Dealing with anxiety disorders or major depression can be difficult and frustrating, especially when it feels like nothing you’ve tried makes your symptoms better. Many people have found that taking medication can help improve symptoms that impair the ability to live life fully.

One common medication used to treat forms of anxiety and depression is sertraline (known by the brand name Zoloft). On this page, we’ve outlined some important information about this popular drug.

What is Sertraline?

What is sertraline? How does it work? 

Sertraline is an antidepressant used to treat conditions such as Major Depressive Disorder, PTSD, OCD, panic disorder, and social anxiety disorder. Also called Zoloft, sertraline is sometimes used to treat premenstrual dysphoric disorder, or PMDD as well. 

Sertraline belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). SSRIs like sertraline work by increasing the amount of serotonin in the brain. Serotonin is a neurotransmitter that affects mood, pain, and anxiety, among others. 

How should sertraline be used?

Sertraline comes in two forms: a tablet and a liquid. If taking the liquid form, you must dilute the medication before use. The prescribed concentrate should be mixed with 120 milliliters of a safe drink such as water, ginger ale, lemonade, or orange juice. 

Average sertraline doses differ depending on the condition that is being treated. 

• 50 mg per day is often recommended for adults with depression and OCD
• 50 mg per day is frequently prescribed for teenagers with OCD
• 25 mg per day is often recommended for adults with panic disorder, PTSD, or social anxiety. 

Note that these are common dosages and that a different dosage may be appropriate for you. For example, your doctor may decide to start you lower and increase your dose as you continue with the medication, depending on how you respond. When increasing in dosage, this often occurs in 25-50mg increments once a week, depending on the person. It may take several weeks before you notice the full effects of sertraline, but do not stop taking the medication or change doses without first consulting your doctor. 

If you miss a dose, take one as soon as possible. However, if it is almost time for your next dose, skip the next dose and go back to your regular schedule. Do not take two doses too close together, as this may cause significant side effects. 

If you take sertraline and have been feeling better for several months, your doctor might suggest coming off of the medication, though a longer course of treatment might be appropriate. This process often involves gradually reducing the dose over several weeks (sometimes longer, if you have been taking the medication for a long time). This process—also called “tapering”—helps reduce any negative reactions associated with coming off of sertraline too quickly. This is also referred to as “SSRI discontinuation syndrome”. 

What are some possible side effects?

The most common side effects of sertraline include:

• Nausea, loss of appetite, diarrhea, or indigestion
• Increased sweating
• Change in sleep habits
• Tremor or shaking
• Feeling tired or fatigued 

Some serious (but uncommon) side effects include:

• Abnormal bleeding or bruising
• Seizure
• Difficulty breathing
• Hallucinations or tremors 

Call 911 or seek emergency care if you notice any severe side effects.

Why do these side effects occur?

Any medication can potentially lead to side effects, and a person’s likelihood of having side effects depends on many factors, including age, lifestyle, and the type of medication itself. Side effects may occur because drugs often have broad or poorly targeted effects, or the drug target itself may have many downstream effects on the body. For example, though sertraline targets the neurotransmitter serotonin to help improve mood, there are other areas affected by serotonin, and unusual changes in serotonin levels can lead to side effects. As pharmaceutical research develops, medicines are often refined to have fewer side effects. 

Many non-serious side effects of mental health medications like sertraline go away after a few weeks as your body gets used to the medication. However, if a side effect persists, is intolerable, or severely hinders your ability to go about your daily life, talk to your doctor, because this might be a sign of a deeper problem. 

How do your genes relate to Sertraline?

Genetics can affect your body’s response to medication. Research suggests that sertraline is metabolized by CYP2C19 and CYP2D6 enzymes. This means that some people with a certain variation of either gene might be slow metabolizers for sertraline. Being a slow metabolizer means your body will break down the medication more slowly than others, which means the drug sticks around for longer than intended and may lead to side effects. For slow metabolizers, a doctor might opt to prescribe a different medication or prescribe a lower dosage. 

One way to predict whether you’ll have a positive outcome while taking sertraline is by taking a genetic test to determine what genetic variations you have and how they affect medication metabolization. Your DNA can help your doctor rule out less suitable medications and make more informed decisions so that you can get better, faster.

Special Precautions 

• Taking sertraline with other drugs that affect serotonin may increase your risk of serotonin syndrome.
• Patients with bipolar disorder should approach sertraline with caution, as it may lead to a manic episode. 
• Sertraline use should be avoided in people with glaucoma.
• If you are pregnant or planning a pregnancy, consult a doctor, as sertraline has been linked with complications in the third trimester. 

Allergic reactions to sertraline are uncommon, but if you show signs of an allergic reaction (hives, difficulty breathing, swelling), call 911 or go to the nearest emergency department.

Some medications, vitamins, and herbs may interfere with how sertraline works. Make sure to tell your doctor about all other medications you are taking before starting sertraline to avoid negative interactions. For full details, see the FDA’s full list of precautions. 

Looking to find the right medication for your mental health? Join Prairie today to be connected to expert providers and affordable medication options.