*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Zoloft, with the active ingredient sertraline, is an antidepressant medication in the selective serotonin reuptake inhibitor (SSRI) drug class. Zoloft is an FDA-approved treatment for depression, social anxiety, OCD, panic disorder, PTSD, and premenstrual dysphoric disorder (PMDD).
Some taking Zoloft may experience common side effects, such as nausea, loss of appetite, and drowsiness. While it is considered a safe and effective treatment, there is a risk for serious side effects as well.
If you’re considering Zoloft, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Zoloft or another medication may help your symptoms.
Boxed Warning: Sertraline (Zoloft) – Risk of suicidal thoughts and behaviors in certain people
Sertraline, the active ingredient in Zoloft, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Sertraline can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with sertraline and any other medications before starting treatment.
Key Takeaways
Zoloft is a prescription antidepressant medication used to treat depression, OCD, panic disorder, and several other mental health disorders.
Zoloft, with the active ingredient sertraline, is a selective serotonin reuptake inhibitor (SSRI).
If you are considering Zoloft, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry or Circle Medical.
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Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
What Is Zoloft (Sertraline)?
Zoloft is a brand name SSRI antidepressant FDA-approved for use in adults and children 8 and older.1 Zoloft is available as the generic medication sertraline with the same risks and treatment benefits as the branded form.
How Does Zoloft Work?
Zoloft is thought to work by increasing levels of serotonin, a chemical in the brain. Serotonin is a chemical in the body involved in mood regulation.1 For some, this change in chemical activity may improve symptoms of depression, anxiety, and other conditions.
What Is Zoloft Used to Treat?
Zoloft is FDA-approved to treat the following mental health conditions in adults:
- Depression
- Social anxiety
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD)
Zoloft is also FDA-approved to treat OCD in children and teens age 6 and older.
Off-Label (Non-FDA-Approved) Uses of Zoloft
Zoloft is also sometimes used as an off-label treatment. Off-label means that a medication is not FDA-approved for a specific use, but a provider can prescribe it as a treatment because they believe the medication may offer a benefit.
Common off-label uses of Zoloft include:2
How Effective Is Zoloft?
Zoloft has been shown to be an effective short- and long-term treatment. Numerous studies on all of its FDA-approved uses support this finding. For depression, three studies demonstrated that Zoloft can be effective at various dosages. It can significantly improve symptoms of depression and reduce the rate of symptom relapse during long-term treatment.1
When studied as a treatment for obsessive-compulsive disorder (OCD), both adults and patients 17 and younger showed improved symptoms. This held true for all dosages when compared to placebo treatment. The patients studied in these initial studies all had moderate to severe OCD symptoms.1
Zoloft has also been shown to significantly improve symptoms of anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD).1 Studies of panic disorders over 10 and 12 weeks showed a significant reduction in panic attacks.
When studied as a treatment for PTSD, however, only two of the four studies showed a clinically significant response to treatment.1 Finally, when studied as a treatment for social anxiety disorder, anxiety symptoms were reduced and were less likely to relapse over a period of 24 weeks.1
How Long Does it Take for Zoloft to Work?
The time it takes for Zoloft to start working varies for each individual. For most, it will take around 2-4 weeks to start noticing the effects of the medication. However, it may take 4-6 weeks to feel the full benefit of Zoloft. It may take even longer, up to 8 weeks, for the medication to start working for some individuals.
How Long Do I Need to Keep Taking Zoloft?
The duration of treatment with Zoloft will greatly depend on patient-specific factors. These may include age, the condition being treated, and the general response to treatment.
For example, if your prescriber treats PMDD with Zoloft, they may direct you to take it only on certain days of your menstrual cycle. With other conditions like PTSD or depression, you may be prescribed Zoloft for months or even years if you tolerate it well.1
If you feel you should no longer take Zoloft, alert your healthcare provider as there is a safe and specific way to discontinue treatment. Never change doses or stop treatment on your own.
Common Zoloft Side Effects
Zoloft is generally well tolerated and used by many people. However, every medication has side effects that patients should be aware of before starting treatment.
Common side effects of Zoloft for adults include:1
- Nausea
- Diarrhea
- Upset stomach
- Loss of appetite
- Tremor
- Increased sweating
- Agitation
- Sexual functioning problems
- Fatigue or drowsiness
- Difficulty sleeping
- Anxiety
*All medications, including Zoloft, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
Serious Zoloft Side Effects
There is a risk for side effects to be severe or persistent. If any of the following serious side effects appear, seek medical care immediately.
Serious side effects of Zoloft that require immediate medical attention include:*1
- Suicidal thoughts or actions
- Bruising or unusual bleeding
- Symptoms of mania or hypomania
- Seizures or convulsions
- Allergic reactions
- Angle-closure glaucoma
- Low sodium levels in the blood
- Muscle rigidity, fever, and/or seizures (could be a sign of serotonin syndrome)
*All medications, including Zoloft, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
What Are The Long-term Effects of Taking Zoloft?
Zoloft is well tolerated by most who take it. But for those using Zoloft long term, watching for new or serious side effects is a priority. Since Zoloft is an SSRI, combining it with other medications that affect serotonin levels increases the risk of serotonin syndrome. Always check with your pharmacist about new medication interactions and let all of your healthcare providers know you are taking Zoloft.1
Studies have shown that the most common long term side effects from SSRI medications are sexual dysfunction, weight gain, and changes in sleep habits. There are also increased risks of more serious side effects like bone density changes and breaks, bleeding disorders, and developing diabetes.3 Always keep follow up appointments to help identify the development of new potentially serious side effects.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
What Are the Risks & Warnings for Zoloft?
Suicidal Ideation & Behavior
Sertraline, the active ingredient in Zoloft, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Sertraline can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with sertraline and any other medications before starting treatment.
Triggering Manic Episodes
For some people with bipolar disorder, taking Zoloft may increase the risk of a manic episode. Prior to starting treatment with an antidepressant like Zoloft, patients with depressive symptoms should be screened to determine if they are at risk for bipolar disorder.
Allergic Reactions
For some people taking Zoloft, an allergic reaction may occur which may be dangerous.
Severe allergic reactions to Zoloft can include:
- Breathing problems
- Swelling
- Rash/hives
If you experience wheezing, difficulty breathing, or swelling in the throat, seek immediate medical help.
Glaucoma (Serious Eye Condition)
Zoloft may cause angle-closure glaucoma, which can develop suddenly and lead to vision loss. If you have eye problems or a family history of glaucoma, your doctor may recommend an eye exam before taking Zoloft.
Serotonin Syndrome
For some people, taking Zoloft may increase the risk of serotonin syndrome. People with a history of serotonin syndrome may be at an even greater risk as they are susceptible to heart arrhythmia, tremors, and increased blood pressure.
Arrhythmias (Irregular Heart Rhythms)
For some people, using Zoloft may increase the risk of irregular heart rhythms. also known as arrhythmias. Any fast, slow, skipping, or irregular heartbeat should be addressed as soon as possible.
Hyponatremia (Low Sodium in the Blood)
A rare but serious side effect, hyponatremia (low sodium levels), has been associated with the use of antidepressants such as Zoloft. Low sodium levels in your blood may be serious and may cause death. Elderly people may be at greater risk for this.
Abnormal Bleeding
For some people with a history of bleeding disorders, taking Zoloft may increase the risk of blood clotting problems. Signs of abnormal bleeding can include bruising under the skin, a cut that does not stop bleeding, discolored stool, nose bleedings, or vomiting blood.
Liver Damage
For some people with liver disease, taking Zoloft may increase the risk of harm to the liver.
Pregnancy Risks
It is not known what risks Zoloft poses to pregnant individuals or their unborn babies. Speak to your prescriber about the risks and potential benefits of taking Zoloft as soon as possible during pregnancy.
Breastfeeding Risks
Zoloft is present in breast milk, which may carry some risk for a nursing newborn.
Antidepressant Discontinuation Syndrome
People discontinuing Zoloft abruptly may have symptoms of Zoloft withdrawal, also called antidepressant discontinuation syndrome. Because of this, it is always recommended to taper the dose of medication as instructed by your provider. Do not stop taking Zoloft or adjust your dosage on your own.
Common symptoms of Zoloft withdrawal include dizziness, nausea, fatigue, anxiety, sweating, seizures, and electric shock sensations.
Drug Interactions
Taking certain medications, herbs, or supplements alongside Zoloft can change how Zoloft works in your body or increase the risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Substances you should avoid using while taking Zoloft include:
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Alcohol
This is not a comprehensive list of medications that interact with Zoloft. Be sure to talk with your doctor or pharmacist about any prescription or over the counter medications you take, as well as supplements, herbs, and teas.
Who Should Not Take Zoloft?
Some people taking Zoloft may be more likely to experience side effects than others. It can be difficult to tell how a person will respond to Zoloft, but certain individuals should be cautious with the medication. Those taking other SSRIs, SNRIs, or medications that increase serotonin in the brain should avoid Zoloft due to the risk of serotonin syndrome.
Adolescent patients and their parents should be aware that Zoloft can increase the risk of suicidal thoughts, especially when starting the medication. It is essential to discuss your health conditions with your provider to select the medication that is the most suitable for you.
Populations who are at an increased risk of side effects include those who are or have:1
- Liver problems
- Kidney problems
- Heart problems, specifically QT prolongation
- Bipolar disorder or mania
- Prior allergic reactions to sertraline
- Prior vision issues such as glaucoma
- A history of seizures
- High blood pressure
- A history of serotonin syndrome
- Bleeding problems
- A history of suicidal thoughts or behaviors
- Older than 65 years of age
- Pregnant or who plan to become pregnant
- Breastfeeding or who plan to breastfeed
Drug Interactions With Zoloft
Taking certain medications, herbs, or supplements along with Zoloft can change how Zoloft works in your body or increase the risk for serious side effects. Always talk with your prescriber about what to avoid while using Zoloft.
Substances you should avoid using while taking Zoloft include:1
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Antiplatelet or anticoagulant drugs, such as warfarin
- Alcohol
This is not a comprehensive list of the possible interactions with Zoloft. You should talk with your provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Zoloft.
Zoloft Withdrawal
If you stop taking Zoloft abruptly, you may develop symptoms of Zoloft withdrawal, also called antidepressant discontinuation syndrome. Doing so may also lead to a relapse of your symptoms. Because of this, it is always recommended to taper the dose of medication as instructed by your provider. Do not stop taking Zoloft or adjust your dosage on your own.
Here are common symptoms of Zoloft withdrawal:1
- Dizziness
- Nausea
- Fatigue
- Anxiety
- Shaking
- Sweating
- Agitation
- Sleep problems
- Seizures
- Electric shock sensations
Zoloft Dosages for FDA-Approved Treatment
The most common Zoloft dosage at the start of treatment is 50 mg. However, this is based on the condition being treated and may vary. Your provider will adjust the dosage up or down based on how you respond to it or if any side effects become bothersome.
How Should I Take Zoloft?
Zoloft should be taken once a day, either in the morning or evening. It is commonly prescribed as a tablet or capsule, but it is also available as an oral suspension (liquid). It is important to take your dosage at the same time every day to maintain a consistent level of the medication in your body.
What Happens If I Miss a Dose of Zoloft?
If you miss a dose of Zoloft, take it as soon as you remember it. If it’s almost time for your next doses, skip the missed dose. Do not take two doses at the same time.
Can You Overdose on Zoloft?
Yes, it is possible to overdose on Zoloft, either by accident or on purpose. An overdose can also occur when taking Zoloft with other substances, such as alcohol. These interactions can be dangerous, possibly causing seizures, heart damage, and serotonin syndrome.
What Should You Do If You Take Too Much Zoloft?
A Zoloft overdose is a medical emergency. If you or someone you know may have overdosed on Zoloft, seek immediate medical care or call 9-1-1 right away. Do not wait to see if overdose symptoms appear.
How to Get a Prescription for Zoloft
To get a prescription for Zoloft in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription for Zoloft should be included in your treatment plan.
Can I Get Zoloft Prescribed Online?
To get an online prescription for Zoloft, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants and some anti-anxiety medications.
Online Psychiatry and Medication Management Covered by Insurance
Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
Questions to Ask Your Provider
It is important to discuss the potential risks and benefits of Zoloft with your doctor, psychiatrist, or therapist. Ask them whether side effects will go away on their own or if any intervention is needed.
Also, many online psychiatry services are available with convenient access to mental health care for depression and anxiety problems. Individuals may even change prescribers and get a mental health evaluation, diagnosis, and personalized treatment plan.
Questions to ask your care team about Zoloft include:
- Is it safe to take Zoloft with my other medications?
- Will my insurance cover Zoloft?
- Does my medical history increase my risk of side effects?
- How long can I expect side effects to last?
- What side effects should I seek immediate medical attention for?
- How often should we check in while I am taking Zoloft?
- Should I let my therapist know I am taking this medication?
- What are the side effects I should watch out for?
- What is the dosage of my prescription?
- How often should I take my medication?
- How long does it take for Zoloft to work?
- Does Zoloft work for OCD symptoms?
- Are there Zoloft alternatives I can consider?
- How much does Zoloft cost, and are there ways I can save money on my prescription?
Prescriber’s Tips
Your prescriber will share important information about your Zoloft prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about side effects. Follow these tips for safe and effective use of Zoloft.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to. Keeping a consistent dosing schedule reduces the chance of unwanted side effects. When taking antidepressants, this approach can prevent withdrawal symptoms such as dizziness, brain zaps, and flu-like symptoms.1
- Take your medication at the same time each day. Doing so can help you remember to take it, making it as effective as possible. Your healthcare provider can help determine the optimal timing based on your sleep patterns and initial medication response.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Antidepressants have a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- You should take your first dose while you are home and not needing to drive. Zoloft has been known to cause drowsiness in some patients, and you should avoid driving after taking Zoloft until you know how it affects you.1
- Do not drink alcohol while taking Zoloft.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications.
Frequently Asked Questions
What Are Common Side Effects of Zoloft?
Common Zoloft side effects include nausea, vomiting, fatigue, changes in sleep and appetite, and dry mouth.
How Long Will Zoloft Side Effects Last?
Side effects are one of the most common reasons people choose to stop taking medication. Some side effects can be managed and may fade away after the first several weeks of treatment. Others may persist unless a person stops taking the medication. Side effects can occur even when taking the medication correctly.
Should I Stop Taking Zoloft If I Experience Side Effects?
Do not stop taking Zoloft unless you have been advised to do so by your provider. Doing so can lead to antidepressant discontinuation syndrome, also known as antidepressant withdrawal. This can cause uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea.
How Does Zoloft Make You Feel During the First Week?
During the first week of taking Zoloft, the medication is building up in your body. This may trigger side effects for some people. It takes several weeks for Zoloft to start working and you may not notice any difference in your symptoms yet.
Does Zoloft Affect Sex Drive?
Zoloft can cause sexual side effects, including decreased sexual desire in both men and women.
Can Zoloft Be Used During Pregnancy?
Taking Zoloft during the third trimester may pose certain risks. Speak to your provider about the risks and potential benefits of taking Zoloft as soon as possible during pregnancy.
Can Zoloft Be Used While Breastfeeding?
A small amount of Zoloft is present in breast milk, which may carry some risk for a nursing newborn.1
Is it Safe to Drive While Taking Zoloft?
Changes in sleep habits are common side effects of Zoloft, and can cause increased sleepiness or insomnia. If you feel that you are tired or fatigued, then you should not drive, operate heavy machinery, or do other dangerous activities.
Is It OK to Drink Alcohol While Taking Zoloft?
No, do not drink alcohol while on Zoloft. The two substances can interact when taken together, worsening side effects such as fatigue and dizziness.1
ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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Zoloft – sertraline hydrochloride tablet, film coated; Zoloft- sertraline hydrochloride solution, concentrate. (August 8, 2023). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Singh HK, Saadabadi A. Sertraline. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from https://www.ncbi.nlm.nih.gov/books/NBK547689/
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Cartwright, C., Gibson, K., Read, J., Cowan, O., & Dehar, T. (2016). Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient preference and adherence, 10, 1401–1407. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC4970636/
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary updates: Added “Key Takeaways” feature. Edited for clarity and reorganized. Revised and retitled content in “What is Zoloft (Sertraline)? & How Is It Used?”, to “What Is Zoloft (Sertraline)?”. Included in this section “How Does Zoloft Work?”, “What Is Zoloft Used to Treat?”, removed “History of Zoloft”. Revised and retitled “What Are Common Zoloft (Sertraline) Dosages & Delivery Methods?” to “Wellbutrin Dosages for FDA-Approved Treatment”. Added new sections titled “How Should I Take Zoloft?”, “How Effective Is Zoloft?”, “How Long Does it Take Zoloft to Work?” “How Long Do I Need to Keep Taking Zoloft?”, “What Are the Long-term Effects of Zoloft?”. Retitled “What to Do If You Overdose” to “Can You Overdose on Zoloft?” Consolidated “Zoloft Warnings & Associated Risks” into new “Risks” feature. Added “Who Should Not Take Zoloft?”, “Zoloft Withdrawal”, “How to Get a Prescription for Zoloft”. Retitled “Questions to Ask Your Health Team About Zoloft” to “Questions to Ask Your Provider”. Removed “For Further Reading” section, added FAQs. Replaced “Final Thoughts” with “Prescriber’s Tips” feature.
Author: OsamaTariq, MD
Medical Reviewer: Dena Westphalen, PharmD
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