Sertraline 101: What It Is, How It Works & Side Effects

Sertraline is an antidepressant. It belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs.

Like other SSRIs, sertraline is most commonly used to treat depression, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and panic attacks. It’s also used as a treatment for premature ejaculation (PE).

In the United States, sertraline is often sold under the brand name Zoloft®. It’s one of the most widely used antidepressant medications on the market, with millions of users.

Below, we’ve explained how sertraline works as a medication, what conditions it’s used for and how you can use it effectively. 

We’ve also listed the most common sertraline side effects and interactions to be aware of if you currently take this medication for depression, panic attacks or any other condition.

How Does Sertraline (Zoloft®) Work?

Sertraline is a selective serotonin reuptake inhibitor, or SSRI. Other medications in this class of drugs include fluoxetine (Prozac®) and paroxetine (Paxil®).

What does Zoloft do? First approved by the FDA in 1991 as a medication for major depressive disorder (MDD), sertraline works by increasing the level of serotonin, a major neurotransmitter, throughout your brain and body.

By increasing serotonin levels, sertraline can reduce the severity of depression symptoms and prevent issues such as panic attacks. It can also produce improvements in your general mood, allowing you to make progress toward recovery from certain mood disorders. 

People with social anxiety disorder also notice benefits from using sertraline, as it can help with some symptoms of anxiety. 

Sertraline is also associated with increases in ejaculation latency (the amount of time required to reach orgasm and ejaculate) in men with premature ejaculation. 

Because of this, sertraline is often prescribed off-label as a treatment for premature ejaculation symptoms.

Available in tablet form, sertraline is typically used daily. It’s a prescription medication, meaning you’ll need to talk with your healthcare provider and receive a prescription before you can use it to treat depression, anxiety or any other condition.

Like with other antidepressants, sertraline may take a few weeks to begin working effectively. In some cases, you may notice benefits from sertraline within the first two to four weeks of use.

When it’s used off-label to treat premature ejaculation, research suggests that sertraline can be taken on an as-needed basis.

What Is Sertraline Used For?

Sertraline is a versatile antidepressant that’s used to treat a range of mental and physical health conditions. It’s most commonly used to treat:

  • Depression. Sertraline is an antidepressant and is often prescribed for the treatment of depression. As an SSRI, sertraline is used as a first-line treatment for depression due to its lower risk of causing side effects when compared to older depression medications.

  • Obsessive-compulsive disorder (OCD). Sertraline is also an effective drug for treating OCD. In a 1992 study, researchers found that people with OCD experienced measurable improvements after eight weeks of treatment using sertraline.

  • Posttraumatic stress disorder (PTSD). Sertraline is also frequently used as a first-line pharmacological treatment for PTSD. A 2016 review found that more than 65 percent of patients with PTSD experienced improvements after using sertraline.

  • Body dysmorphic disorder (BDD). Sertraline is one of several antidepressants used to treat body dysmorphic disorder, a disorder that can cause people to obsessively worry or think negatively about their real or imagined physical flaws.

  • Premenstrual dysphoric disorder (PMDD). Sertraline and other SSRIs are often used to treat premenstrual dysphoric disorder, a more severe form of premenstrual syndrome (PMS) that can involve irritability, depression and/or anxiety.

  • Social anxiety disorder (SAD). Studies show that sertraline is an effective treatment for social anxiety disorder. In one study published in 2006, researchers found that sertraline reduced social anxiety symptoms significantly more than a placebo treatment.

  • Premature ejaculation. Although sertraline was not originally developed as a treatment for premature ejaculation (PE), studies show that it can increase ejaculation latency (the average time until ejaculation) in men affected by this form of sexual dysfunction.

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How Does Sertraline Make You Feel?

As an antidepressant, sertraline can improve your moods and help you feel better. However, it’s not a fast-acting drug that will produce an immediate improvement in your mood, or any type of “high” like a psychoactive substance.

Antidepressants like sertraline are typically used as long-term treatments for depression. During the first few weeks of using sertraline, you may not notice a significant change in your moods or feelings. 

It usually takes four to eight weeks for SSRIs like sertraline to produce noticeable improvements in your depression symptoms.

After you start taking sertraline, you may notice that your sleep, ability to concentrate on specific tasks and appetite improve before your mood.

Make sure to keep using sertraline, even if you don’t notice any immediate changes. If you think sertraline isn’t working for you after four to eight weeks, don’t stop taking it. Instead, reach out to your healthcare provider to let them know how you’re feeling.

How Long Does Sertraline Take to Work for Anxiety?

Sertraline is approved by the FDA as a treatment for social anxiety disorder. It’s also prescribed as an “off-label” treatment (meaning for a condition other than its FDA-approved indications) for other forms of anxiety, such as generalized anxiety disorder (GAD).

Your healthcare provider will inform you about what time of day you should take sertraline. Most people can take sertraline at any time of day, provided they use the medication at the same time on a daily basis.

Other research suggests that sertraline produces noticeable improvements in the symptoms of generalized anxiety disorder after 12 weeks of use.

Like with depression, if you have anxiety and are prescribed sertraline, it’s important to continue using your medication even if you don’t notice improvements in the first few weeks.

Sertraline takes time to start working, and consistent use is essential for good results. If you feel like your medication isn’t effective after eight to 12 weeks of use, make sure that you inform your healthcare provider before you consider making any changes.

How Do You Take Sertraline?

Sertraline typically comes in tablet form. There are three different sertraline dosage forms — a 25mg tablet, a 50mg tablet and a 100mg tablet. Sertraline is also available as an oral solution, typically with a 20mg per mL concentration.

There’s no one-size-fits-all sertraline dosage. Most of the time, healthcare providers will use a starting dosage of 50mg of sertraline per day to treat depression, panic disorder, social anxiety disorder, PTSD and several other conditions.

This sertraline dosage can be adjusted based on the patient’s response and the severity of the depression or anxiety symptoms.

The maximum dose for sertraline is 200mg per day. This dose is typically used in patients who don’t respond to lower doses. Your healthcare provider may gradually adjust your dosage up to 200mg if you have severe depression symptoms that do not improve.

For conditions such as premature ejaculation, a normal dose of sertraline is 25mg to 100mg daily, depending on the patient’s symptoms and response to the medication.

Sertraline is designed for use once per day. For best results, you’ll need to take sertraline at the same time every day. It’s okay to take sertraline on an empty stomach or after eating a meal, as food does not appear to have a significant impact on your body’s ability to absorb the drug.

If you’re prescribed sertraline and forget to take a dose, take it as soon as you can. If it’s almost time for your next dose, wait until then, then take it as usual. You should not take two doses of sertraline at a time, even if you forgot the previous dose of this medication.

What are Sertraline Side Effects?

Overall, sertraline is a safe and effective medication. However, like most SSRIs, sertraline side effects can occur. Most sertraline side effects are minor and occur during the first few weeks of using sertraline. 

Common sertraline side effects include:

  • Fatigue and tiredness. Tiredness is a common side effect of sertraline and other SSRIs used to treat depression and anxiety. It’s common during the first few weeks of treatment and usually becomes less severe as your body gets used to the medication. One way to deal with tiredness from sertraline is to take your medication at night, which may lighten its effects on your energy levels during the daytime.

  • Difficulty sleeping. Some people experience insomnia after using sertraline. This can contribute to daytime tiredness, making it hard to maintain your normal routine. Using sertraline in the morning can often make falling and staying asleep easier.

  • Reduced appetite. It’s common to experience a loss of appetite after you begin to take sertraline. Like other side effects, this tends to pass after a few weeks. To avoid losing weight, try to maintain your normal eating habits and caloric intake.

  • Headaches. Sertraline can cause you to experience mild headaches, particularly in the first few weeks of using the medication. Headaches from sertraline typically disappear after a few weeks or months as your body gets used to the medication. You can treat headaches by staying hydrated or, if needed, taking an over-the-counter pain medication.

  • Dizziness. Dizziness is one of the most common side effects of sertraline. As with other adverse effects, it’s most common during the first few weeks of treatment and will usually stop as the medication reaches a steady state in your body.

  • Diarrhea. Diarrhea can develop during the first few weeks of treatment with sertraline. If you have diarrhea after using sertraline, make sure to consume lots of fluids to avoid becoming dehydrated.

  • Dry mouth. You might experience dry mouth while using sertraline. This can be treated by chewing sugar-free gum, drinking water frequently, avoiding cigarettes and making an effort to breathe only through your nose.

  • Sexual side effects. Sertraline is one of several antidepressants that can cause sexual side effects, such as difficulty getting an erection and a reduced libido. Some men find it more difficult to orgasm after starting sertraline.

  • Changes in body weight. Because of its effects on appetite, sertraline may cause you to gain or lose weight during treatment. Like avoiding weight loss, avoiding weight gain from sertraline (Zoloft) can be managed by maintaining your normal eating habits, activity level and caloric intake.

Over time, these side effects should become less severe as sertraline reaches a steady state in your body. If you experience persistent side effects from sertraline that do not get better over the course of one month, you should contact your healthcare provider.

Sertraline is also linked to several serious side effects. These side effects occur rarely and only affect a tiny percentage of people who use sertraline. However, they’re important to know about if you’re prescribed this medication. 

Rare side effects of sertraline include:

  • Fainting and severe dizziness. A small percentage of people who use sertraline may experience extreme dizziness, lightheadedness and fainting.

  • Persistent bleeding. Sertraline and other SSRIs can act as a blood thinner, meaning it may affect your body’s ability to form blood clots. This can lead to persistent bleeding if you cut yourself or experience a nosebleed.

  • Suicidal thoughts. Although very rare, clinical trials show that sertraline may contribute to an increase in suicidal thoughts and suicide-related events in people under the age of 25 years old.

If you experience any of the side effects listed, you should seek medical assistance as soon as you can. These are rare, potentially serious adverse effects that should be treated by a medical professional.

Like other medications, sertraline may cause rare allergic reactions. Seek medication attention if you develop any of the following side effects:

  • Swelling

  • Chest pain

  • Difficulty breathing

  • Skin rash or hives

  • Fever and/or sweating

  • Fast heartbeat

  • Hallucinations

  • Agitation

  • Seizures

Because of its effect on serotonin levels, sertraline can increase your risk of serotonin syndrome when it’s used with other medications and/or substances that increase serotonin levels.

To keep yourself safe while using sertraline, make sure to inform your healthcare provider about all medications and/or recreational drugs you use before taking sertraline.

Overall, sertraline is a safe and effective medication. It’s been used for decades to treat a range of conditions with few cases of significant side effects. 

It’s also safe to use for the long term, with few patients experiencing negative effects after taking sertraline for several months or years.

Sertraline Side Effects in the First Week of Use

After you start taking sertraline, you may begin to notice some nausea, drowsiness, headaches and other issues. 

Most side effects of sertraline become less severe over time, meaning it’s important not to panic if you experience adverse effects during the first week of treatment. Continue using sertraline as you normally would and let your healthcare provider know if your side effects continue.

Are There Long-Term Side Effects of Zoloft?

Currently, there’s no evidence to suggest that brand-name Zoloft or generic sertraline cause any side effects that only develop over the long term.

Most side effects of sertraline appear to develop during the first few weeks of treatment. If you’re a long-term sertraline user and begin to develop side effects after using it for several months, it’s important to let your healthcare provider know. 

Can Sertraline Interact With Other Medications?

Like other SSRIs, sertraline can interact with other medications. The most common interactions with sertraline involve medications that treat depression, such as other antidepressants, as well as medications that can affect your heart rate and cardiovascular function.

Sertraline can also interact with some non-pharmaceutical herbal supplements. Common herbal depression treatments like St. John's Wort are known to interact with sertraline and other SSRI medications, increasing your risk of some side effects.

If you use any prescription medications or herbal supplements, make sure you tell your healthcare provider before considering sertraline.

Is it Safe to Drink Alcohol While Using Sertraline?

The FDA recommends avoiding alcohol completely while using sertraline. Alcohol’s activity on your brain’s neurotransmitters can reduce the effectiveness of sertraline. Drinking alcohol is also linked to higher rates of side effects from SSRIs such as sertraline.

If you experience tiredness or fatigue after using sertraline, alcohol may make these side effects more severe. If you use sertraline to treat depression, there’s also a risk of alcohol causing your depression symptoms to get worse.

In short, while you use sertraline or any other SSRI, it’s best to avoid consuming beverages that contain alcohol. Our guide to sertraline and alcohol goes into more detail on the risks of drinking while using sertraline or other SSRIs.

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The Bottom Line on What Sertraline is Used For

Sertraline is one of the most widely-used antidepressants. It’s prescribed to treat depression, as well as mental health conditions such as anxiety, obsessive-compulsive disorder, posttraumatic stress disorder and others.

Due to its effects on sexual function, sertraline is also used to treat premature ejaculation — one of the most common forms of sexual dysfunction in men. 

We offer sertraline through our online psychiatry service, following a consultation with a mental health provider who will determine if a prescription is appropriate. 

We also offer sertraline for PE as part of our range of evidence-based treatments for premature ejaculation

Interested in learning more about how to use sertraline? Our sertraline FAQ answers several of the most common questions about sertraline in greater detail, with links to detailed studies and more.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.

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