning well then you may not be able to filter medications properly, resulting in higher levels of Zoloft in your system.  

Side effects that can occur when Zoloft is taken alongside certain medications: 

  • Increased risk of serotonin syndrome can occur when Zoloft is taken with monoamine oxidase inhibitors, linezolid, intravenous methylene blue, triptans, lithium, fentanyl, tramadol, and St John’s wort.

  • Heart problems can occur when Zoloft is taken with pimozide.

  • Bruising and bleeding can occur when taken with nonsteroidal anti-inflammatory medications, e.g. aspirin.

  • A build-up of medications (including Zoloft) can occur in your system when taken with cimetidine, tricyclic antidepressants.

While it’s important to stick to the dose recommended by your doctor, there are legitimate and safe reasons why your doctor may increase your Zoloft dose. 

For instance, your doctor may increase your Zoloft dose if you aren’t seeing a significant reduction in your anxiety symptoms, so long as it is safe.  

The risks of altering your Zoloft dosage without medical approval are substantial. However, with a prescribed dosage and professional advice, Zoloft can have a positive impact on your anxiety and improve your quality of life. 

Research tells us that Zoloft can effectively reduce anxiety scores. One study⁴ found that Zoloft managed to significantly improve anxiety, worry, and depressive symptoms in patients (60 years and older), with an anxiety diagnosis (generalized anxiety disorder, panic disorder, agoraphobia, or social phobia). 

Zoloft is also an effective treatment option for children suffering from anxiety. A 2018 study found that SSRIs significantly reduced anxiety symptoms⁵ in children. The study also found that a combination of Zoloft and cognitive behavioral therapy was a particularly effective treatment option. 

What To Expect When You Take Anxiety Medication

Zoloft is an effective treatment for managing anxiety. Your doctor will prescribe Zoloft if they believe it is a good fit, and may gradually increase your dose until you start to see results or reach a maximum dose.  

However, since Zoloft can have some serious side effects and can interact negatively with other drugs, do not increase your dosage until you have consulted a medical professional.

Active substance SERTRALINUM | Compendium - drug reference book

  • Pharmacological properties
  • Indications SERTRALINE
  • Application of SERTRALINE
  • Contraindications
  • Side effects
  • Special instructions
  • Interactions
  • Overdose
  • Diagnosis
  • Recommended alternatives
  • Trade names

Medicinal preparations containing the active substance SERTRALINE

Prices in pharmacies


tablets covered with a shell 100 mg blister, No. 28


Prices in pharmacies


tablets 25 mg blister, No. 30



Sertraloft 50

film-coated tablets 50 mg blister, № 30


Pharmacy prices

Sertraloft 100

film-coated tablets, № 100 mg0029


Prices in pharmacies

Stimalon ®

tablets covered with a shell 50 mg blister, No. 30


Price in pharmacies

stimulota ® 10029

tablets, covered scrapp No. 28


Prices in pharmacies


Capsules 50 mg container, No. 30

Ersel Pharma

Price in pharmacies


Tablets covered with film shell 50 mg Blista, No. 30

Ersel Pharma

Pharmacy prices

specific serotonin (5-HT) reuptake inhibitor in neurons in vitro . It has little effect on the reuptake of norepinephrine and dopamine. At clinical doses, sertraline blocks the uptake of serotonin in human platelets. It does not have a stimulating, sedative or anticholinergic effect and does not have cardiotoxicity. Due to selective inhibition of 5-HT uptake, sertraline does not enhance catecholaminergic activity. Sertraline has no affinity for muscarinic (cholinergic), serotonin, dopamine, adrenergic, histamine, GABA or benzodiazepine receptors. Long-term use of sertraline in animals led to a decrease in the activity of norepinephrine receptors in the brain; other clinically effective antidepressant and anti-obsessional drugs have a similar effect. nine0029

Unlike tricyclic antidepressants, sertraline does not cause weight gain in the treatment of depression or obsessive-compulsive disorder (OCD); in some patients, it even decreases. The development of drug dependence has not been established.

Sertraline is actively biotransformed during the first pass through the liver. The main metabolite, N-desmethylsertraline, is almost 20 times less active than sertraline in vitro and is actually inactive in models of depression in vivo . T ½ N-desmethylsertraline varies within 62–104 hours. Sertraline and N-desmethylsertraline are actively biotransformed in the body; the resulting metabolites are excreted in the feces and urine in equal amounts. Unchanged sertraline is excreted in the urine in small amounts (<0.2%). Eating does not significantly affect the bioavailability of sertraline.

depression (symptomatic treatment), including accompanied by anxiety, with or without a history of mania. After achieving a clinical effect, maintenance therapy with sertraline can prevent relapses of depression. nine0029

Sertraline is also indicated for the treatment of OCD, including in children. Long-term (up to 2 years) treatment of OCD with sertraline is quite effective, safe and well tolerated after the initial effect is achieved.

Sertraline is also used to treat panic disorders with or without agoraphobia.

sertraline is prescribed once a day in the morning or evening, regardless of the meal. The usual therapeutic dose is 50 mg/day.

Treatment of panic disorders should be started at 25 mg/day, after 1 week of use the dose of sertraline is increased to 50 mg/day. Such a scheme helps to reduce the frequency of occurrence of negative reactions characteristic of panic disorder at an early stage of treatment. nine0029

The daily dose of the drug for all indications can be increased from 50 mg/day (with insufficient therapeutic effect) to 200 mg/day over several weeks.

Initial therapeutic effect may develop within 7 days; however, it usually takes 2-4 weeks or more to achieve the full effect (in the treatment of OCD). Maintenance dose for long-term treatment should be minimally effective; in the future, it is corrected depending on the therapeutic effect. Like many drugs, sertraline should be used with caution in patients with renal or hepatic impairment. nine0029

The safety and efficacy of sertraline in children aged 6–17 years has been established. The initial dose for the treatment of OCD in children aged 13-17 years is 50 mg / day, for children aged 6-12 years, a dose of 25 mg / day is prescribed initially, after 1 week it is increased to 50 mg / day. If necessary, in the future, the dose can be increased from 50 mg / day (with insufficient therapeutic efficacy) to 200 mg / day. When increasing the dose to prevent overdose, the lower body weight in children compared with adults should be taken into account. Considering 24 hour T ½ sertraline, the dose should be changed no more than once a week.

simultaneous treatment with MAO inhibitors, hypersensitivity to sertraline.

possible nausea and other dyspeptic symptoms, unstable stool or diarrhea, tremor, dizziness, insomnia, drowsiness, increased sweating, dry mouth and sexual dysfunction in men (mainly delayed ejaculation), withdrawal syndrome (rare cases), asymptomatic increased activity of ALT and AST (usually during the first 9weeks of treatment and quickly disappear after the abolition of sertraline), hyponatremia, platelet dysfunction, sometimes reactions that cannot be distinguished from the manifestations of the course of the underlying disease: paresthesia, hypoesthesia, symptoms of depression, hallucinations, aggressive behavior, agitation, anxiety and psychosis.

during treatment with antidepressants or anti-obsessional agents, there may be cases of exacerbation of mania or hypomania, convulsions. If seizures occur, in all cases, sertraline should be discontinued. nine0029

Patients with depression are prone to suicidal attempts, therefore, at the beginning of treatment, such patients should be under strict medical supervision.

The safety and efficacy of sertraline in children under 6 years of age have not been established. Sertraline should only be used during pregnancy if the expected benefit to the mother outweighs the potential risk to the fetus. Women of reproductive age during treatment with sertraline should use adequate methods of contraception. There is no information on the penetration of sertraline into breast milk, so it is not recommended to prescribe it during breastfeeding. nine0029

severe reactions (symptoms resembling serotonin syndrome) are possible in patients receiving sertraline in combination with MAO inhibitors. Symptoms of the interaction of selective serotonin reuptake inhibitors and MAO inhibitors include: hyperthermia, rigidity, muscle cramps, autonomic instability, changes in mental state (confusion, irritability and excessive arousal with the development of delirium and coma). In this regard, sertraline should not be used in combination with MAO inhibitors and should not be administered within 14 days after stopping treatment with them. You can prescribe an MAO inhibitor no earlier than 14 days after the abolition of sertraline. nine0029

When prescribing sertraline with other serotonergic drugs (tryptophan, fenfluramine), care must be taken and, if possible, such a combination should be avoided due to the existing possibility of pharmacodynamic interaction.

Substitution of other antidepressants or anti-obsessional drugs with sertraline should be done with extreme caution, especially when replacing long-acting drugs (eg fluoxetine).

Co-administration of sertraline 200 mg/day does not potentiate the effects of alcohol, carbamazepine, haloperidol, or phenytoin on cognitive and psychomotor function in healthy individuals; however, concomitant use of sertraline and alcohol should be avoided. nine0029

Co-administration of sertraline with diazepam or tolbutamide results in a small but statistically significant change in some pharmacokinetic parameters. Cimetidine causes a significant decrease in the clearance of sertraline in their combined use. The clinical significance of this effect is unknown. Sertraline had no effect on the β-adrenergic blocking activity of atenolol. Signs of interaction of sertraline at a dose of 200 mg/day with glibenclamide and digoxin were not identified.

Co-administration of sertraline 200 mg/day with warfarin resulted in a slight but statistically significant increase in prothrombin time; the clinical significance of this effect is unknown. In this regard, the prothrombin time should be carefully monitored at the beginning of sertraline therapy and after its withdrawal. nine0029

Caution should be exercised when sertraline is co-administered with drugs such as lithium, the effect of which may be mediated by serotonergic mechanisms.

possible death if the dose of sertraline is exceeded in combination with other drugs and / or alcohol. There is no specific antidote for sertraline. It is advisable to wash the stomach, prescribe enterosorbents, control vital functions, ensure airway patency and adequate ventilation of the lungs, and carry out symptomatic and supportive therapy. Given the large volume of distribution of sertraline, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are ineffective. nine0029

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