Sertraline, better known by the brand name Zoloft, is an antidepressant medication. It belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressants, meaning it works by increasing serotonin levels in the brain to regulate mood and ease symptoms of depression, anxiety, and a range of other conditions.
As with most drugs, there are some side effects and factors that users need to keep in mind….
Understanding Sertraline: How Does Zoloft Work?
The brain naturally produces a neurotransmitter called serotonin, a complex chemical that affects mood, reward, learning, memory, cognition, and several physiological processes. SSRIs, like Zoloft, work by preventing the reabsorption of serotonin, increasing its levels in the brain. Because of their effectiveness in treating conditions like major depressive disorder—along with their relative safety—SSRIs have become the most frequently prescribed antidepressants in many countries.
The difference between sertraline drugs like Zoloft and other antidepressants lies largely in their side effects, though even these are typically quite similar.
Uses and Benefits
Experts have approved Zoloft for use in treating many different conditions. Some of the most common conditions that doctors treat with sertraline include major depressive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder. Zoloft is also approved for treating post-traumatic stress disorder, but improvement is usually modest so it is not the primary choice of medication in these cases. Some people with premenstrual dysphoric disorder find that Zoloft alleviates their symptoms.
When taking sertraline to treat depression or anxiety disorders, many individuals will notice a significant improvement in symptoms and a decrease in symptom frequency. In a few double-blind studies, Zoloft was significantly more effective than placebo in treating dysthymia, a chronic form of depression. These results were similar to those of a type of tricyclic antidepressant drug, but most people tolerate sertraline much more.
In cases of treating OCD with coexisting depression symptoms, Zoloft appears to be more effective than several other drugs for both conditions. In panic disorder with depression, Zoloft is as effective as tricyclic drugs and better tolerated.
During case studies involving participants over the age of 60, sertraline appears to be comparable to other SSRIs and provides a better quality of life than any tricyclic antidepressant. In adults over 70, sertraline is one of the most effective and safe antidepressants.
Long-term research has shown that sertraline is an effective treatment for preventing relapses of OCD for up to 24 months. It may even perform better than the current go-to OCD medication, clomipramine, while being better tolerated. It’s worth noting that the sertraline dosages for OCD are higher than those for depression.
Outside of its confirmed uses, some research also indicates that sertraline could be useful for treating premature ejaculation.
Risks and Side Effects
Though Zoloft is typically safe and well-tolerated, it has several side effects that users must keep in mind. Most of these side effects are similar to those of other SSRIs, including a potential increase in suicidal thoughts in people under 25 years old. Should you experience any issues, you should notify your doctor, though many side effects are expected and do not require care.
Side effects that do not typically require medical care include:
- Dry mouth
- Tremor
- Headache
- Fatigue
- Reduced libido
- Restless leg syndrome
- Diarrhea
- Insomnia
- Nausea
- Ejaculation failure
Rarely, some people experience side effects that require immediate medical attention. These are:
- Allergic reactions
- Blood in the stool, dark brown or red urine, vomiting blood or brown material, unusual bleeding or bruising
- Heart rhythm changes
- Signs of low sodium levels, such as muscle weakness, dizziness, confusion, headache
- Sudden eye pain or changes in vision
- Worsening mood
All SSRIs carry a small risk of causing serotonin syndrome, a unique condition that occurs when the body’s serotonin levels are too high. Signs of this include muscle rigidity, heavy sweating, agitation, confusion, shivering, goosebumps, seizures, and high fever.
If you feel unwell or are unsure if your symptoms are a sign of something more serious, immediately call your physician.
Unlike other antidepressants, Zoloft appears to have little or no effect on weight.
Precautions and Considerations
Before you begin taking Zoloft, make sure your medical team knows of any medical issues that you currently have or have previously experienced. You should also notify them if you are taking Zoloft and plan to become pregnant.
Your medical team also needs to know if you have been taking any kind of stimulant medication, opioids, herbal products, or any drugs for mental health conditions.
Sertraline can increase the risk of bleeding, so taking it alongside aspirin, warfarin, non-steroidal, anti-inflammatory drugs, or anticoagulants carries a certain amount of risk.
Because Zoloft could potentially inhibit your coordination and reaction time, don’t operate heavy machinery or drive until you know how the medication affects you. Drinking alcohol while taking Zoloft can increase the risk of coordination problems.
Dosage and Administration
Zoloft tablets can be taken with or without food. If you are using the oral solution, it typically requires mixing with water or another liquid like ginger ale, lemon-lime soda, lemonade, or orange juice. Do not attempt to mix the solution with any other liquids without first discussing it with your doctor.
Zoloft dosages vary for each patient, condition, and application method. Always follow your physician’s instructions or the directions on the label. We’ll discuss the average doses, but your specific instructions always have priority over these measurements.
For oral solutions and tablets for depression, adults will usually take 50 mg once a day. The dose doesn’t typically exceed 200 mg. Doctors will handle doses for children on a case-by-case basis.
The doses are typically higher for obsessive-compulsive disorder, but will usually fall between 50 and 200 mg per day for adults.
For stress or anxiety disorders, doctors may start adults on a lower dose of 25 mg and then adjust from there. Again, the doses rarely exceed 200 mg.
Many people wonder what the best time to take sertraline is. One of the most common questions doctors get is, “Can you take Zoloft at night?”
The answer is a bit nuanced. Yes, you can take Zoloft in the evening. However, some people struggle to sleep shortly after taking their medication. Other individuals may notice a more frequent urge to urinate, which could interrupt sleep. For these individuals, it is probably best to take the medication in the morning.
Should you miss a dose, take another as soon as you remember. If it is almost time for your next dose, just skip it and notify your doctor.
Treatment Duration and Withdrawal
Studies have consistently proven that Zoloft is safe for long-term treatments. In fact, many people may need to take SSRIs like Zoloft for several months before noticing any real changes in their depression symptoms. For OCD or other conditions, it may take up to 12 weeks to have a noticeable impact. For premenstrual dysphoric disorder, however, effects may be prominent within the first week.
Remember, if a professional is recommending it, they believe it will help. Give it a bit of time and stay in contact with your doctor.
Continue taking Zoloft until its effects wane or a physician advises otherwise.
Should you need to stop taking Zoloft for any reason, discuss how to do so with your doctor. Do not simply stop taking the medication. You can experience withdrawal symptoms when stopping the use of any SSRI. These include flu-like symptoms, nausea, vivid dreams or nightmares, and severe mood changes. Experts consider Zoloft to carry a moderate risk of these withdrawal issues.
If you believe you need Zoloft or are currently taking it and have questions, our team of experts may be able to help.
