Sertraline (Zoloft) Overview: Uses, Side Effects, Dosage, and More

What is sertraline?

Sertraline is a generic drug prescribed to treat depression (also called major depressive disorder) and other mental health conditions. It comes as an oral tablet that you swallow.

Oral capsule and oral solution forms of sertraline are also available. But this article is focused on the oral tablet form.

Sertraline tablets and solution are also available as the brand-name drug Zoloft.

Boxed warning

Sertraline has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “Sertraline precautions” section.

Uses for sertraline

Specifically, sertraline is approved by the FDA to treat the following conditions in adults:

• depression (major depressive disorder)
• panic disorder
• post-traumatic stress disorder (PTSD)
• social anxiety disorder
• premenstrual dysphoric disorder

Sertraline is also prescribed to treat obsessive-compulsive disorder (OCD) in adults and some children.

Sertraline may be used alone or as part of a combination therapy (meaning you 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.

Sertraline works by increasing the amount of serotonin in your brain to help maintain mental health balance. This can improve the symptoms of depression and anxiety.

Sertraline side effects

Like most drugs, sertraline may cause mild to serious side effects. The following lists contain some of the more common side effects sertraline may cause. These lists don’t include all possible side effects.

Keep in mind that the side effects of a drug can depend on:

• your age
• the condition you are taking sertraline to treat
• other health conditions you have
• other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of sertraline. They can also suggest ways to help reduce side effects.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking sertraline and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

Here’s a list of some of the mild side effects that sertraline can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read sertraline’s prescribing information.

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

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

Serious side effects from sertraline can occur, but they aren’t common. If you have serious side effects from sertraline, call your doctor right away. If you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of sertraline that have been reported include:

• agitation, restlessness, anger, or irritability
• manic episodes
• aggressive or violent behavior
• difficulty sleeping
• new or worsening depression
• new or worsening anxiety or panic attacks
• serotonin syndrome
• unusual bleeding
• seizures or convulsions
• changes in appetite or weight
• low sodium levels
• eye swelling, redness, or pain
• changes in vision, including blurred and double vision
• boxed warning: suicidal thoughts and behavior (see “Sertraline precautions”)

Side effects in children

Sertraline may be prescribed to treat obsessive-compulsive disorder (OCD) in some children. Additional side effects of sertraline for children can include:

• unusual increase in muscle movement or agitation
• nose bleed
• more frequent urination
• urine leakage
• aggressiveness
• slowed growth rate and weight change

Allergic reaction

For some people, sertraline can cause an allergic reaction.

In general, symptoms of an allergic reaction can be mild or serious.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking sertraline.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to sertraline, they may have you switch to a different treatment.

Sertraline dosage

This dosage information is for sertraline oral tablet.

The sertraline dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re taking sertraline to treat
• your age
• other medical conditions you have
• how you react to the first dose

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Form and strength

Sertraline oral tablet is available in three strengths:

• 25 milligrams (mg)
• 50 mg
• 100 mg

Your doctor will prescribe the dosage of sertraline that’s right for you. Keep reading to learn more.

Dosage for major depressive disorder

Adult dosage

• 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.

Dosage for obsessive-compulsive disorder (OCD)

Adult dosage

• 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 to 5 years)

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

Child dosage (ages 6 to 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 to 17 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.

Dosage for panic disorder

Adult dosage

• 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.

Dosage for post-traumatic stress disorder (PTSD)

Adult dosage

• The typical starting dose is 25 to 50 mg per day. This is usually increased in increments of 25 to 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.

Dosage for social anxiety disorder

Adult dosage

• The typical starting dose is 25 to 50 mg per day. This is usually increased by 25 to 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.

Dosage for premenstrual dysphoric disorder

Adult dosage

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 per day as needed.
• Luteal: The typical starting dose is 50 mg per day in the first 2 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 per day.

Take as directed

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

Missed dose

For sertraline to work well, a certain amount needs to be in your body at all times.

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

Overdose

Do not take more sertraline than your doctor prescribes, as this can lead to harmful effects.

Symptoms caused by an overdose can include:

• tiredness
• vomiting
• fast heart rate
• nausea
• dizziness
• agitation
• tremors

What to do in case of overdose

Call your doctor if you think you’ve taken too much sertraline. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Sertraline interactions

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 of 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 of 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 of 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 sertraline increases your risk of serotonin syndrome.
• Serotonergic medications such as fentanyl, tramadol, and St John’s wort: Taking these drugs with sertraline increases your risk of 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.

Sertraline cost and savings

Whether you have health insurance or not, cost may be a factor when you’re considering sertraline. What you’ll pay for sertraline may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

• Comparing pharmacies: The price of sertraline may vary depending on which pharmacy you use, so it can help to compare prices across pharmacies to find the lowest cost.
• Drug coupons: You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.
• Financial assistance: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:
  • Medicine Assistance Tool
  • NeedyMeds

Considerations when taking sertraline

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

General

• You can take sertraline 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 sertraline 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.

Travel

Always carry your drugs with you when you travel.

• When flying, never put sertraline 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.

Your age

If you are age 65 years or older, your kidneys may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of the drug stays in your body for a longer time, which can increase your risk of side effects. Your doctor may start you on a low dose of sertraline or a different dosing schedule. This can help keep levels of this drug from building up too much in your body.

Clinical monitoring

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

• Your mental health and symptoms of depression: Your doctor will monitor your symptoms of depression to make sure that sertraline is working and that you’re not having suicidal thoughts. They’ll watch you closely during the first few months after you start taking sertraline 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 taking sertraline 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 of certain types of glaucoma.
• Cholesterol levels: Sertraline 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 sertraline. If your liver isn’t working well, your doctor may decide to lower your dose of sertraline.

Insurance

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

Sertraline precautions

Be aware of the following warnings and precautions for sertraline.

FDA warning: Risk of suicidal thoughts and behavior

Sertraline has a boxed warning for risk of suicidal thoughts and behavior. A boxed warning is the most serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Sertraline 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.

Other precautions

Before taking sertraline, discuss your health history with your doctor. Sertraline may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• glaucoma
• bipolar disorder
• seizures
• liver problems
• kidney problems
• previous allergic reaction to this or a similar drug
• pregnancy
• breastfeeding
• alcohol consumption

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 another 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.