Zoloft (Sertraline) - How Does it Work?

Zoloft (sertraline) is in a category of medications known as selective serotonin reuptake inhibitors (SSRIs.) These medications work by blocking the reuptake of serotonin by nerve cells so that more serotonin is present. Serotonin is a neurotransmitter in the brain that has been coined one of the “feel good chemicals.” If you are interested, you can learn more about the chemistry of depression, and how the levels of different neurotransmitters in the brain may affect your mood.

Conditions Treatable with Zoloft

The U.S. Food and Drug Administration (FDA) has approved Zoloft for the treatment of adults over age 18 diagnosed with:

DepressionSocial anxiety disorderPost-traumatic Stress Disorder (PTSD)Panic disorderObsessive-compulsive disorder (OCD)Premenstrual dysphoric disorder (PMDD)

Zoloft is also approved for OCD in children and adolescents aged 6-17 years.

Zoloft and Bipolar Disorder

With bipolar disorder, Zoloft is usually used only for acute bipolar depression. Medications such as Zoloft may trigger bipolar mania or hypomania, so careful monitoring by a physician is needed.

Important Cautions About Zoloft Medication

There are several important things to note if you will be using Zoloft. These include:

You should not take Zoloft if you’re taking a monoamine oxidase inhibitor (MAOI), and there should be a two-week break between stopping or starting Zoloft and starting or stopping a MAOI. Serious, even fatal, complications can occur when these types of drugs are combined. The manufacturer advises that you should not drink alcohol while taking Zoloft. Do not discontinue Zoloft without talking to your doctor. You should also not stop taking Zoloft all at once to avoid SSRI discontinuation syndrome or sertraline withdrawal symptoms. Practice caution if you are using any other medications which may increase your levels of serotonin. There are several medications, both mental health medications and non-mental health related drugs, such as some pain medications, which can add together to increase levels. The resultant serotonin syndrome, which can be medically serious, is often avoided by making sure your doctor is aware of all medications you are taking. It could take up to eight weeks before your medicine has its full effect. Be aware that any antidepressant has the possibility of triggering hypomania or mania.

Dosage and Administration of Zoloft Medication

The way in which your doctor prescribes Zoloft, including the initial dose, will vary between different people and with different diagnoses. General information about dosing includes:

The initial dosage of Zoloft is generally 25-50 mg, depending on the age of the patient and the illness being treated.The maximum recommended dose is 200 mg.Take Zoloft once daily, morning or evening.Zoloft can be taken with or without food.

Zoloft and Pregnancy

In March 2006 Health Canada issued a warning for SSRI antidepressants saying that there could be complications for infants born to mothers taking any of these medications, including Zoloft, during the third trimester of pregnancy. The manufacturer’s prescribing information states, “Zoloft should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.”

Zoloft Side Effects

You may or may not have side effects while taking Zoloft, If you do, most people do not have all of the possible side effects. The most common side effects of Zoloft include:

Decreased appetite or weight loss Diarrhea or loose stools Dizziness Drowsiness Dry mouth Headache Increased sweating Nausea Stomach or abdominal cramps, gas, or pain Tiredness or weakness Trembling or shaking Trouble sleeping Sexual side effects

Although uncommon, all SSRI antidepressants have some potential to cause weight gain.

Major Warnings Regarding Zoloft Medication

The FDA has mandated that all SSRI antidepressants carry a warning contained in a bold black box regarding the potential for increased suicidal thinking and behavior in children, adolescents, and young adults. Children and young adults who are started on Zoloft should be monitored very closely by a psychiatrist. Learn more about the risks and benefits of antidepressants in children.

Zoloft Overdose

Zoloft overdose can be potentially medically serious. As with any medication, the possible benefits of the medication should outweigh the risks of taking the drug, including the risk of overdose. If your loved one is taking Zoloft, learn to recognize the symptoms of an overdose. For more mental health resources, see our National Helpline Database.