Bipolar Disorder Treatment Medications How Long Does It Take for Zoloft to Work? Important Precautions Before You Take Zoloft By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on November 08, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Verywell / JR Bee Table of Contents View All Table of Contents Starting Zoloft How Does Zoloft Make You Feel? Zoloft Side Effects Serious Side Effects Before Taking Zoloft How to Take Zoloft Overdose Stopping Zoloft Zoloft (sertraline) belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs. These medications work by increasing the level of available serotonin in the brain. Low levels of serotonin in the brain are linked to a depressed mood as well as other psychiatric symptoms. You may begin to feel Zoloft working one to two weeks after you start taking the medication. However, some symptoms such as depressed mood may take longer to improve (up to eight weeks). Besides major depressive disorder, Zoloft is also approved by the Food and Drug Administration (FDA) to treat the following psychiatric conditions: Post-traumatic stress disorder (PTSD) Panic disorder Obsessive-compulsive disorder (OCD) Social anxiety disorder (SAD) Premenstrual dysphoric disorder (PMDD) Zoloft Timeline Learning how Zoloft works and what to watch out for when taking it can help you better cope with your illness and stick to your treatment plan. For example, it's important not to expect immediate results when taking Zoloft. Zoloft may improve physical symptoms of depression (such as difficulty sleeping, low energy levels, and lack of appetite) in one to two weeks. It may take between six and eight weeks for you to notice improvement in emotional symptoms (like depressed mood, apathy, and social withdrawal). Zoloft may improve the symptoms of anxiety in as few as four weeks. A 12-week trial found that daily doses of sertraline—between 50mg and 150mg—noticeably reduced psychic and somatic symptoms of generalized anxiety disorder in participants by week four. (Psychic symptoms of anxiety include nervousness, worry, and irritability, whereas somatic symptoms include chest pain, stomach ache, and nausea.) Sertraline may reduce OCD symptoms in four to six weeks. A daily dose of sertraline between 50mg and 200mg is linked with the reduction of anxiety, fear, physical symptoms, and avoidance behaviors in people with OCD. However, if no improvements have occurred after four weeks (and there are no side effects), a doctor may increase the dosage. How Does Zoloft Make You Feel? During your first few days on Zoloft, you may feel fatigued or drowsy. A doctor may recommend that you take sertraline in the evening to avoid feeling tired during the day. In other cases, sertraline can actually have a stimulatory effect and cause an increase in energy. It may cause sleep disturbances such as insomnia. In this instance, a doctor may recommend that you take Zoloft early in the day, and avoid other stimulants such as caffeine, so that your sleep isn't negatively impacted. Like other antidepressants, Zoloft may worsen your symptoms before they improve. This is why it's important to monitor how you feel, and talk to a doctor right away if you notice any side effects. Can Antidepressants Make You Feel Worse? How to Know If Zoloft Is Working SSRIs like Zoloft work by boosting serotonin levels, which can help you regulate your emotions and feel less inhibited by any disruptive symptoms of your mental health condition. You may know that Zoloft is working if you: Experience emotional stability Feel an increase in happiness and well-being Feel calmer Feel more focused Zoloft Side Effects In addition to changes in energy levels, you may experience additional side effects during the first few weeks of taking Zoloft. The most common side effects of Zoloft include nausea or upset stomach, diarrhea, sweating, tremor, or a decreased appetite. Sexual side effects may also occur, most notably delayed ejaculation and decreased libido. If any of these side effects don't go away or are causing significant problems, talk to a doctor. Sometimes simple remedies can ease Zoloft side effects, like taking it at a different time of day or changing the dose. Or your doctor may also recommend switching to a different SSRI or a different class of medication altogether. Serious Side Effects In addition to the common side effects mentioned above, there are some serious effects to be aware of if you are taking Zoloft. If you experience any of these, contact your doctor right away. Suicidal Thoughts and Behavior A "black-box warning" refers to a serious notice made by the FDA about a medication. The black-box warning for Zoloft indicates it may cause or increase thoughts of suicide in children and young adults. Monitor your loved one, or yourself if you're in this age group, for any signs of such thoughts, and seek help immediately if they occur. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Serotonin Syndrome Taking Zoloft may put you at risk for a rare, possibly life-threatening condition called serotonin syndrome. This risk is higher if you are also taking other serotonin-related medications like triptans (a common migraine medication), tricyclic antidepressants, or the pain medication Ultram (tramadol). But the syndrome can occur when taking Zoloft alone, as well. Signs and symptoms of this condition include: AgitationConfusionFluctuating blood pressureGastrointestinal problems like diarrheaHigh heart rateRigid muscles and/or coordination problemsTremors To be proactive in avoiding this rare syndrome, be sure to tell your doctor all the medications you are taking, including any over-the-counter drugs or supplements. Before You Start Taking Zoloft It's important that a doctor is aware of your relevant medical history prior to prescribing Zoloft. This includes any pre-existing conditions you may have, medications you're taking, or if you're pregnant or breastfeeding. Zoloft, like any medication, presents certain risks and precautionary measures should be taken when possible. Risk of Bleeding There is an increased chance of bleeding when taking Zoloft along with medications that block platelets or medications that thin your blood. Examples include aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and Coumadin (warfarin). Notify your doctor right away of any bleeding events, like nosebleeds or increased bruising. Seek medical attention immediately if you notice more serious bleeding events, such as blood in your stool. Low Sodium Levels Low sodium levels in the bloodstream (called hyponatremia) may occur with Zoloft and other SSRIs. In severe cases, hyponatremia can lead to seizures and other serious neurologic and medical issues. Signs and symptoms of hyponatremia include: ConfusionHeadacheMemory difficultiesProblems concentratingUnsteadiness and potentially fallingWeakness Hypomanic or Manic Episodes Zoloft can trigger a hypomanic or manic episode in a person with bipolar disorder. Before taking Zoloft, tell your doctor if you have ever been diagnosed or suspected of having bipolar disorder, or have a family history of it. Allergic Reactions While not common, if you take Zoloft and develop signs or symptoms of an allergic reaction like rash, hives, swelling, or problems breathing, contact your doctor right away. Risk to Unborn Babies You should inform your doctor if you become pregnant while taking Zoloft or are planning a pregnancy. Zoloft use in the third trimester may increase a baby's chance of developing complications like a rare condition known as persistent pulmonary hypertension, which can cause breathing problems. In addition, third-trimester use of Zoloft may cause neonatal withdrawal symptoms. However, some women may need to continue taking Zoloft during pregnancy because the benefit of treating their illness outweighs the potential risks. Overall, this decision requires a careful and thoughtful discussion with both an obstetrician and mental health professional. Low levels of Zoloft may be present in breast milk, so lactating parents should consult with their doctors before nursing while taking this medication. Breastfeeding is typically encouraged unless there is a medical reason for the parent to avoid breastfeeding. How to Take Zoloft It's important to follow the instructions that a doctor provides when taking Zoloft. The dosage that is prescribed will vary from person to person. Zoloft is most often taken in tablet form once per day. A typical dosage for those with depression, obsessive-compulsive disorder, and premenstrual dysphoric disorder is 50mg per day. Those with panic disorder, PTSD, and anxiety disorders may start out at 25mg per day. Try to take your Zoloft at the same time every day. Setting a timer on your phone may be helpful so you don't forget. What Happens If I Miss a Dose of Zoloft? If you do miss a dose of Zoloft, take it as soon as you remember, unless it is too close to your next dose. In other words, never take two doses of Zoloft at the same time. Simply take your next scheduled dose and then return to your usual schedule. Overdose Contact a poison control center and your doctor for guidance if you or a loved one overdoses on Zoloft. The most common signs and symptoms associated with Zoloft overdose include: AgitationDizzinessFast heart rateNauseaSleepinessTremorVomiting Symptoms of a Zoloft Overdose Stopping Zoloft Stopping Zoloft may result in symptoms of sertraline withdrawal, also known as SSRI discontinuation syndrome. This is one reason why it's important to consult with your doctor before stopping this medication. If you and your doctor decide it's best for you to stop Zoloft, they can provide you with a tapering strategy to minimize any withdrawal symptoms like irritability, increased anxiety, or flu-like symptoms. What to Expect When Weaning Off Zoloft A Word From Verywell Before prescribing Zoloft, a doctor will take a thorough medical history. Even so, it's important for you to play an active role in your care. Inform your doctor of all the details of your health history, regardless of whether or not you think they are essential. Overall, Zoloft is a generally well-tolerated and safe medication and has significantly helped many people cope with their psychiatric conditions. You deserve to get well. The good news is that if Zoloft doesn't help, there are lots of other options to try. 18 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Dale E, Bang-Andersen B, Sánchez C. Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs. Biochem Pharmacol. 2015;95(2):81-97. doi:10.1016/j.bcp.2015.03.011 National Alliance on Mental Illness. Sertraline (Zoloft). Koen N, Stein DJ. 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Breastfeed Med. 2011;6(2):89-98. doi:10.1089/bfm.2010.0019 Mayo Clinic. Sertraline (oral route). Cooper JM, Duffull SB, Saiao AS, Isbister GK. The pharmacokinetics of sertraline in overdose and the effect of activated charcoal. Br J Clin Pharmacol. 2015;79(2):307-15. doi:10.1111/bcp.12500 Hosenbocus S, Chahal R. SSRIs and SNRIs: A review of the discontinuation syndrome in children and adolescents. J Can Acad Child Adolesc Psychiatry. 2011;20(1):60-7. Additional Reading Jenkins TA, Nguyen JC, Polglaze KE, Bertrand PP. Influence of tryptophan and serotonin on mood and cognition with a possible role of the gut-brain axis. Nutrients. 2016;8(1). doi:10.3390/nu8010056 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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