Zoloft (Sertraline) Side Effects: Common, Rare, & Severe

What Is Zoloft (Sertraline)?

Zoloft (sertraline) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It impacts the neurochemical balance in the brain by inhibiting the serotonin reuptake in the brain, increasing neurotransmitters’ effects on mood regulation.¹ It often takes some time for the antidepressant to work, anywhere from a few weeks to a few months. During that time, patients should report all side effects to their physician and use it in conjunction with psychotherapy.

Zoloft is an FDA approved for the treatment of:

• Major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder (PD)
• Post-traumatic stress disorder (PTSD)
• Social Anxiety disorder (SAD)
• Premenstrual dysphoric disorder (PMDD)

Deciding to use SSRIs or serotonin-norepinephrine reuptake inhibitors (SNRI) medications as first-line treatments for these disorders will depend on the prescriber’s comfort with that medication, the patient’s preference or previous experience with these drugs, and cost preference.

Side Effects of Zoloft

The side effects of Zoloft can range from common self-resolving effects to more severe ones that may need medical attention. The Zoloft side effects in the first week will likely resolve shortly after starting the medication.² Severe side effects that require immediate care and possibly hospitalization will likely be caused by allergic reactions or prior medical conditions exacerbated by the medication. Consistent communication with your provider about experienced side effects is crucial to help them take corrective action. The side effects listed below are not a comprehensive list of possible side effects of sertraline.

Common Side Effects

These generally do not need medical attention and last a few days to weeks.¹ However, if they infringe on your day-to-day living, it may be worth discussing the side effects with your physician.

Common side effects of Zoloft (sertraline) may include:¹

• Headache
• Nausea, diarrhea, constipation, vomiting
• Anxiety symptoms, agitation
• Drowsiness, insomnia 
• Dizziness
• Sexual dysfunction
• Weight gain

Severe Side Effects

While Zoloft is generally well tolerated, it still comes with risks of side effects that all patients should be informed about. If any of these side effects were to present, patients should immediately report to their nearest emergency department or call an ambulance.

Severe side effects of Zoloft that require immediate attention may include ¹:

• Low levels of salt in your body
• QTc prolongation
• Suicidal ideation

Rare Side Effects

Occasionally, Zoloft can cause side effects that are not common or well documented, as their cause is not entirely known. These rare instances are usually reported as case reports.

Rare side effects of Zoloft may include:

• Heart palpitations (skipping beats or abnormal beating)
• Problems with vision
• Increased sweating

Allergic Reactions

Allergic reactions can occur with any medication. Patients should always check for rashes and hives when starting a new prescription. Patients who have had an allergic reaction to Zoloft should not take medicines with the same active ingredient, sertraline. You should always report to your nearest emergency room if you have any problems breathing or notice swelling when taking sertraline.

Severe allergic to Zoloft can include:

• Breathing problems (stridor)
• Swelling
• Rash/hives

Long-Term Effects

One study found that individuals may have a decreased sex drive or post-SSRI sexual dysfunction when taking certain antidepressants.¹⁰
This side effect may be a reason why patients do not want to continue to take SSRIs. Also, a small study reported an increased risk of coronary artery disease in patients using sertraline.¹¹More research is needed to know if these effects are caused by Zoloft and how many people they may affect.

Interactions With Zoloft

Taking certain medications, herbs, or supplements alongside Zoloft can change how Zoloft works in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Substances you should avoid using while taking Zoloft include¹:

• Additional SSRI or SNRI medications
• Tricyclic antidepressants (TCAs)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Buspar
• 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 Experiences Side Effects More?

Some patients may experience side effects from Zoloft more than others. While predicting who will respond poorly is difficult, specific patient populations should be cautious with Zoloft. Patients taking other SSRI/SNRI medications 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 of the risk of increased suicidal ideation when starting Zoloft. It is essential to discuss your health conditions with your physician to select the medication that is the most suitable for you.

Populations who are at an increased risk for experiencing side effects include those who are or have:¹²

• Susceptible to nausea and vomiting
• Suicidal ideations
• A history of serotonin syndrome
• Bipolar disorder
• Prior allergic reactions to sertraline
• Prior vision issues such as glaucoma
• A history of seizures

Zoloft Side Effects In Women

It is not known what risks Zoloft poses to pregnant individuals or their unborn babies. Animal studies showed that sertraline, the active ingredient in Zoloft, delayed fetal development in later trimesters. These studies do not always represent what will happen in humans. It is known that babies exposed to sertraline in the third trimester do experience more birth complications.

This does not mean pregnant patients can not take sertraline, as untreated depression and anxiety can also negatively affect the baby, but it is important to talk with a doctor about the risks and benefits of taking Zoloft during pregnancy.¹³ Zoloft has been shown to reach breast milk during lactation, but no adverse effects have been noted. It’s important to talk with your doctor about the risks and benefits of breastfeeding while taking Zoloft.

Withdrawal Symptoms From Zoloft

Zoloft is not a DEA-regulated medication and is not considered addictive, but it can cause dependency after long periods of use. Because of this, it is always recommended to taper the dose of medication when attempting to stop it. It is never recommended to stop the medication cold turkey. If medication is stopped abruptly, you may have symptoms of antidepressant discontinuation syndrome. This withdrawal can present with flu-like symptoms, nausea, dizziness, and hypersexuality.¹ Speaking to your physician about stopping your antidepressant and following a tapering dose is the best way to stop the medication.

Questions to Ask Your Health Team About Zoloft Side Effects

Deciding whether or not to start medication treatment and which medication is right for you can be daunting. If you feel that therapy alone is not working or the medication that you are currently taking is not helping, Zoloft may be a good solution. When deciding which antidepressant to take, it is essential to discuss its benefits, risks, and possible side effects with a doctor.

Questions to ask your care team when considering the side effects of Zoloft include:

• How long will it take for me to adjust to taking Zoloft?
• Am I at risk for more severe symptoms if I am already taking other anxiety medications?
• Will a previous history of addiction make me more susceptible to dependency?
• What is the best dosage to ensure fewer side effects?
• Are there drugs I am taking that could have harmful interactions?
• When should I reach out to you if I am experiencing side effects?
• Is there anything I should tell my therapist about this new medication?
• Are there Zoloft alternatives I can consider?
• Is it safe to take Zoloft and Adderall at the same time?

Final Thoughts

Zoloft is generally well tolerated but does come with side effects that all patients should know about. Patients’ most common side effect is nausea/vomiting, which is usually self-resolving ². However, patients should go to their nearest emergency room for more serious side effects, which include serotonin syndrome, and suicidal ideation. If side effects become intolerable or challenging, speak with a physician about changing the dosage or stopping the medication, as withdrawal effects may exacerbate them.