Sertraline FAQs: 24 Common Questions Answered

As a commonly used SSRI medication, sertraline is used by millions of people in the United States to treat major depressive disorder, anxiety and a range of other conditions.

Below, we’ve answered 30 of the most common questions about sertraline, covering everything from the medication’s benefits to side effects, common dosages, and more.

Sertraline was developed throughout the 1970s and 80s. The medication was approved by the FDA in 1991 to treat major depressive disorder (MDD, or depression) and has since been used as a common treatment for depression and other mental health and mood disorders.

Although sertraline was originally sold exclusively by Pfizer, today it’s commonly available as a generic medication from a range of different companies.

Sertraline belongs to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs. It works by increasing levels of serotonin, a hormone that’s involved in regulating certain aspects of your moods and behavior, in your brain and body.

Like other SSRIs, sertraline is used for a variety of purposes. It’s approved by the FDA to treat major depression, post-traumatic stress disorder, obsessive-compulsive disorder, premenstrual dysphoric disorder and social anxiety disorder.

Sertraline is one of the most widely used antidepressants, as well as one of the most common prescription medications in the United States. Currently, tens of millions of people in the United States have prescriptions for sertraline. 

According to research published in the journal Pharmacy, sertraline ranks in the 20 most widely used prescription medications in the country.

According to one study using data from the 2013 Medical Expenditure Panel Survey, sertraline was by far the most commonly prescribed antidepressant in the United States.

As a selective serotonin reuptake inhibitor (SSRI), sertraline works by slowing down the rate at which your body reabsorbs serotonin, an important neurotransmitter. This leads to higher levels of serotonin activity in your brain.

This increase in serotonin levels can help to improve and regulate your moods, resulting in an improvement in the symptoms of depression, obsessive-compulsive disorder and certain types of anxiety.

Although sertraline is effective, it doesn’t always work immediately. Most of the time, it takes six to eight weeks for the full benefits of sertraline to take effect.

This is the amount of time required for sertraline to reach a steady state in your body, meaning it’s fully absorbed and active at a steady dosage every day.

It’s normal to experience some improvements from sertraline during the first one or two weeks of use. For example, you may notice that your sleep, appetite and energy levels improve after using sertraline for just a few weeks. 

It’s common for symptoms of depression, such as a low mood and a lack of interest in activities, to improve after using sertraline for six to eight weeks.

Make sure to inform your healthcare provider if you don’t notice any improvements after eight or more weeks of treatment with sertraline. 

Sertraline is a versatile medication that’s used to treat a variety of conditions. The most common uses for sertraline include treating:

• Major depressive disorder (MDD) 

• Obsessive-compulsive disorder (OCD) 

• Posttraumatic stress disorder (PTSD) 

• Body dysmorphic disorder (BDD) 

• Social anxiety disorder (SAD) 

• Premenstrual dysphoric disorder (PMDD)

Sertraline is also prescribed off-label to treat other conditions, including premature ejaculation (PE).

Zoloft is the name for a specific brand of sertraline manufactured and marketed by Pfizer. When sertraline first came onto the market, it was only available as Zoloft.

The active ingredient in Zoloft is sertraline hydrochloride -- the exact same ingredient that’s used in unbranded, generic versions of sertraline. Today, sertraline is available under the brand name Zoloft and as a generic medication.

So, whether you’re using a Zoloft 100 mg pill or a sertraline 100 mg pill, or a Zoloft 25mg and a sertraline 25mg, your body will react similarly to each. 

Yes. Zoloft/sertraline is a safe and effective medication that’s been thoroughly tested in a wide range of clinical trials. It’s safely used by people of all ages, from young children to teenagers, adults and the elderly.

Like all medications, sertraline can cause some side effects. It can also interact with some other medications, supplements and natural substances. 

We’ve provided more information about these side effects and interactions in the four questions below.

Like other SSRIs, sertraline can cause a range of side effects. Most side effects from sertraline are mild and transient, although some may be persistent or bothersome.

Potential side effects of sertraline include:

• Lightheadedness

• Syncope (fainting or passing out)

• Nausea

• Diarrhea

• Dizziness

• Sweating

• Dry mouth

• Tremor

• Confusion

• Hallucinations

• Fatigue

• Somnolence (drowsiness)

• Rhinitis (nasal congestion)

• Erectile dysfunction

• Difficulty ejaculating

• Reduced sexual desire

Like other antidepressants, sertraline may contribute to an increased risk of suicidal thoughts or behavior in children and young adults with depression. It may also cause some additional side effects in people above the age of 65.

For most people, sertraline only causes minor side effects. If you develop severe or bothersome side effects from sertraline, it’s important to inform your healthcare provider.

If you miss a dose of sertraline, take it as soon as you remember. The exception here is if it’s closer to your next dose. In that case, call your healthcare provider.

However, never double up on doses of sertraline, or consume more than what’s prescribed by your healthcare provider.

Antidepressants can potentially cause side effects at any time, including in the first few weeks of treatment. In fact, it’s far from uncommon for people to experience side effects in the first month of treatment with an antidepressant, only to have these side effects decline over time.

It’s common for your body to “get used to” an antidepressant over time, meaning the side effects you experience during the first week of treatment with sertraline may not continue forever.

Yes. Sertraline and other antidepressants can interact with other medications. In certain cases, drug interactions that involve sertraline may produce a risk of serotonin syndrome, a condition that can be life-threatening.

Make sure to inform your healthcare provider about any other medications, supplements and/or natural treatments you use before starting treatment with sertraline.

Sertraline should not be taken with other medications that increase serotonin levels, including other antidepressants. It’s especially important not to use sertraline with monoamine oxidase inhibitors (MAOIs), an older class of antidepressants known for interactions.

MAOIs can cause interactions several weeks after the end of treatment. Make sure to let your healthcare provider know about any MAOIs or other antidepressants that you’ve recently used or are currently using, including medications taken in the last two weeks.

Other medications that may interact with sertraline include thioridazine, pimozide, linezolid and methylene blue. To keep yourself safe, inform your healthcare provider about any medications and supplements you use prior to starting treatment with sertraline.

Diarrhea is a common side effect of sertraline. In fact, research shows that sertraline is slightly more likely to cause this side effect than other commonly used antidepressants.

As with many other sertraline side effects, diarrhea may develop during your first few weeks of using sertraline. If you have persistent diarrhea from sertraline, make sure that you drink plenty of fluids to keep your body hydrated.

Contact your healthcare provider for help if you have persistent diarrhea that doesn’t improve on its own.

Yes. Nausea is a common side effect of sertraline, as well as other antidepressants. Like many other common side effects, it tends to occur during the first few weeks of use and become less severe over time. 

Research suggests that between 17 and 26 percent of people who use antidepressants develop nausea at some point.

Of these people, 83 percent experience nausea after two weeks, with 32 percent continuing to experience nausea after using antidepressants for three months.

Like nausea and diarrhea, most side effects from sertraline occur during the first few weeks of using the medication.

It’s common for side effects to gradually become less apparent over the course of the first few weeks, as your body adjusts to the consistent dose of sertraline. If you have side effects from sertraline that don’t improve, it’s best to discuss them with your healthcare provider.

If you feel dizzy, sleepy or fatigued after taking sertraline, you should not drive a car, ride a bike or operate any kind of motor vehicle after you take your medication. 

Like other side effects of sertraline, issues like dizziness and sleepiness often occur during the first few weeks of use. 

Sertraline is available as a tablet and as an oral solution. The tablet is the most common version of the medication.

In tablet form, the sertaline dosage range is usually 25mg, 50mg and 100mg. The typical starting dose for most conditions is 50mg per day, although a dose of 25mg per day may be used for children and people with certain anxiety disorders.

In oral solution form, sertraline is typically dosed at 20mg per milliliter. Make sure to follow your healthcare provider’s instructions and only use sertraline at the prescribed dose.

Sertraline is typically prescribed at a dosage of 25mg per day as a treatment for panic disorder, social anxiety disorder and post-traumatic stress disorder. For obsessive-compulsive disorder, it may be prescribed at a slightly higher starting dosage of 50mg per day.

Since anxiety disorders can vary in severity, your healthcare provider may adjust your dosage of sertraline based on your symptoms and response to the medication. 

No. Sertraline is a prescription medication. Both the tablet and the solution versions of sertraline are only available with a prescription, meaning you’ll need to talk to a healthcare provider before you can purchase and use them. Sertraline is not sold over the counter in the United States.

A normal dosage is sertraline 50mg to sertraline 100 mg per day, which is typically prescribed to adults as a treatment for depression and some anxiety disorders.

Currently, the highest dose of Zoloft approved by the FDA is 200mg per day. A slightly lower maximum dosage of 150mg of sertraline per day (or 100mg daily during the luteal phase) is used to treat premenstrual dysphoric disorder.

If you’re prescribed sertraline at a high dose, your healthcare provider may instruct you to slowly increase your dosage over the course of several weeks.

Sertraline should only be used at the dosage recommended by your healthcare provider. Do not increase your sertraline dosage without first consulting your healthcare provider. 

Two of the most common questions new patients have is: when is the best time to take Zoloft or sertraline? Should I take Zoloft in the morning or at night?

This drug is designed for use once per day. It’s safe to take it at any time of day, with or without food. Many people who experience nausea and other side effects from sertraline opt to take it at night in order to limit these adverse effects.

Since sertraline can interfere with sleep in a small percentage of users, many people also opt to take sertraline in the morning.

​​There’s no “perfect” time of day to take your tablet. Instead, it’s best to take it whenever it’s most convenient for you.

You can take sertraline with or without food. Some research suggests that your body may better absorb sertraline if you consume it with a meal. It’s best to take sertraline at approximately the same time of day to ensure it maintains a steady state in your body.

Sertraline has a half-life of approximately 24 hours, meaning it will typically reach half of its total concentration about one day after you take it.

It takes approximately 5.4 days for your body to get 99 percent of a standard sertraline dose out of your system.

Clinical trials of sertraline show that it’s safe to use for the long-term, with many cases of people using sertraline for years at a time.

Your healthcare provider will advise you about how long you should continue using sertraline or other medication to treat your depression or anxiety. You may need to continue after you start to experience improvements in order to reduce your risk of relapse.

Many people who use sertraline for the long term (and most other antidepressant medications) are advised to gradually taper their dosage of the medication as they stop taking it, rather than stopping treatment abruptly.

It is important to discuss going off your medication with your healthcare provider prior to changing how you take it. 

Antidepressants such as sertraline are generally effective, but not for everyone. Since everyone responds differently to medication, it’s entirely possible that you might not experience the same results from sertraline as other people.

If you don’t feel that sertraline is working effectively for you, the best approach is to talk about it with your healthcare provider. Your healthcare provider might recommend adjusting your sertraline dosage or switching to another type of antidepressant medication for better results.

If you’re advised to increase your sertraline dosage, it may take several weeks before you start to experience improvements. Make sure to inform your healthcare provider if you don’t develop any improvements after adjusting your dosage of sertraline. 

If you’re wondering how to ween off Zoloft 25 mg, 50 mg, 100 mg or any of the sertraline equivalents, it’s important to understand that you can’t just stop taking it. Sertraline has a relatively short half-life, meaning it will leave your body quickly if you decide to stop taking it abruptly.

Because of this, some people notice discontinuation symptoms such as insomnia, nausea and anxiety after stopping sertraline. These symptoms are commonly referred to as antidepressant discontinuation syndrome -- an issue that affects about 20 percent of people who abruptly stop using antidepressants.

To avoid these symptoms, your healthcare provider will recommend tapering down your dosage of sertraline over the course of several weeks. This helps you to gradually reduce the amount of sertraline in your body and reduce your risk of experiencing discontinuation issues. 

You should not abruptly stop taking sertraline because it doesn’t feel effective, or because you’d like to use a different medication. Instead, it’s always best to talk to your healthcare provider and let them know about your concerns.

So, what happens if you take too much Zoloft or sertraline? Like with other SSRIs, taking too much sertraline can result in a range of potentially serious side effects.

Taking too much sertraline may cause serious symptoms, including the following:

• Drowsiness

• Dizziness

• Agitation

• Skin rash

• Mania

• Nausea

• Vomiting

• Seizures

• Loss of consciousness

• Hallucinations

• Sweating

• Fever

• Confusion

• Rapid heartbeat

• Twitching and/or muscle stiffness

• Loss of coordination

Sertraline overdoses can occur if you take too much sertraline at once, or if you combine your dose of sertraline with other drugs. 

Do not ever take more than your prescribed dose of sertraline. If you forgot to take sertraline on one day, do not take two tablets at once.

If you are concerned about a potential overdose situation, seek emergency medical assistance immediately.

Yes. Although sertraline and other SSRIs are usually linked to weight gain, monitoring your food intake and activity can allow you to either lose weight or maintain your current body weight while you’re using sertraline.

Although experts aren’t yet fully aware of what causes weight gain on SSRIs, some researchers claim that SSRIs can interfere with people’s ability to “switch off” their urge to eat.

Despite this, there’s no evidence that sertraline affects your body’s metabolism and causes you to use fewer calories than normal. This means that you may lose or gain weight as you normally would by adjusting your calorie intake or activity level.

If you notice weight gain after starting sertraline and feel worried, it’s best to let your healthcare provider know when you next see them. 

Yes. Although sertraline isn’t designed specifically to treat premature ejaculation, studies show that it can increase ejaculation latency --  the amount of time required for a man to orgasm and ejaculate during sex -- in men.

If you have premature ejaculation, your healthcare provider may prescribe sertraline off-label to help you control your symptoms and improve your sexual function. 

Our guide to sertraline and premature ejaculation goes into more detail about how and why PE occurs, as well as how SSRIs such as sertraline are often effective at delaying ejaculation and improving sexual stamina. 

Sertraline is one of several common antidepressants used to treat depression, anxiety disorders and other mental health conditions.

You can learn more about these medications in our full list of antidepressants, which covers the most widely-used drugs for depression and anxiety. 

Concerned about your mental health? You can connect with a mental health provider online and access treatment from home using our range of mental health services, including psychiatry and online counseling. 

You can also learn proven strategies for dealing with depression, anxiety and other issues using our free mental health resources.