Usual zoloft dosage

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.

Zoloft Dosage Guide | hers

Medication is a common treatment for mental or psychiatric disorders, and some medications can treat multiple disorders or conditions. Zoloft® (the brand name of sertraline) is one of those medications. Often the first-line medication for depression, certain anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and more, a Zoloft dosage may vary depending on which condition you have.

Whether you suffer from a depressive disorder primarily or find your anxiety interfering with your daily life, healthcare providers may prescribe Zoloft differently to best treat your symptoms.

We’ll cover what Zoloft dosage you may be prescribed by healthcare providers for each disorder, as well as when to increase Zoloft dosage. We’ll also cover the basics of depression and anxiety disorders that Zoloft treats.

An Introduction to Zoloft

An antidepressant medication used for various disorders, Zoloft is the brand name for the antidepressant while sertraline is the generic version.

Brand-name and generic drugs go through the same testing process and use the same ingredients, according to the Food and Drug Administration (FDA). The differences between generic sertraline and brand-name Zoloft may be some inactive ingredients, cost and slight but not medically significant differences in how the antidepressant drugs perform.

Zoloft belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs or serotonergic antidepressants). Selective serotonin reuptake inhibitors are thought to work by increasing serotonin levels.

Serotonin is a neurotransmitter or chemical that regulates mood and other functions like energy level, sex drive and mental focus. With normal levels of serotonin, you feel calmer, happier and more focused. Low levels are associated with symptoms of depression and anxiety.

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The Basics of Depression

Now that you know more about Zoloft, we’ll go over the psychiatric disorders a healthcare professional would prescribe this medication — starting with major depression.

Major depressive disorder — also referred to as major depression or depression — is a mood disorder characterized by ongoing patterns of negative feelings. More than just periodically feeling sad, major depression is an empty and anxious feeling that negatively affects your ability to function.

Women are almost twice as likely as men to develop depressive symptoms. Some of the most common symptoms of depression in women include:

  • Pessimistic feelings

  • Loss of interest in usual activities

  • Fatigue or low energy

  • Difficulty sleeping or oversleeping

  • Noticeably slower speech or movement

  • Trouble concentrating or remembering things

  • Physical pain such as headaches, muscle or joint pain

  • Reduced sex drive

  • Weight gain or weight loss

  • Thoughts of suicide

Although the exact cause of depression is relatively unknown, there are certain risk factors for developing major depression including environmental, biological, genetic and psychological factors. Different types of depression can be caused by different factors.

A depressive episode can also be a part of bipolar disorder, which may be prescribed treatment with sertraline. Bipolar disorder is a psychiatric disorder that includes both low, depressed moods (depressive episodes) and high, elevated moods of energized behavior (manic episodes).

While depression is a part of bipolar disorder, taking serotonergic drugs like Zoloft can increase the risk of switching from depression to mania.

The most common treatments for managing depressive symptoms are therapy and antidepressant drugs — with Zoloft being a first-line treatment for depression.

A review of studies comparing sertraline to other antidepressant drugs including tricyclic antidepressants and other serotonergic drugs (SSRIs) found that sertraline was more effective in treating major depression.

Although not quite classified as a depressive disorder, premenstrual dysphoric disorder (PMDD) has similarities to depression — including depressive symptoms. Zoloft and other serotonergic drugs are also treatments for PMDD.

Premenstrual dysphoric disorder is a condition of severe symptoms that occur before and during your period. PMDD can be similar to premenstrual syndrome (PMS) but involves more serious and debilitating mood disorder symptoms.

What Is Anxiety?

While everyday feelings of worry or anxiety are normal, anxiety disorders are a group of psychiatric disorders representing persistent feelings of anxiety, unease or panic that interfere with daily activities.

Just like major depression, there are different types of anxiety disorders — some of which healthcare providers may prescribe Zoloft for.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is one of the most common psychiatric disorders, affecting 6.8 million U.S. adults. Generalized anxiety disorder also often occurs at the same time as major depression.

If you struggle with persistent feelings of worry or anxiety, you may have generalized anxiety disorder (GAD). You may worry about your health, work or daily life in a way that goes beyond typical anxiety and negatively affects your life.

Multiple studies have found certain serotonergic drugs — like sertraline — to be effective in the treatment of anxiety disorders. Sertraline may be prescribed by healthcare providers as an “off-label” medication for anxiety — a use for medication other than one it’s been approved for.

Social Anxiety Disorder

Another anxiety disorder that Zoloft is FDA-approved as a treatment for is social anxiety disorder.

Social anxiety disorder (also known as social phobia) can cause intense fear or anxiety of being judged or viewed negatively in social settings.

If you struggle with this type of anxiety, you’re not alone — approximately 15 million U.S. adults are affected by this disorder.

Treatment with sertraline (the generic form of Zoloft) was both effective and well-tolerated by patients with social phobia for 20 weeks of treatment on a flexible dosage range between 50mg and the maximum dosage of 200mg a day.

Panic Disorder

Panic disorders are a type of anxiety disorder where someone experiences unexpected, frequent panic attacks (a sudden sense of fear with no obvious danger).

Other symptoms during panic attacks include a pounding heart, sweating, shaking, chest pain or numbness. Our guide on panic disorder covers more information on other possible symptoms.

Similar to depression, the exact cause of panic disorder is unknown although several parts of the brain play an important role in fear and anxiety. 

Like many other psychiatric disorders, an untreated panic disorder can negatively affect your life. Fortunately, Zoloft is an FDA-approved effective medication for panic disorder.

A study found that patients who received treatment with sertraline experienced fewer panic attacks for more than a couple months of treatment (10 weeks) compared to placebo-treated patients (those treated with an inactive drug).

Obsessive-Compulsive Disorder

Another FDA-approved use of Zoloft, obsessive-compulsive disorder is a common disorder where a person has uncontrollable, recurring behaviors (compulsions) and thoughts (obsessions) that interfere with their daily life.

Those with obsessive-compulsive disorder may have obsessions, compulsions or both symptoms that take up time and interfere with their life.

Post-Traumatic Stress Disorder

A long-term disorder, posttraumatic stress disorder develops after someone has been through a shocking or dangerous event and may continue to feel stress or fear long after the event.

Women have a higher risk of developing posttraumatic stress disorder and may experience symptoms differently than men.

Some post-traumatic stress disorder symptoms in women include avoiding anything that triggers a memory of the traumatic event, mood symptoms like dissociating, startling easily, difficulty sleeping and more.

Zoloft is also approved by the FDA to treat post-traumatic stress disorder. A 12-week study comparing treatment with sertraline against a placebo found that the sertraline-treated patients had significant improvements in treating their PTSD symptoms over the placebo-treated patients.

Zoloft Dosage for Anxiety and Depression

Zoloft is available in different strengths. The Zoloft (sertraline) dosage for anxiety may differ from the Zoloft dosage for depression.

As an oral tablet, Zoloft comes in three strengths: 25mg, 50mg and 100mg strengths. The liquid concentrate is typically dosed at 20mg per milliliter.

The typical starting Zoloft dosage for depression and most conditions is 50mg per day, although a dose of 25mg per day may be used for children and people with panic disorder, social anxiety disorder and post-traumatic stress disorder.

Multiple short and long-term studies found that an effective and well-tolerated Zoloft dosage for panic disorder is 50mg to 175mg per day.

For treating obsessive-compulsive disorder, however, typically higher doses of serotonergic drugs — like Zoloft — are used to treat symptoms.

Healthcare providers might start with a dose of 50mg per day for eight to 12 weeks, with four to six of those weeks at the highest tolerable dose before the maximum 200mg daily dose.

There are two different ways to take Zoloft for PMDD: either as a daily dose ranging between 50mg to 150mg per day or taken before your period starts during the luteal phase in a dosage range of 50mg to 100mg per day.

Your healthcare provider may start you on a lower Zoloft dosage and gradually increase the dosage no more than once a week.

Since anxiety disorders can vary in severity, healthcare providers may adjust your Zoloft dosage for anxiety based on your symptoms and how you respond to the medication.

What To Expect When Taking Zoloft

Zoloft can take some time to start having an effect. You may notice improvements in energy, appetite and sleep quality in the first one to two weeks. However, a depressed mood may take longer, around six to eight weeks to start showing improvement.

Zoloft and generic sertraline come in the form of either an oral tablet or a liquid concentrate. Your healthcare provider may recommend you dilute the liquid concentrate in water, ginger ale, orange juice or a lemon or lime soda.

You typically take Zoloft once a day, in the morning or evening, unless you’ve been prescribed Zoloft for PMDD and take your Zoloft dosage during your luteal phase.

Follow the instructions provided by your healthcare provider and use the medication only as directed. Seek medical advice from healthcare providers if your symptoms persist.

Compared to other antidepressant drugs, serotonergic drugs like Zoloft generally have fewer side effects while still being an effective treatment. However, you can still experience mild side effects when taking a Zoloft dosage for depression or anxiety.

Common side effects of Zoloft can include:

  • Dry mouth

  • Nausea

  • Vomiting

  • Palpitations

  • Decreased appetite

  • Weight gain or weight loss

  • Fatigue

  • Tremor

  • Sleepiness or drowsiness

  • Insomnia

  • Sexual side effects such as decreased libido

  • Agitation

  • Dizziness

Although these mild side effects of Zoloft are typically not dangerous, there are several adverse effects or potentially severe side effects that you should be aware of before using this medication.

Adverse reactions to Zoloft can include eye pain, trouble breathing, swelling, unusual bleeding, seizures, faster than usual heart rate, hallucinations or more. If you experience any of these adverse effects, seek medical advice from healthcare providers immediately.

Certain medications can also cause adverse reactions with Zoloft. These include other antidepressant drugs such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs), amphetamines, blood thinners, atomoxetine, buspirone, fentanyl, lithium, irregular heart rate medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and more.

You also should not abruptly stop taking Zoloft as you may experience withdrawal symptoms. These can include irritability, vomiting, nightmares, headache or a tingling sensation on the skin.

The risk of serotonin syndrome also increases when taking serotonergic drugs like Zoloft. Serotonin syndrome is a drug interaction from having too much serotonin in the body. Symptoms of serotonin syndrome can range from mild to severe and even potentially life-threatening.

The risk for serotonin syndrome increases if you take sertraline with other medications or supplements that increase serotonin such as other serotonergic drugs, other antidepressant drugs (like tricyclic antidepressants), migraine medications called triptans, St. John’s wort and certain pain medications.

If you experience symptoms of serotonin syndrome, you should seek medical advice from a healthcare professional immediately.

It’s always a good idea to let your healthcare provider know about any other drugs or supplements you currently use before you start taking Zoloft.

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Taking Zoloft for Mental Health

When used correctly, Zoloft has the potential to help reduce or eliminate the symptoms of the medical conditions it treats. And like any other medication, following the directions from a healthcare professional is crucial.  

That’s why Zoloft dosage is so important: an improper dose may have serious side effects — such as the risk of serotonin syndrome — or cause major issues with the effectiveness of your treatment. 

Zoloft may also be just one part of an effective treatment for your mood disorder. 

Others may include lifestyle changes or therapy — healthcare providers will likely make recommendations for your individual needs, which may include some or all of the options available for treatment. 

You should never change a prescription on your own, but there are things you can do without a healthcare provider’s input to work on your mental health — like reading.

If you’re just learning about depression and anxiety, you can learn more about the types of therapy. Our mental health resources guide is also a useful tool to continue learning.

If you’re ready to talk to someone, you can look into scheduling an online psychiatry evaluation today.

28 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Mikulic, M. (n.d.). • Sertraline hydrochloride prescriptions number U.S. 2004-2019. Statista. Retrieved from
  2. Singh HK, Saadabadi A. Sertraline. Updated 2022 May 2. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieved from
  3. Generic Drugs: Questions & Answers. (2021, March 16). FDA. Retrieved from
  4. Serotonin: What Is It, Function & Levels. (2022, March 18). Cleveland Clinic. Retrieved from
  5. NIMH » Depression. (n.d.). NIMH. Retrieved from
  6. Products - Data Briefs - Number 303 - February 2018. (n.d.). Centers for Disease Control and Prevention. Retrieved from
  7. NIMH » Bipolar Disorder. (n.d.). NIMH. Retrieved from
  8. Sertraline (Zoloft). (n.d.). NAMI. Retrieved from
  9. Cipriani, A., La Ferla, T., Furukawa, T. A., Signoretti, A., Nakagawa, A., Churchill, R., McGuire, H., & Barbui, C. (2010). Sertraline versus other antidepressive agents for depression. The Cochrane database of systematic reviews, (4), CD006117. Retrieved from
  10. Bhatia, S. C., & Bhatia, S. K. (2002). Diagnosis and Treatment of Premenstrual Dysphoric Disorder. American Family Physician, 66(7), 1239-1249. Retrieved from
  11. Premenstrual dysphoric disorder (PMDD). (2021, February 22). Office on Women's Health. Retrieved from
  12. NIMH » Anxiety Disorders. (n.d.). NIMH. Retrieved from
  13. Anxiety Disorders - Facts & Statistics. (2022, June 27). Anxiety and Depression Association of America, ADAA. Retrieved from
  14. NIMH » Anxiety Disorders. (n.d.). NIMH. Retrieved from
  15. Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070. Retrieved from
  16. Social Anxiety Disorder. (2009, October 19). Anxiety and Depression Association of America, ADAA. Retrieved from
  17. an Ameringen, M. A., Lane, R. M., Walker, J. R., Bowen, R. C., Chokka, P. R., Goldner, E. M., Johnston, D. G., Lavallee, Y.-J., & Nandy, S. (2001). Sertraline Treatment of Generalized Social Phobia: A 20-Week, Double-Blind, Placebo-Controlled Study. The American Journal of Psychiatry, 158, 275–281. Retrieved from
  18. NIMH » Panic Disorder: When Fear Overwhelms. (n.d.). NIMH. Retrieved from
  19. Pollack MH, Otto MW, Worthington JJ, Manfro GG, Wolkow R. Sertraline in the Treatment of Panic Disorder: A Flexible-Dose Multicenter Trial. Arch Gen Psychiatry. 1998;55(11):1010–1016. Retrieved from
  20. NIMH » Obsessive-Compulsive Disorder. (n.d.). NIMH. Retrieved from
  21. NIMH » Post-Traumatic Stress Disorder. (n.d.). NIMH. Retrieved from
  22. Davidson JRT, Rothbaum BO, van der Kolk BA, Sikes CR, Farfel GM. Multicenter, Double-blind Comparison of Sertraline and Placebo in the Treatment of Posttraumatic Stress Disorder. Arch Gen Psychiatry. 2001;58(5):485–492. Retrieved from
  23. ZOLOFT (sertraline hydrochloride) Label. (n.d.). Retrieved from
  24. Hobgood, C. D., & Clayton, A. H. (2009). Sertraline in the treatment of panic disorder. Drugs of today (Barcelona, Spain : 1998), 45(5), 351–361. Retrieved from
  25. Fenske, J. N., & Petersen, K. (2015). Obsessive-Compulsive Disorder: Diagnosis and Management. American family physician, 92(10), 896–903. Retrieved from
  26. Sertraline. (2022, January 15). MedlinePlus. Retrieved from
  27. Sanchez, C., Reines, E. H., & Montgomery, S. A. (2014). A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike?. International clinical psychopharmacology, 29(4), 185–196. Retrieved from
  28. Serotonin Syndrome: What It Is, Causes, Symptoms & Treatment. (2022, March 24). Cleveland Clinic. Retrieved from https://my.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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

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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

Zoloft instructions for use: Side effects, analogues, contraindications


Author of the article

Khokhrina Kristina Sergeevna,


All authors

Content of the article

  • Zoloft: active substance
  • 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 estimates of the WHO from the deposit estimate . 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. nine0029

    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

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    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: nine0029

    • 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. nine0004

    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 nine0004
    • 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
    • decreased potency, disruption of the reproductive system, disruption of the menstrual cycle 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 nine0004

    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: nine0029

    • 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: nine0029

    • 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. nine0029

    Zoloft and Atarax: compatibility

    The combined use 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 the 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! nine0202 Getting a training manual is easy: subscribe to our social networks and write “analogues” in the messages.

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